Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001

Cukor, Judith; Wyka, Katarzyna; Jayasinghe, Nimali; Weathers, Frank W.; Giosan, Cezar; Leck, Pamela; Roberts, Jennifer; Spielman, Lisa; Crane, Michael; Difede, JoAnn

doi:10.1002/da.20776

Cited by 67 publications

(60 citation statements)

References 34 publications

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“…This sample comprises 2,960 WTC disaster recovery utility workers who were assessed at their workplace through the Weill Cornell 9/11 Screening Program (see Cukor et al, 2011;Difede, Roberts, Jayasinghe, & Leck, 2006 for greater detail). During the course of their work assisting in clean-up and utility service restoration, these individuals were exposed to the excavation of human remains and the danger of working within and on top of unstable structures, in an environment at high risk for another attack.…”

Section: E T H O D Subjectsmentioning

confidence: 99%

“…Perceptions of safety may also play a role, since those 9/11 disaster workers who had greater exposure reported lower perceived safety, which was in turn associated with greater intrusion and hyperarousal PTSD symptoms as well as depressive symptoms (Fullerton, Ursano, Reeves, Shigemura, & Grieger, 2006). Additionally, disaster workers who perceived their lives were in danger were more likely to report PTSD symptoms (Cukor et al, 2011).…”

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confidence: 97%

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The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th

Cukor

Wyka

Mello

et al. 2011

Journal of Traumatic Stress

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This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.

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Section: E T H O D Subjectsmentioning

confidence: 99%

mentioning

confidence: 97%

The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th

Cukor

Wyka

Mello

et al. 2011

Journal of Traumatic Stress

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“…Although several studies have found an association between exposure and post-traumatic symptoms (Hansen et al, 2013; Heir, Blix, & Knatten, 2016), other studies did not find such association (Bleich et al, 2003; Ford et al, 2007). Subjective perception of threat is a good predictor of probable PTSD (Cukor et al, 2011). These findings point towards the importance of the subjective perception of threat by such attacks.…”

Section: Introductionmentioning

confidence: 99%

Association between feeling threatened by a terrorist attack and subjective health: a web survey a week after the attacks of 22 March 2016 in Belgium

Deschepper

Six

Gidron

et al. 2018

European Journal of Psychotraumatology

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Background: The wave of terrorist attacks over the past years in Europe and other regions may cause problems such as anxiety and depressive symptoms. Some studies suggest that perceived threat might also trigger physical health problems.Objective: To investigate the association between feeling threatened and subjective health during the week following a terrorist attack.Method: Online survey with a self-selected sample in the Belgian population one week after the terrorist attacks in 2016. Participants were invited through the Belgian media to fill in a questionnaire in Dutch, French or English on a website. The main outcomes were the association between ‘feeling threatened’ and subjective health problems. Perceived threat was measured with the question ‘During the week after the attacks … Did you feel threatened?’ Subjective health was measured by using standardized scales (ACSA, PHQ-4, PHQ-15).Results: A total of 2620 respondents completed the questionnaire, of whom 69.8% were female, 27.7% lived and 43.1% worked in Brussels. Gender, age, place of living and working, media exposure, religiousness and religious affiliation were associated significantly with higher perceived threat. A total of 21% of the respondents felt much or very much threatened during the week after the attacks. They reported significantly higher levels of mental and physical health problems. The most frequently reported problems were anxiety and depressive symptoms. The health problems that differentiated most markedly between those with low and high levels of perceived threat were fainting spells, chest pain and shortness of breath.Conclusion: In a self-selected sample of respondents, ‘feeling threatened’ was strongly associated with lower level of wellbeing and higher levels of mental and physical health problems. The most prevalent health problems were mental health problems but the most pronounced differences between people with low versus high levels of perceived threat were physical health problems.

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“…The targets of these attacks were workplaces housing large numbers of employees—the intent of terrorism is to cause widespread fear and distress (Vineburgh, 2004). Epidemiologic research on the mental health effects of the 9/11 terrorist attacks on New York City (Breslau, Bohnert and Koenen, 2010), in contrast to prior disaster mental health research, has largely focused on populations not confined to those directly exposed to immediate danger in the disaster (Schuster et al, 2001; Galea et al, 2002; Schlenger et al, 2002; Silver et al, 2002; DeLisi et al, 2003; Boscarino et al, 2004; Stein et al, 2004; DiGrande et al, 2008); many other studies have examined rescue and recovery workers (Smith et al, 2004; Jayasinghe et al, 2005; Elhai et al, 2006; Evans et al, 2006; Katz et al, 2006; Long, Meyer and Jacobs, 2007; Jayasinghe et al, 2008; Stellman et al, 2008; Evans et al, 2009; Berninger et al, 2010; Chiu et al, 2010; Cukor et al, 2010). This body of work points to substantial widespread distress and psychiatric symptoms in these populations.…”

Section: Introductionmentioning

confidence: 99%

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus‐group study

North

Pfefferbaum

Hong³

et al. 2012

Disasters

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The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company’s workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees’ emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals.

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Prevalence and predictors of posttraumatic stress symptoms in utility workers deployed to the World Trade Center following the attacks of September 11, 2001

Cited by 67 publications

References 34 publications

The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th

The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th

Association between feeling threatened by a terrorist attack and subjective health: a web survey a week after the attacks of 22 March 2016 in Belgium

Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus‐group study

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