(Photo: U.S. Navy Mate 2nd Class Jim Watson)

Grief counselors are finding that many Americans are still dealing with the mental and emotional ramifications from the 9/11 attacks nearly 10 years later. But a new study released by Disaster Medicine and Public Health Preparedness shows there is also a continued association between probable post-traumatic stress disorder (PTSD) and the firefighters who arrived first at the World Trade Center on 9/11, according to the Journal of the American Medical Association.

The researchers analyzed data from more than 11,000 firefighters who completed questionnaires between 2001 and 2010. They also underwent physical and mental health exams and took self-administered questionnaires every 18 months as part of the Medical Monitoring Program, which was put into effect for all FDNY rescue and recovery workers. The researchers also split the workers into four groups based on their arrival times. The first group came the morning of the attacks, the second came in the afternoon, the third came two days afterward and the fourth arrived between three days and two weeks after the attack.

“‘Nine years after the WTC attacks, in the longest longitudinal study to date, we found that about 7 percent of the WTC-exposed firefighters met the criteria for current probable PTSD, a decrease from the almost 10 percent prevalence in the first year post-9/11,’ the authors report.They note that by comparison, the current national statistic for 12-month prevalence of PTSD in the U.S. male population is 1.8 percent. ‘Arrival group was significantly associated with delayed onset of probable PTSD, with individuals in arrival group 1 more likely to experience delayed onset of probable PTSD compared with individuals in arrival groups 3 and 4.’”

According to the authors, “We found that nine years after 9/11, PTSD continues to be a significant concern in the WTC-exposed FDNY population. Factors associated with the persistence or onset of PTSD symptoms include early arrival at the WTC site, decreases in exercise, increases in alcohol intake, and concurrent symptoms of respiratory or gastroesophageal illness. PTSD may thus persist, or may arise, not solely due to the intensity of the event experienced, but also due to physical injuries or illnesses sustained during the event, as well as changes in health behaviors after the event. A full comprehensive treatment approach that addresses the physical, behavioral, and mental health consequences of WTC exposure is of critical importance.”

Heather Rudow is a staff writer for Counseling Today. Email her at hrudow@counseling.org.

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