Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48104, USA.
World Trade Center Health Registry, Division of Epidemiology, New York City Department of Health and Mental Hygiene, New York, NY 10013, USA.
Psychol Med. 2022 Oct;52(14):2950-2961. doi: 10.1017/S0033291720004912. Epub 2021 Apr 7.
Individuals present in lower Manhattan during the 9/11 World Trade Center (WTC) disaster suffered from significant physical and psychological trauma. Studies of longitudinal psychological distress among those exposed to trauma have been limited to relatively short durations of follow-up among smaller samples.
The current study longitudinally assessed heterogeneity in trajectories of psychological distress among WTC Health Registry enrollees - a prospective cohort health study of responders, students, employees, passersby, and residents in the affected area ( = 30 839) - throughout a 15-year period following the WTC disaster. Rescue/recovery status and exposure to traumatic events of 9/11, as well as sociodemographic factors and health status, were assessed as risk factors for trajectories of psychological distress.
Five psychological distress trajectory groups were found: none-stable, low-stable, moderate-increasing, moderate-decreasing, and high-stable. Of the study sample, 78.2% were classified as belonging to the none-stable or low-stable groups. Female sex, being younger at the time of 9/11, lower education and income were associated with a higher probability of being in a greater distress trajectory group relative to the none-stable group. Greater exposure to traumatic events of 9/11 was associated with a higher probability of a greater distress trajectory, and community members (passerby, residents, and employees) were more likely to be in greater distress trajectory groups - especially in the moderate-increasing [odds ratios (OR) 2.31 (1.97-2.72)] and high-stable groups [OR 2.37 (1.81-3.09)] - compared to the none-stable group.
The current study illustrated the heterogeneity in psychological distress trajectories following the 9/11 WTC disaster, and identified potential avenues for intervention in future disasters.
911 世界贸易中心（WTC）灾难期间身处下曼哈顿的个人遭受了重大的身体和心理创伤。对暴露于创伤后的长期心理困扰进行的研究仅限于对较小样本的相对短期随访。
本研究通过对 WTC 健康登记处（WTC 健康登记处）的参与者进行的纵向评估，评估了 WTC 灾难后 15 年内心理困扰轨迹的异质性，WTC 健康登记处是对受灾地区的救援人员、学生、员工、过路人、居民的前瞻性队列健康研究（n = 30839）。作为心理困扰轨迹的危险因素，评估了救援/恢复状态和 911 事件的创伤暴露，以及社会人口统计学因素和健康状况。
发现了五个心理困扰轨迹组：无稳定、低稳定、中增加、中减少和高稳定。在研究样本中，78.2%的人被归类为无稳定或低稳定组。与无稳定组相比，女性、911 时年龄较小、受教育程度和收入较低与处于更高困扰轨迹组的可能性更高。更多的 911 创伤事件暴露与更高的困扰轨迹可能性相关，社区成员（过路人、居民和员工）更有可能处于更大的困扰轨迹组——尤其是在中度增加组（优势比[OR]2.31（1.97-2.72）]和高稳定组[OR 2.37（1.81-3.09）]——与无稳定组相比。
本研究说明了 911 世贸中心灾难后心理困扰轨迹的异质性，并确定了未来灾难中干预的潜在途径。
