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Studies have found that police demonstrated considerable resilienceto posttraumatic stress disorder (PTSD) compared to other disaster workers after the September 11,2001 terrorist attack on the World Trade Center (WTC). This hasbeen attributed to effective screening and extensive training inthe police force. New research suggests that, despite this greaterresilience to PTSD, 15.4% of police endorse symptoms ofsubsyndromal PTSD that do not reach the level for a formaldiagnosis of PTSD, but which are nonetheless associated withelevated rates of other psychiatric disorders and functionaldifficulties. The study is published online in advance ofpublication in the July issue of the Journal of Psychiatric Research. "The prevalence of full PTSD observed in this study (5.4%) wascomparable to previous studies of police responders to the WTCdisaster. However, the rate of subsyndromal PTSD was nearly 3 timesgreater (15.4%), suggesting that one in five police exposed to WTCrescue and recovery work may have clinically significantWTC-related PTSD symptoms," says lead investigator Robert H.Pietrzak, PhD, MPH, of the National Center for Posttraumatic StressDisorder, VA Connecticut Healthcare System, and Department ofPsychiatry, Yale University School of Medicine. "Further,subsyndromal PTSD, which is not commonly assessed as part ofscreening efforts, was associated with elevated rates of comorbidpsychiatric disorders, functional difficulties, somatic symptoms,and perceived need for mental health care." Researchers assessed 8,466 police who worked or volunteered as partof rescue, recovery, restoration, or cleanup in Manhattan south ofCanal Street, at the barge-loading piers in Manhattan, or theStaten Island landfill between September 11 and December 31, 2001.Participants completed an initial evaluation as part of the WorldTrade Center Medical Monitoring and Treatment Program. An interviewassessed level of WTC exposure, such as early arrival, being caughtin the dust cloud, or exposure to human remains. A range ofself-report psychiatric assessments were completed, includingmeasures of depression , panic disorder, and alcohol use; impairment in work, social orfamily life; and somatic symptoms, such as feeling run down orhaving headaches. Respondents identified important sources of social support whileworking at the WTC site, including spouse/partner, supervisor, andco-workers. They also indicated whether they thought they wouldneed any mental health services in the next year. The level ofposttraumatic stress was measured using the PTSD Checklist. WTC-related work exposures that were most strongly associated withfull and subsyndromal PTSD were losing someone on 9/11 and knowingsomeone who was injured in the disaster. A greater number ofstressors prior to 9/11 was also associated with both full andsubsyndromal PTSD. Union membership and greater family supportplayed a protective role. Depression, panic disorder, alcohol useproblems, and somatic symptoms and functional difficulties werehighest among police with full PTSD, and occurred in intermediatelevels among those with subsyndromal PTSD. Police with subsyndromal PTSD were nearly five times as likely ascontrols to report that they might need at least one of the mentalhealth services assessed, such as one-on-one counseling, stressmanagement or psychotropic medication. "This finding underscoresthe importance of assessing for subsyndromal PTSD indisaster-exposed police responders, as these individuals may beoverlooked despite some of these responders having an increasedperception of need for mental healthcare," explains Dr. Pietrzak. Dr. Pietrzak and colleagues note that subsyndromal PTSD is not adiagnostic classification and may not be routinely identified aspart of screenings in police and other disaster response personnel."Current screening and diagnostic criteria for disaster-relatedPTSD may be too restrictive in identifying the full complement ofpolice who have clinically significant psychiatric and functionaldifficulties after responding to a mass disaster. These findingsunderscore the importance of screening, monitoring, and possiblytreating disaster responders with subsyndromal PTSD," he concludes,adding that additional research is needed to confirm these findingsusing structured diagnostic interviews, to understand thelongitudinal course of subsyndromal PTSD, and to evaluate thegeneralizability of these results to the broader population ofpolice WTC responders. Additional References Citations. I am an expert from medical-hospitalbeds.com, while we provides the quality product, such as Hospital Bed Accessories , China Hospital Furniture Chairs, Examination Couch,and more.
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