Article Text
Abstract
Objectives The World Trade Centre Health Registry (WTCHR) prospectively follows a cohort of over 71 000 individuals who reported being directly exposed to the 9/11/01 terrorist attack. Among police registrants at Survey Wave 2, 5–6 years after 9/11/01, four unique trajectories of probable PTSD symptoms were identified: resilient (83%), recovered (2.5%), delayed onset (11.2%) and chronic (5.3%). The current study documents the longitudinal trajectories of PTSD in police officers exposed to the WTC attacks at Wave 3 (2011–2012), over 10 years since the WTC attack.
Method We examined the prevalence of probable PTSD at the Wave 3 survey using a cut-off score of 44 or greater on the event-specific Posttraumatic Stress Disorder Checklist (PCL) and at least one re-experiencing symptom (DSM-IV criterion B), three avoidance or numbing symptoms (DSM-IV criterion C), and two hyperarousal symptoms (DSM-IV criterion D).
Results Probable PTSD was 14.4% (95% CI 13.0–15.9%) at Wave 2 and 12.9% (95% CI, 11.6–14.3%) at Wave 3. Significant predictors of chronic probable PTSD 10 years post-disaster (n = 59/2241, 2.6%) include age 45–69 (aOR 3.16, 95% CI, 1.7–6.0), number of stressful events witnessed on 9/11/01 (aOR 3.00, 1.6–5.8), five or more stressful life events since 9/11/01 (aOR 5.42, 1.9–15.2), and unmet mental health care needs (aOR 6.86, 3.3–14.1). Protective factors include social support (aOR 0.34, 0.1–0.97) and number of close friends or relatives (aOR 0.92, 0.87–0.98).
Conclusions Chronic probable PTSD among police responders continues to be a significant problem, associated both with intervening stressful life events and unmet mental health care needs.