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The burden of full and subsyndromal posttraumatic stress disorder among police involved in the World Trade Center rescue and recovery effort.

Pietrzak RH; Schechter CB; Bromet EJ; Katz CL; Reissman DB; Ozbay F; Sharma V; Crane M; Harrison D; Herbert R; Levin SM; Luft BJ; Moline JM; Stellman JM; Udasin IG; Landrigan PJ; Southwick SM
J Psychiatr Res 2012 Jul; 46(7):835-842
BACKGROUND: This study examined the prevalence, correlates, and perceived mental healthcare needs associated with subsyndromal PTSD in police involved in the World Trade Center (WTC) rescue and recovery effort. METHODS: A total of 8466 police completed an interview/survey as part of the WTC Medical monitoring and Treatment Program an average of four years after 9/11/2001. RESULTS: The past month prevalence of full and subsyndromal WTC-related PTSD was 5.4% and 15.4%, respectively. Loss of someone or knowing someone injured on 9/11 (odds ratios [ORs]=1.56-1.86), pre-9/11 stressors (ORs=1.30-1.50), family support (ORs=0.83-0.94), and union membership (ORs=0.50-0.52) were associated with both full and subsyndromal PTSD. Exposure to the dust cloud (OR=1.36), performing search and rescue work (OR=1.29), and work support (OR=0.89) were additionally associated with subsyndromal PTSD. Rates of comorbid depression, panic disorder, and alcohol use problems (ORs=3.82-41.74), and somatic symptoms and functional difficulties (ORs=1.30-1.95) were highest among police with full PTSD, with intermediate rates among police with subsyndromal PTSD (ORs=2.93-7.02; and ORs=1.18-1.60, respectively). Police with full and subsyndromal PTSD were significantly more likely than controls to report needing mental healthcare (41.1% and 19.8%, respectively, versus 6.8% in trauma controls). CONCLUSIONS: These results underscore the importance of a more inclusive and dimensional conceptualization of PTSD, particularly in professions such as police, as operational definitions and conventional screening cut-points may underestimate the psychological burden for this population. Accordingly, psychiatric clinicians should assess for disaster-related subsyndromal PTSD symptoms in disaster response personnel.
Mental-health; Humans; Men; Women; Police-officers; Law-enforcement-workers; Injuries; Stress; Exposure-levels; Dusts; Workers; Worker-health; Work-environment; Work-areas; Statistical-analysis; Alcohols; Psychological-stress; Psychological-reactions; Emergency-responders; Author Keywords: Posttraumatic stress disorder; Police; World Trade Center; Depression; Healthcare needs
Robert H. Pietrzak, National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, Yale University School of Medicine, 950 Campbell Avenue 151E, West Haven, CT 06516
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Contract; Cooperative Agreement
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U10-OH-008232; Contract-200-2002-0038; Contract-200-2011-39377; Contract-200-2011-39356; B08292012
Issue of Publication
NIOSH Division
Source Name
Journal of Psychiatric Research
Performing Organization
Mount Sinai School of Medicine of New York
Page last reviewed: March 25, 2022
Content source: National Institute for Occupational Safety and Health Education and Information Division