Post-traumatic stress disorder dimensions and asthma morbidity in World Trade Center rescue and recovery workers. Academic Article uri icon

Overview

abstract

  • OBJECTIVE: Using data from a cohort of World Trade Center (WTC) rescue and recovery workers with asthma, we assessed whether meeting criteria for post-traumatic stress disorder (PTSD), sub-threshold PTSD, and for specific PTSD symptom dimensions are associated with increased asthma morbidity. METHODS: Participants underwent a Structured Clinical Interview for Diagnostic and Statistical Manual to assess the presence of PTSD following DSM-IV criteria during in-person interviews between December 2013 and April 2015. We defined sub-threshold PTSD as meeting criteria for two of three symptom dimensions: re-experiencing, avoidance, or hyper-arousal. Asthma control, acute asthma-related healthcare utilization, and asthma-related quality of life data were collected using validated scales. Unadjusted and multiple regression analyses were performed to assess the relationship between sub-threshold PTSD and PTSD symptom domains with asthma morbidity measures. RESULTS: Of the 181 WTC workers with asthma recruited into the study, 28% had PTSD and 25% had sub-threshold PTSD. Patients with PTSD showed worse asthma control, higher rates of inpatient healthcare utilization, and poorer asthma quality of life than those with sub-threshold or no PTSD. After adjusting for potential confounders, among patients not meeting the criteria for full PTSD, those presenting symptoms of re-experiencing exhibited poorer quality of life (p = 0.003). Avoidance was associated with increased acute healthcare use (p = 0.05). Sub-threshold PTSD was not associated with asthma morbidity (p > 0.05 for all comparisons). CONCLUSIONS: There may be benefit in assessing asthma control in patients with sub-threshold PTSD symptoms as well as those with full PTSD to more effectively identify ongoing asthma symptoms and target management strategies.

authors

  • Mindlis, Irina
  • Morales-Raveendran, E
  • Goodman, E
  • Xu, K
  • Vila-Castelar, C
  • Keller, K
  • Crawford, G
  • James, S
  • Katz, C L
  • Crowley, L E
  • de la Hoz, R E
  • Markowitz, S
  • Wisnivesky, J P

publication date

  • December 1, 2016

Research

keywords

  • Asthma
  • Rescue Work
  • September 11 Terrorist Attacks
  • Stress Disorders, Post-Traumatic

Identity

PubMed Central ID

  • PMC9318000

Scopus Document Identifier

  • 85011633148

Digital Object Identifier (DOI)

  • 10.1080/02770903.2016.1263650

PubMed ID

  • 27905829

Additional Document Info

volume

  • 54

issue

  • 7