Posttraumatic Stress Symptom Heterogeneity in World Trade Center Responders: Relations to Maladaptive Personality
Shely Khaikin1, Nick Galef2, Jonathan DePierro1
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Background:
There has been growing interest in symptom heterogeneity in posttraumatic stress disorder (PTSD), yet examinations of personality variation across symptom typologies have been largely limited to veteran samples.
Methods:
The present study expands this literature by examining self-reported PTSD symptoms (PTSD Checklist for DSM-IV) and potentially maladaptive personality traits (Millon Clinical Multiaxial Inventory-III) in 516 treatment-seeking World Trade Center (WTC) rescue, recovery, and cleanup workers (mean age = 51.1; 75% male).
Results:
Latent class analysis identified five distinct PTSD symptom profiles: severe (n = 216), low symptom (n = 82), threat arousal (n = 73), mild numbing-hyperarousal (n = 71), and avoidance-numbing-hyperarousal (n = 68). PTSD symptom heterogeneity was meaningfully associated with distinct patterns of personality scale elevations and the total number of clinical elevations observed.
Conclusions:
These findings underscore the need for assessment strategies that integrate personality profiles into conceptualization of PTSD subtypes and suggest that personality-informed approaches may enhance treatment engagement or outcomes in populations with disaster-related occupational trauma exposure.
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