ArticleThe Journal of clinical psychiatry2020
The Burden of Subthreshold Posttraumatic Stress Disorder in World Trade Center Responders in the Second Decade After 9/11.
Article in The Journal of clinical psychiatry, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Resilience enhancement interventions for disaster rescue workers: a systematic review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Pooled it
- Brief transdiagnostic cognitive behavioral therapy and expressive writing for hazardous drinking and posttraumatic stress symptoms among sexual and gender minority adults: Pilot trial protocol.Contemporary clinical trials communications · 2026Article
- A Clinician-Supported Mobile App to Reduce Mental Health Symptoms Among World Trade Center Responders in Florida: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2026Article
- Functioning and disability consequences of comorbid posttraumatic stress disorder and diabetes in Vietnam era men and women veterans.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2025Article
- Association Between Receipt of Ketamine vs Etomidate for Emergency Tracheal Intubation and Symptoms of Posttraumatic Stress Disorder at 12 Months.CHEST critical care · 2025Article
- Trajectory of adjustment difficulties following disaster: 10-year longitudinal cohort study.BJPsych open · 2024Article
- Posttraumatic stress disorder in Belgian police officers: prevalence and the effects of exposure to traumatic events.European journal of psychotraumatology · 2023Article
- Genome-wide association study of posttraumatic stress disorder among childhood cancer survivors: results from the Childhood Cancer Survivor Study and the St. Jude Lifetime Cohort.Translational psychiatry · 2022Article
- Investigating the impact of terrorist attacks on the mental health of emergency responders: systematic review.BJPsych open · 2022Review
- The Relationship Between Post-Traumatic Stress Disorder and Self-Management Behaviors in World Trade Center Workers with Asthma.The journal of allergy and clinical immunology. In practice · 2022Article
- A Public Health Framework for Preventing Mental Disorders in the Context of Pandemics.Cognitive and behavioral practice · 2021Article
- Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature.Behavioral sciences (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
Abstract
objectiveTo characterize the prevalence, risk and protective correlates, and clinical characteristics associated with probable subthreshold posttraumatic stress disorder (PTSD) in police and nontraditional (eg, construction workers) World Trade Center (WTC) responders a median of 12.2 years after September 11, 2001.
methodsA total of 4,196 WTC responders, monitored via the WTC Health Program, completed a web-based survey between 2012 and 2014 assessing a range of variables, including demographics, WTC exposures, medical and psychiatric comorbidities, and mental health services use. The sample included 2,029 police responders and 2,167 nontraditional responders. Current (past-month) probable WTC-related PTSD level (none, subthreshold, or full PTSD) was assessed based on DSM-IV criteria using the PTSD Checklist-Specific Stressor version (PCL-S).
resultsThe prevalence of current probable full and subthreshold WTC-related PTSD in police responders was 9.3% and 17.5%, respectively, and in nontraditional responders was 21.9% and 24.1%, respectively. Risk and protective correlates for subthreshold PTSD included post-9/11 medical comorbidities and traumatic events (odds ratios [ORs] = 1.1-1.2). Clinical characteristics included elevated rates of comorbid depression (OR = 3.2 and 3.9 for subthreshold PTSD and 17.2 and 30.3 for full PTSD for nontraditional and police responders, respectively). Among responders with subthreshold PTSD, police were more likely to have accessed mental health services and utilized a greater variety of treatments than nontraditional responders.
conclusionsOverall, 26.8% of police and 46.0% of nontraditional responders met criteria for probable WTC-related full or subthreshold PTSD an average of 12 years after 9/11. Probable subthreshold PTSD, which is not typically assessed in clinical settings, was more prevalent than probable full PTSD and was associated with significantly elevated rates of psychiatric comorbidities, functional impairment, and reduced quality of life. These findings underscore the importance of assessing, monitoring, and possibly treating subthreshold PTSD in WTC and other disaster responders.
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