Article

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: 1.63). 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
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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. AlthoughNandi 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.
    Full-text · Article · May 2014 · Psychiatry Research
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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. AlthoughNandi 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. "
    [Show abstract] [Hide abstract]
    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.
    Full-text · Article · Jan 2014
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    • "Addressing this issue is critical, as delivering effective, preventive interventions for PTSD could save the USA up to 180 million dollars each year in health care costs [74–79] and the lives of up to 9,000 individuals from suicide [80–83]. Health care providers have an opportunity to reduce the risk for PTSD onset as up to 3 million adults seek immediate medical care for traumatic injuries each year [84], resulting in the onset of PTSD in almost 1 million of Americans annually [1, 4, 85–87]. "
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    ABSTRACT: Posttraumatic stress disorder (PTSD) develops in approximately one-quarter of trauma-exposed individuals, leading us and others to question the mechanisms underlying this heterogeneous response to trauma. We suggest that the reasons for the heterogeneity relate to a complex interaction between genes and the environment, shaping each individual's recovery trajectory based on both historical and trauma-specific variables. Epigenetic modifications provide a unique opportunity to elucidate how preexisting risk factors may contribute to PTSD risk through changes in the methylation of DNA. Preexisting risks for PTSD, including depression, stress, and trauma, result in differential DNA methylation of endocrine genes, which may then result in a different biological responses to trauma and subsequently a greater risk for PTSD onset. Although these relationships are complex and currently inadequately described, we provide a critical review of recent studies to examine how differences in genetic and proteomic biomarkers shape an individual's vulnerability to PTSD development, thereby contributing to a heterogeneous response to trauma.
    Full-text · Article · Apr 2013
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