{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:12:41Z","timestamp":1777615961328,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T00:00:00Z","timestamp":1520985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Traumatic Stress"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Posttraumatic stress disorder (PTSD) is associated with functional deficits, poor physical health, and diminished quality of life. Limited research has examined PTSD symptom clusters and their associations with functioning and distress among disaster recovery workers, a population at high risk for PTSD due to potential for repeated trauma. The purpose of this study was to investigate associations between overall PTSD severity, as well as PTSD symptom clusters, and social and occupational functioning and subjective distress in World Trade Center (WTC) disaster workers after the terrorist attacks on September 11, 2001 (9\/11). Disaster workers deployed to the site of the attacks completed assessments at three time points over approximately 5 years post\u20109\/11. Our sample consisted of participants who met criteria for PTSD or subthreshold PTSD at baseline (<jats:italic>n<\/jats:italic> = 514), 1\u2010year (<jats:italic>n<\/jats:italic> = 289), and 2\u2010year follow\u2010up (<jats:italic>n<\/jats:italic> = 179). Adjusted linear regression indicated that Clinician Administered PTSD Scale (CAPS)\u2010rated PTSD severity was positively associated with subjective distress, and deficits in social and occupational functioning, over time, CAPS Criterion F items; \u03b2s = .20 to .62, <jats:italic>p<\/jats:italic>s &lt; .001. The reexperiencing and avoidance\/numbing symptom clusters were associated with increased subjective distress, the avoidance\/numbing and hyperarousal clusters were associated with deficits in social functioning, and the reexperiencing and hyperarousal clusters were associated with worse occupational functioning. These associations were consistent across the study period. Findings point to the importance of targeting PTSD symptom clusters associated with specific areas of functional impairment, with the goal of improving global outcomes.<\/jats:p>","DOI":"10.1002\/jts.22268","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T12:22:11Z","timestamp":1521116531000},"page":"234-243","source":"Crossref","is-referenced-by-count":13,"title":["Posttraumatic Stress Disorder, Functional Impairment, and Subjective Distress in World Trade Center Disaster Workers"],"prefix":"10.1002","volume":"31","author":[{"given":"Kallio","family":"Hunnicutt\u2010Ferguson","sequence":"first","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna E.","family":"Wyka","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"},{"name":"City University of New York Graduate School of Public Health and Health Policy  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Peskin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith","family":"Cukor","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Olden","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JoAnn","family":"Difede","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Weill Cornell Medicine  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,14]]},"reference":[{"key":"e_1_2_5_2_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"APA","year":"1994"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20894"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.2490080106"},{"key":"e_1_2_5_5_1","first-page":"187","article-title":"A clinician rating scale for assessing current and lifetime PTSD: The CAPS\u20101","volume":"13","author":"Blake D.","year":"1990","journal-title":"Behavioral Therapist"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00038-1"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/10615806.2010.515304"},{"key":"e_1_2_5_8_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.janxdis.2010.06.017"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20672"},{"key":"e_1_2_5_12_1","first-page":"333","volume-title":"September 11, 2001: Treatment, research and public mental health in the wake of a terrorist attack","author":"Difede J.","year":"2006"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20575"},{"key":"e_1_2_5_14_1","volume-title":"Structured Clinical Interview for DSM\u2010IV Axis I DIsorders \u2014 Non\u2010patient edition (SCID\u2010N\/P Version 2.0)","author":"First M. 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