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Int J Environ Res Public Health. 2019 Apr 4;16(7). pii: E1215. doi: 10.3390/ijerph16071215.

Longitudinal Change of PTSD Symptoms in Community Members after the World Trade Center Destruction.

Rosen R1,2, Zhu Z3,4, Shao Y5,6, Liu M7,8,9, Bao J10,11, Levy-Carrick N12,13, Reibman J14,15,16.

Author information

1
Department of Psychiatry, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. rebeccarosen18@gmail.com.
2
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. rebeccarosen18@gmail.com.
3
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. zhaoyin.zhu@nyu.edu.
4
Department of Population Health, NYU School of Medicine, 180 Madison Ave., New York, NY 10016, USA. zhaoyin.zhu@nyu.edu.
5
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. yongzhao.shao@nyulangone.org.
6
Department of Environmental Medicine, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. yongzhao.shao@nyulangone.org.
7
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. Mengling.Liu@nyulangone.org.
8
Department of Population Health, NYU School of Medicine, 180 Madison Ave., New York, NY 10016, USA. Mengling.Liu@nyulangone.org.
9
Department of Environmental Medicine, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. Mengling.Liu@nyulangone.org.
10
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. jia.bao@nyulangone.org.
11
Department of Population Health, NYU School of Medicine, 180 Madison Ave., New York, NY 10016, USA. jia.bao@nyulangone.org.
12
Department of Psychiatry, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. nlevy-carrick@bwh.harvard.edu.
13
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. nlevy-carrick@bwh.harvard.edu.
14
Health and Hospitals World Trade Center Environmental Health Center, Bellevue Hospital Center, H7E, 462 First Ave, New York, NY 10016, USA. joan.reibman@nyumc.org.
15
Department of Environmental Medicine, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. joan.reibman@nyumc.org.
16
Department of Medicine, NYU School of Medicine, 550 First Ave, New York, NY 10016, USA. joan.reibman@nyumc.org.

Abstract

The World Trade Center (WTC) Environmental Health Center (EHC) is a treatment program for community members with exposure to the 9/11 terrorist attack and its physical and emotional aftermath. Compared to the general responders program, the WTC EHC is diverse with equal gender distribution, representation of many races and ethnicities, and a wide range of social economic status. Patients in the WTC EHC were initially enrolled for physical symptoms, most of which were respiratory, however a large portion of the enrollees scored positive for probable posttraumatic stress disorder (PTSD). In this paper we identify patient characteristics associated with probable PTSD. We also determine the characteristics associated with the longitudinal change of PTSD symptoms, including persistence and remittance, using the widely used Posttraumatic Check List-17 (PCL) cut-off value of 44, as well as changes in PCL total score and symptom cluster scores in patients of Low and High PTSD symptom severity. Few patients with elevated scores achieved a score below 44. However, longitudinal improvement in PCL score at follow-up was identified for patients with High PTSD scores (PCL > 57.5). Changes in PCL symptom clusters differed between those with High and Low PCL scores. These data suggest improvement over time in PCL score that differs depending on the severity of the score and variable responses in the PCL symptom clusters.

KEYWORDS:

9/11 disaster; PCL score; PTSD cluster; PTSD symptom change; WTC survivors; longitudinal analysis

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