Latent typologies of posttraumatic stress disorder in World Trade Center responders. (December 2016)

• Record Type: Journal Article
• Authors: Horn, Sarah R.; Pietrzak, Robert H.; Schechter, Clyde; Bromet, Evelyn J.; Katz, Craig L.; Reissman, Dori B.; Kotov, Roman; Crane, Michael; Harrison, Denise J.; Herbert, Robin; Luft, Benjamin J.; Moline, Jacqueline M.; Stellman, Jeanne M.; Udasin, Iris G.; Landrigan, Philip J.; Zvolensky, Michael J.; Southwick, Steven M.; Feder, Adriana
• Is Part Of: Journal of psychiatric research. Volume 83(2016:Dec.)
• Page Start: 151
• Page End: 159
• Publication Date: 2016-12
• Subjects: Posttraumatic stress disorder (PTSD) -- World Trade Center (WTC) -- Latent class analysis (LCA) -- Typologies; Psychiatry -- Periodicals; Mental Disorders -- Periodicals; Maladies mentales -- Périodiques; Psychiatry; Electronic journals; Periodicals; 616.89005
• DOI: 10.1016/j.jpsychires.2016.08.018
• Languages: English
• ISSNs: 0022-3956

Abstract

Abstract: Posttraumatic stress disorder (PTSD) is a debilitating and often chronic psychiatric disorder. Following the 9/11/2001 World Trade Center (WTC) attacks, thousands of individuals were involved in rescue, recovery and clean-up efforts. While a growing body of literature has documented the prevalence and correlates of PTSD in WTC responders, no study has evaluated predominant typologies of PTSD in this population. Participants were 4352 WTC responders with probable WTC-related DSM-IV PTSD. Latent class analyses were conducted to identify predominant typologies of PTSD symptoms and associated correlates. A 3-class solution provided the optimal representation of latent PTSD symptom typologies. The first class, labeled "High-Symptom (n = 1, 973, 45.3%), " was characterized by high probabilities of all PTSD symptoms. The second class, "Dysphoric (n = 1, 371, 31.5%), " exhibited relatively high probabilities of emotional numbing and dysphoric arousal (e.g., sleep disturbance). The third class, "Threat (n = 1, 008, 23.2%), " was characterized by high probabilities of re-experiencing, avoidance and anxious arousal (e.g., hypervigilance). Compared to the Threat class, the Dysphoric class reported a greater number of life stressors after 9/11/2001 (OR = 1.06). The High-Symptom class was more likely than the Threat class to have a positive psychiatric history before 9/11/2001 (OR = 1.7) and reported a greater number of life stressors after 9/11/2001 (OR = 1.1). The High-Symptom class was more likely than the Dysphoric class, which was more likely than the Threat class, to screen positive for depression (83% > 74% > 53%, respectively), and to report greater functional impairment (High-Symptom > Dysphoric [Cohen d = 0.19], Dysphoric > Threat [Cohen d = 0.24]). These results may help inform assessment, risk stratification, and treatment approaches for PTSD in WTC and disaster responders.