ArticlePublic health reports (Washington, D.C. : 1974)
Evaluating risk factors and possible mediation effects in posttraumatic depression and posttraumatic stress disorder comorbidity.
Article in Public health reports (Washington, D.C. : 1974). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Individual Participant Data Meta-Analysis Identifies Risk Factors for Acute and Persistent Posttraumatic Stress Disorder and Depression Symptoms Following Trauma.Depression and anxiety · 2026Pooled it
- What work-related exposures are associated with post-traumatic stress disorder? A systematic review with meta-analysis.BMJ open · 2021Pooled it
- Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review.BMC psychology · 2016Pooled it
- A systematic review of the comorbidity between PTSD and alcohol misuse.Social psychiatry and psychiatric epidemiology · 2014Pooled it
- Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: a review of the literature among highly exposed populations.The American psychologist · 2011Pooled it
- Posttraumatic stress disorder, major depression, and mild cognitive impairment: A cohort study of world trade center responders.Psychiatry research · 2026Article
- Impact of Natural Disasters on Mental Health: Evidence and Implications.Healthcare (Basel, Switzerland) · 2024Review
- Proposing a model whereby negative valence bias increases the risk for more severe dysphoric posttraumatic stress disorder and depression symptomology.Emotion (Washington, D.C.) · 2024Article
- The development and initial validation of the Trauma-Related Alcohol Use Coping Measure (TRAC).Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors · 2024Article
- Mindful attention training workshop for firefighters: Design and methodology of a pilot randomized clinical trial.Contemporary clinical trials communications · 2022Article
- PTSD and Depression in Healthcare Workers in the Italian Epicenter of the COVID-19 Outbreak.Clinical practice and epidemiology in mental health : CP & EMH · 2021Article
- Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake.JAMA network open · 2020Article
- Mortality among Fire Department of the City of New York Rescue and Recovery Workers Exposed to the World Trade Center Disaster, 2001-2017.International journal of environmental research and public health · 2020Article
- Impact of Health on Early Retirement and Post-Retirement Income Loss among Survivors of the 11 September 2001 World Trade Center Disaster.International journal of environmental research and public health · 2019Article
- The Association of the Exposure to Work-Related Traumatic Events and Work Limitations among Firefighters: A Cross-Sectional Study.International journal of environmental research and public health · 2019Article
- PTSD and comorbid depression: Social support and self-efficacy in World Trade Center tower survivors 14-15 years after 9/11.Psychological trauma : theory, research, practice and policy · 2019Article
- Factors mediating the impacts of child abuse and intimate partner violence on chronic pain: a cross-sectional study.BMC women's health · 2018Article
- Health-related quality of life among US military personnel injured in combat: findings from the Wounded Warrior Recovery Project.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2018Article
- Comorbidity amplifies the effects of post-9/11 posttraumatic stress disorder trajectories on health-related quality of life.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2018Article
- Post-traumatic stress disorder and alcohol misuse: comorbidity in UK military personnel.Social psychiatry and psychiatric epidemiology · 2016Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesOn September 11, 2001 (9/11), attacks on the World Trade Center (WTC) killed 341 Fire Department of the City of New York (FDNY) firefighters and injured hundreds more. Previous WTC-related studies reported high rates of comorbid depression and posttraumatic stress disorder (PTSD), identifying disability retirement, alcohol use, and early arrival at the WTC site as correlates. However, those studies did not evaluate risk factors that could have mediated the observed comorbidity. We identified unique risk factors for each condition in an effort to better understand comorbidity.
methodsWe screened retired WTC-exposed firefighters using self-administered questionnaires including the Center for Epidemiologic Studies Depression Scale, the Post Traumatic Stress Disorder Checklist, and the Alcohol Use Disorders Identification Test. We performed regression analyses to compare independent predictors of elevated depression and PTSD risk, and also tested a mediation hypothesis.
resultsFrom December 2005 to July 2007, 23% and 22% of 1,915 retirees screened positive for elevated depression and PTSD risk, respectively, with comorbidity > 70%. Controlling for comorbidity, we identified unique risk factors for (1) depression: problem alcohol use and (2) PTSD: early arrival at the WTC site.
conclusionsOur data support the premise that PTSD and depression are different responses to trauma with unique risk factors. The data also suggest a hypothesis that PTSD mediates the relationship between early WTC arrival and depression, while depression mediates the relationship between alcohol use and PTSD, a more complex relationship than shown in previous studies. Clinicians should consider these factors when evaluating patients for depression and PTSD.
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