Effects of job loss, unemployment, work stress, and work satisfaction on the persistence of PTSD: Results from a cohort study of New York City metropolitan area residents one year after the September 11 attacks

Arijit Nandi, MPH¹, Melissa Tracy, BA¹, Jennifer Ahern, MPH¹, Heidi Resnick, PhD², Robyn R.M. Gershon, MHS DrPH³, David Vlahov, PhD¹, and Sandro Galea, MD, MPH, DrPH¹. (1) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (917)553-3577, akn2005@columbia.edu, (2) National Crime Victims' Research and Treatment Center, Medical University of South Carolina, 165 Cannon Street PO Box 2590852, Charleston, SC 250852, (3) Sociomedical Sciences, Columbia University, Mailman School of Public Health, 600 west 168th st, 4th floor, New York, NY 10032

There were substantial psychological consequences of the September 11 attacks in New York City (NYC). In addition, the attacks were associated with a deepening economic recession in NYC, accompanied by high unemployment. Few studies have investigated the influence of unemployment and adverse working conditions on the course of psychopathology after a mass disaster. Approximately six months after the attacks, we used random-digit dialing to recruit a representative sample of adults living in the NYC metropolitan area. At twelve months after the attacks, follow-up interviews were successfully completed on 71% of the baseline sample (N=1939). At follow-up, probable PTSD persisted in 42.7% of the 149 cases that met criteria for probable PTSD at baseline. In multivariable models, unemployment for any time since baseline predicted probable PTSD persistence in the entire cohort (p=0.02) and also among persons employed at follow-up (p=0.02). High levels of perceived work stress predicted probable PTSD persistence among persons employed at follow-up (p=0.02). These findings suggest that persons who are unemployed in the aftermath of a disaster may benefit from interventions aimed at improving mental health.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.