Bibliographic Details
| Title: |
Functional Limitations Among Responders to the World Trade Center Attacks 14 Years After the Disaster: Implications of Chronic Posttraumatic Stress Disorder. |
| Authors: |
Clouston, Sean A. P., Guralnik, Jack M., Kotov, Roman, Bromet, Evelyn J., Luft, Benjamin J. |
| Source: |
Journal of Traumatic Stress. Oct2017, Vol. 30 Issue 5, p443-452. 10p. |
| Subjects: |
Post-traumatic stress disorder, Functional assessment, World Trade Center (New York, N.Y. : 1970-2001), September 11 Terrorist Attacks, 2001, Psychological stress, Terrorism & psychology, Longitudinal method, Medical emergencies, Multivariate analysis, Research funding, Terrorism, Volunteers, Disease prevalence, Severity of illness index, Case-control method, Psychology |
| Abstract (English): |
Posttraumatic stress disorder (PTSD) is associated with self-reported difficulties navigating the social and physical world and may also be associated with risk of functional limitations. The Short Physical Performance Battery (SPPB), an objective functional assessment, was administered during monitoring exams between January and December 2015 to a consecutive sample of 1,268 rescue workers, volunteers, and other responders who had aided in response, recovery, and cleanup efforts at the World Trade Center (WTC) in New York after the September 11, 2011 attacks. Data were linked with diagnostic and longitudinal data from the WTC monitoring study. Multivariable analyses were used to examine predictors of functional limitations. Prevalence estimates weighted to the general responder population revealed a relatively high prevalence of functional limitations, SPPB ≤ 9; 16.0%, 95% CI [13.7, 18.4]. Current PTSD was associated with a twofold increased risk of functional limitations after controlling for predisposing factors, trauma severity, behavioral factors, and WTC-related medical conditions, adjusted risk ratio (aRR) = 2.11, 95% CI [1.48, 3.01]. Exposure to ergonomic risk factors at the WTC also increased the risk of functional impairments, aRR = 1.34 95% CI [1.05, 1.70]. Longitudinal results suggest that individuals with current functional limitations experienced high baseline PTSD severity, B = 2.94, SE = 1.33, and increasing PTSD symptom severity, B = 0.29, SE = 0.10, since September 11, 2001. This study identified a cross-sectional relationship between functional limitations and PTSD and a worsening of PTSD symptoms in persons who eventually demonstrated functional limitations. Results highlight the potential role of chronic PTSD in functional limitations. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): |
Resumen Limitaciones funcionales en operadores del World Trade Center El trastorno de estrés postraumático (TEPT) se asocia con dificultades auto-reportadas al explorar el mundo social y físico y también puede estar asociado con el riesgo de limitaciones funcionales. La Baterìa Breve de Desempeño Fìsico (SPPB, por sus siglas en inglés), una evaluación funcional objetiva, se administró durante los exámenes de monitoreo entre enero y diciembre de 2015 a una muestra consecutiva de 1.268 trabajadores de rescate, voluntarios y otros operadores quienes ayudaron en respuesta, recuperación y esfuerzos de limpieza en el World Trade Center (WTC) en Nueva York después de los ataques del 11 de septiembre de 2011. Los datos se relacionaron con datos diagnósticos y longitudinales del estudio de monitoreo del WTC. Los análisis multivariantes se utilizaron para examinar los predictores de limitaciones funcionales. Las estimaciones de prevalencia ponderadas a la población operadora general reveló una prevalencia relativamente alta de limitaciones funcionales, SPPB ≤ 9; 16,0%, IC del 95% [13,7, 18,4]. El TEPT actual se asoció con un riesgo dos veces mayor de limitaciones funcionales después de controlar los factores predisponentes, la gravedad del trauma, los factores comportamentales y las condiciones médicas asociadas al WTC, Razón de Riesgo Ajustado (aRR) = 2,11, IC del 95% [1,48, 3,01]. La exposición a factores de riesgo ergonómicos en el WTC también aumentaron el riesgo de deterioros funcionales, aRR = 1,34 IC del 95% [1,05, 1,70]. Los resultados longitudinales sugieren que los individuos con limitaciones funcionales actuales experimentaron alta severidad basal de TEPT, B = 2.94, SE = 1.33, y el aumento de la gravedad de los síntomas de TEPT, B = 0,29, SE = 0,10, desde el 11 de septiembre de 2001. Este estudio identificó una relación transaccional entre las limitaciones funcionales y el TEPT y un empeoramiento de los síntomas de TEPT en personas que eventualmente demuestran limitaciones funcionales. Los resultados destacan el rol potencial del TEPT crónico en las limitaciones funcionales. [ABSTRACT FROM AUTHOR] |
| Abstract (Chinese): |
抽象 Functional limitations in World Trade Center responders 14 years after the disaster: Implications of chronic posttraumatic stress disorder Traditional Chinese 標題: 世界貿易中心事件的搜救者14年後的身體功能障礙:慢性創傷後壓力症的影響 撮要: 創傷後壓力症(PTSD)跟個人就日常面對社交困難作出的自評有關, 亦可能跟身體功能障礙的風險有關。「簡短身體功能量表(Short Physical Performance Battery, SPPB)」是客觀的身體功能評估工具。本研究從2011年9月11日紐約世界貿易中心(WTC)遇襲事件裡, 協作搜救、治療和清理工作的人士當中找尋樣本。我們以序貫抽樣法, 取得由1,268名拯救人員、義工和其他搜救者組成的樣本, 並於2015年1至12月進行的監察評估裡, 對樣本採用「簡短身體功能量表」進行測量。我們把取得的數據, 與WTC監察研究中的診斷和縱貫數據作結合分析。我們採用多變量分析, 檢視身體功能障礙的預測變量。我們基於一般反應人口作普遍率估計, 發現身體功能障礙普遍率較高 (SPPB ≤ 9; 16.0%, 95% CI [13.7, 18.4])。我們因應誘因、創傷嚴重度、行為因素、與WTC事件相關的醫療情況作對照試驗後, 發現當前PTSD跟身體功能障礙的風險提升兩倍有關(已調節的相對風險率, aRR = 2.11, 95% CI [1.48, 3.01])。於WTC事件暴露於人體工學風險因素, 亦會提升功能受損的風險(aRR = 1.34 95% CI [1.05, 1.70])。縱貫研究結果反映, 有當前身體功能障礙的人士, 自2001年9月11日起, 有高水平的PTSD嚴重度基線(B = 2.94, SE = 1.33), PTSD症狀嚴重度亦有提升(B = 0.29, SE = 0.10)。研究發現了身體功能障礙跟PTSD的橫斷關係, 而日後有身體功能障礙的樣本其PTSD症狀會惡化。結果反映慢性PTSD對身體功能障礙的潛在影響。 Simplified Chinese 标题: 世界贸易中心事件的搜救者14年后的身体功能障碍:慢性创伤后压力症的影响 撮要: 创伤后压力症(PTSD)跟个人就日常面对社交困难作出的自评有关, 亦可能跟身体功能障碍的风险有关。「简短身体功能量表(Short Physical Performance Battery, SPPB)」是客观的身体功能评估工具。本研究从2001年9月11日纽约世界贸易中心(WTC)遇袭事件里, 协作搜救、治疗和清理工作的人士当中找寻样本。我们以序贯抽样法, 取得由1,268名拯救人员、义工和其他搜救者组成的样本, 并于2015年1至12月进行的监察评估里, 对样本采用「简短身体功能量表」进行测量。我们把取得的数据, 与WTC监察研究中的诊断和纵贯数据作结合分析。我们采用多变量分析, 检视身体功能障碍的预测变量。我们基于一般反应人口作普遍率估计, 发现身体功能障碍普遍率较高 (SPPB ≤ 9; 16.0%, 95% CI [13.7, 18.4])。我们因应诱因、创伤严重度、行为因素、与WTC事件相关的医疗情况作对照试验后, 发现当前PTSD跟身体功能障碍的风险提升两倍有关(已调节的相对风险率, aRR = 2.11, 95% CI [1.48, 3.01])。于WTC事件暴露于人体工学风险因素, 亦会提升功能受损的风险(aRR = 1.34 95% CI [1.05, 1.70])。纵贯研究结果反映, 有当前身体功能障碍的人士, 自2001年9月11日起, 有高水平的PTSD严重度基线(B = 2.94, SE = 1.33), PTSD症状严重度亦有提升(B = 0.29, SE = 0.10)。研究发现了身体功能障碍跟PTSD的横断关系, 而日后有身体功能障碍的样本其PTSD症状会恶化。结果反映慢性PTSD对身体功能障碍的潜在影响。 [ABSTRACT FROM AUTHOR] |
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| Database: |
Psychology and Behavioral Sciences Collection |
