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PTSD and Depressive Symptoms as Potential Mediators of the Association between World Trade Center Exposure and Subjective Cognitive Concerns in Rescue/Recovery Workers.
International Journal of Environmental Research and Public Health ( IF 4.614 ) Pub Date : 2020-08-06 , DOI: 10.3390/ijerph17165683
Ankura Singh 1, 2 , Rachel Zeig-Owens 1, 2, 3 , Laura Rabin 4 , Theresa Schwartz 1, 2 , Mayris P Webber 1, 3 , David Appel 1, 2 , David J Prezant 1, 2 , Charles B Hall 5, 6
Affiliation  

We observed that World Trade Center (WTC) exposure, post-traumatic stress disorder (PTSD) symptoms and depressive symptoms were associated with subjective cognitive concerns in Fire Department of the City of New York (FDNY) rescue/recovery workers. This follow-up study examined whether PTSD symptoms and/or depressive symptoms mediate the observed association between WTC exposure and subjective cognitive concerns. We included WTC-exposed FDNY workers who completed the Cognitive Function Instrument (CFI), measuring self-perceived cognitive decline (N = 9516). PTSD symptoms and depressive symptoms were assessed using the PCL-S and CES-D, respectively. Multivariable linear regression estimated the association between WTC exposure and CFI score, adjusting for confounders. Mediation analyses followed the methods of Vanderweele (2014). Participants’ average age at CFI assessment was 56.6 ± 7.6 years. Higher-intensity WTC exposure was associated with worse CFI score, an effect that was entirely mediated by PTSD symptoms (%mediated: 110.9%; 95%CI: 83.1–138.9). When substituting depressive symptoms for PTSD symptoms, the WTC exposure–CFI association was largely mediated (%mediated: 82.1%; 95%CI: 60.6–103.7). Our findings that PTSD symptoms and depressive symptoms mediate the association between WTC exposure and subjective cognitive concerns indicate that in the absence of these symptoms, WTC exposure in rescue/recovery workers would not be associated with subjective cognition. Interventions targeting PTSD and depression may have additional value in mitigating cognitive decline in WTC-exposed populations.

中文翻译:

PTSD和抑郁症状是世界贸易中心暴露与救援人员/恢复工人的主观认知问题之间的潜在关联。

我们观察到世界贸易中心(WTC)暴露,创伤后应激障碍(PTSD)症状和抑郁症状与纽约市消防局(FDNY)救援/恢复工作者的主观认知问题相关。这项后续研究检查了PTSD症状和/或抑郁症状是否介导了WTC暴露与主观认知问题之间的相关性。我们纳入了完成了认知功能工具(CFI),测量自我感知的认知能力下降(N= 9516)。分别使用PCL-S和CES-D评估PTSD症状和抑郁症状。多变量线性回归估计了WTC暴露与CFI评分之间的关​​联,并针对混杂因素进行了调整。中介分析遵循范德韦勒(2014)的方法。参加CFI评估的参与者的平均年龄为56.6±7.6岁。较高强度的WTC暴露与较差的CFI评分有关,这种影响完全由PTSD症状介导(介导的百分比:110.9%; 95%CI:83.1-138.9)。当用抑郁症状代替PTSD症状时,WTC暴露与CFI的关联主要是通过介导的(%介导的:82.1%; 95%CI的:60.6-103.7)。我们的研究发现PTSD症状和抑郁症状介导了WTC暴露与主观认知问题之间的关联,这表明在没有这些症状的情况下,救援人员/恢复人员的WTC暴露与主观认知无关。针对PTSD和抑郁症的干预措施在减轻WTC暴露人群的认知能力下降方面可能具有附加价值。
更新日期:2020-08-06
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