Job Loss, Unemployment, Work Stress, Job Satisfaction, and the Persistence of Posttraumatic Stress Disorder One Year After the September 11 Attacks

Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, NY 10029-5283, USA.
Journal of Occupational and Environmental Medicine (Impact Factor: 1.8). 11/2004; 46(10):1057-64. DOI: 10.1097/01.jom.0000141663.22902.0a
Source: PubMed

ABSTRACT The influence of unemployment and adverse work conditions on the course of psychopathology after a mass disaster is unclear. We recruited a representative sample of adults living in the New York City metropolitan area six months after the September 11 attacks and completed follow-up interviews on 71% of the baseline sample six months later (N = 1939). At follow-up, posttraumatic stress disorder (PTSD) persisted in 42.7% of the 149 cases with PTSD at baseline. In multivariable models, unemployment at any time since baseline predicted PTSD persistence in the entire cohort (P = 0.02) and among persons employed at follow-up (P = 0.02). High levels of perceived work stress predicted PTSD persistence among persons employed at follow-up (P = 0.02). Persons unemployed in the aftermath of a disaster may be at risk for poor mental health in the long-term.

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Available from: Robyn R M Gershon, Jul 28, 2015
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    • "These results are remarkable, given the fact that we also entered lack of general social support and demographics into the equations, since lack of general social support was very strongly associated with postdisaster mental health. Although Nandi et al. (2004) examined a somewhat different type of organizational stressors and controlled for other variables in the multivariate analyses, our findings appear to be in line with their conclusions that organizational stress was strongly associated with post-disaster mental health. Thus, our findings confirm COR theory in general that the loss of resources either related to the disaster (loss of safety), related to work (problems with colleagues) or in general (lack of social support), is independently related to mental health problems 1.5-year post-disaster. "
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    ABSTRACT: Social organizational stressors are well-known predictors of mental health disturbances (MHD). However, to what extent these stressors predict post-disaster MHD among employed victims hardly received scientific attention and is clearly understudied. For this purpose we examined to what extent these stressors independently predict MHD 1.5 years post-disaster over and above well-known risk factors such as disaster exposure, initial MHD and lack of general social support, life-events in the past 12 months and demographics (N=423). Exposure, social organizational stressors and support were significantly associated with almost all examined mental health disturbances on a bi-variate level. Multivariate logistic regression analyses showed that these stressors, i.e. problems with colleagues, independently predicted anxiety (Adj. OR=5.93), depression (Adj. OR=4.21), hostility (Adj. OR=2.85) and having two or more mental health disturbances (Adj. OR=3.39) in contrast to disaster exposure. Disaster exposure independently predicted symptoms of PTSD symptoms (Adj. OR=2.47) and agoraphobia (Adj. OR=2.15) in contrast to social organizational stressors. Importantly, levels of disaster exposure were not associated nor correlated with (levels of) social organizational stressors. Findings suggest that post-disaster mental health care programs aimed at employed affected residents, should target social organizational stressors besides disaster-related stressors and lack of general social support. © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 05/2014; 219:177–182. DOI:10.1016/j.psychres.2014.05.032 · 2.68 Impact Factor
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    • "ry ( Hoven et al . , 2003 ) . Risk factors for persistence of PTSD symptomatology include the severity and duration of exposure ( Hoven et al . , 2003 ) , functional impairment and seeking mental health treatment shortly after dis - aster ( North et al . , 2002 ) , as well as post - disaster conditions , such as unemployment and high work stress ( Nandi et al . , 2004 ) . Depression . Depression is also commonly studied in post - disaster settings . In this section we include studies that look at depression symptomatology as well as diagnoses . Research includes samples from both rescue and cleanup workers and the general population as well as special populations , such as adolescents ( Goenjian et a"
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    ABSTRACT: Peer Reviewed population health_2009.pdf
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    • "We predicted an increase in the suicide rate following the disaster based on the parallel findings that exposure to mass trauma is associated with severe psychological distress, and that such psychological distress, particularly depression and posttraumatic stress disorder, is associated with elevated suicide risk. In particular, there is evidence that severe and persistent psychological distress developed in New York City residents not directly exposed to the event (DiGrande et al., 2008; Galea & Resnick, 2005; Marshall et al., 2007), and that the event was characterized by substantial disruptions in domains of finances, work, and interpersonal relationships that influence psychopathology after a disaster event (Galea, Tracy, Norris, & Coffey, 2008; Nandi et al., 2004). Therefore, the extant evidence suggests that this disaster had the potential to influence suicide risk among the population overall. "
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    ABSTRACT: The authors investigated the relationship between the September 11, 2001 terrorist attacks and suicide risk in New York City from 1990 to 2006. The average monthly suicide rate over the study period was 0.56 per 100,000 people. The monthly rate after September 2001 was 0.11 per 100,000 people lower as compared to the rate in the period before. However, the rate of change in suicide was not significantly different before and after the disaster, and regression discontinuity analysis indicated no change at this date. There was no net change in the suicide rate in New York City attributable to this disaster, suggesting that factors other than exposure to traumatic events (e.g., cultural norms, availability of lethal methods) may be key drivers of suicide risk in this context.
    Journal of Traumatic Stress 01/2009; 22(6):481-8. DOI:10.1002/jts.20473 · 2.72 Impact Factor
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