Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers

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DOI: https://doi.org/10.1002/jts.22011

Abstract

The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster.

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🎯 Relevance Assessment: After careful analysis, this paper does not meet the primary inclusion criteria for this systematic review on PTSD symptom trajectories.

📋 Exclusion Rationale: The paper may focus on a different aspect of PTSD (e.g., treatment outcomes, risk factors, prevalence) or lacks the longitudinal trajectory analysis required by the review protocol.

🔍 Content Analysis: While the paper may discuss PTSD-related topics, it does not specifically examine symptom trajectories over time using appropriate statistical methods (e.g., growth curve modeling, latent class analysis).

❌ Recommendation: EXCLUDE — This paper does not align with the eligibility criteria. The focus or methodology does not match the systematic review's scope of longitudinal PTSD symptom trajectory analysis.

ℹ️ In the full version, Pixel-Bot generates unique summaries for each paper based on your specific eligibility criteria.

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