Likelihood Of PTSD In 9/11 Rescue And Recovery Personnel Dependent Upon Prior Training And Experience, New AJP Study Says

Main Category: Psychology / Psychiatry
Also Included In: Anxiety / Stress
Article Date: 02 Sep 2007 - 1:00 PDT

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Working at the World Trade Center (WTC) site after the Sept. 11, 2001, terrorist attacks was a traumatic and difficult experience for nearly all who participated in the initial rescue and recovery efforts. However, a new study, appearing in the September issue of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association (APA), reports that the likelihood of developing posttraumatic stress disorder (PTSD) as a result of working at the WTC site was highly dependent upon an individual's background, how soon they reported to work at the site and how long they worked at the site.

Individuals with a wide variety of previous training and experience worked at the WTC site in the days, weeks, and months following Sept. 11. Highly experienced personnel, such as medical, fire and rescue personnel as well as police officers, participated in the rescue/recovery efforts, as did individuals with little or no previous experience who volunteered.

In "Differences in PTSD Prevalence and Associated Risk Factors Among World Trade Center Disaster Rescue and Recovery Workers," Megan A. Perrin, M.P.H., former research scientist with the New York City Department of Health and Mental Hygiene, and her colleagues report that approximately 20 percent of construction/engineering personnel and unaffiliated volunteers were likely to develop PTSD within two to three years, compared with only six percent of police officers. The likelihood of developing PTSD was also higher for people who started working at the site on or immediately after Sept. 11, for those who worked on site for longer periods of time, and for those who were injured while working at the site.

"The findings of this study establish a substantial risk of mental repercussions in volunteers who respond to disasters, including terrorist attacks," said AJP Editor-in-Chief Robert Freedman, M.D. "While we always knew that people who were directly involved were at risk, we now know that the risk extends to those who come to help."

The analysis was based on interviews with 28,692 workers enrolled in the World Trade Center Health Registry. The workers were assessed through 30-minute computer-assisted telephone interviews, conducted between Sept. 5, 2003, and Nov. 20, 2004.

The highest rates of PTSD were found among workers who performed tasks outside of their training. These included emergency, medical, and disaster personnel who engaged in firefighting and sanitation workers who performed search and rescue operations.

The probability of developing PTSD was also elevated for those who worked at the site for more than three months, for all types of workers except police officers. Again with the exception of police officers, the relationship between time worked and the probability of developing PTSD was strongest for those who began working at the WTC site on Sept. 11, when the exposure to trauma and risk of injury were greatest.

"These findings confirm that the mental health impact of the WTC disaster was significant for rescue and recovery workers, especially for those who worked outside their area of training or regular occupation," said Megan Perrin, M.P.H., lead author of the study. "The results also reflect the critical importance of preparedness training and reinforce the necessity of providing mental health services to workers following a disaster."

The study was supported in part by the New York City Department of Health and Mental Hygiene, Research Triangle International, and the U.S. Agency for Toxic Substances and Disease Registry.

About the American Journal of Psychiatry

The American Journal of Psychiatry, the official journal of the American Psychiatric Association, publishes a monthly issue with scientific articles submitted by psychiatrists and other scientists worldwide. The peer review and editing process is conducted independently of any other American Psychiatric Association components. Therefore, statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association. The Journal's editorial policies conform to the Uniform Requirements of the International Committee of Medical Journal Editors, of which it is a member. For further information about the Journal visit http://www.ajp.psychiatryonline.org.

About the American Psychiatric Association

The American Psychiatric Association is a national medical specialty society whose more than 38,000 physician members specialize in diagnosis, treatment, prevention and research of mental illnesses including substance use disorders. Visit the APA at http://www.psych.org and http://www.HealthyMinds.org.