Dissociation and Posttraumatic Stress 1 Year After the World Trade Center Disaster: Follow-Up of a Longitudinal Survey
Abstract
BACKGROUND: We conducted a 1-year follow-up of an original mail survey of early reactions to the World Trade Center disaster. METHOD: Of the 75 subjects originally surveyed, 58 (77%) responded. The survey included measures of dissociation (Dissociative Experiences Scale, Cambridge Depersonalization Scale, Clinician-Administered Dissociative States Scale), post-traumatic stress (Impact of Event Scale-Revised), social support (Interpersonal Support Evaluation List-short form), and a life quality measure (Quality of Life Enjoyment and Satisfaction Questionnaire-short form). We hypothesized that dissociative versus posttraumatic symptoms at follow-up could be dissected on the basis of early reactions. RESULTS: Responders and nonresponders did not differ in baseline characteristics. Exposure was not associated with dissociation or posttraumatic stress at follow-up. Of distress, dissociation, and posttraumatic stress at baseline, baseline dissociation was the strongest predictor of outcome dissociation while baseline posttraumatic stress was the strongest predictor of outcome posttraumatic stress. Of 4 peritraumatic distress factors generated in the original survey, "loss of control" and "guilt/shame" were significantly related to dissociation and posttraumatic stress at outcome, while "helplessness/anger" was only associated with posttraumatic stress at outcome. Lesser improvement in posttraumatic stress over the first year was significantly related to less social support and greater comorbid dissociation. Interim social support was associated with better life quality and fewer symptoms at outcome. CONCLUSION: There was evidence for partly independent pathways toward dissociation versus posttraumatic stress 1 year after the disaster. Feelings of guilt and shame, and persistent dissociation, were poor prognostic factors, while social support had a powerful ameliorating influence.
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Fewer studies have demonstrated relations between perceived social support and anxiety, but observed effects parallel findings with depression.
“Fewer studies have demonstrated these relations with anxiety as well, but the observed effects parallel the findings with depression.16–20”
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- Authors
- Simeon, D., Greenberg, J., Nelson, D., Schmeidler, J., & Hollander, E.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2005-02-15
- Volume
- 66
- Issue
- 02
- Pages
- 231-237
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2046086346
- Cited by
- 84
- References
- 0
- Citations by year
- 2024: 1 · 2023: 3 · 2021: 2 · 2020: 4 · 2019: 9 · 2018: 3 · 2017: 2 · 2016: 5 · 2015: 3 · 2014: 3 · 2013: 5 · 2012: 3
- FWCI
- 12.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- World Trade Center disaster, dissociation, post-traumatic stress, peritraumatic dissociation, loss of control, social support, quality of life, prognostic factors, disaster exposure, long-term follow-up
- MeSH terms
- Adult, Disasters, Dissociative Disorders, Female, Follow-Up Studies, Health Status, Humans, Life Change Events, Longitudinal Studies, Male, New York City, Personal Satisfaction, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Social Support, Stress Disorders, Post-Traumatic, September 11 Terrorist Attacks
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