Childhood maltreatment, 9/11 exposure,and latent dimensions of psychopathology: A test of stress sensitization |
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| Affiliation: | 1. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;2. Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA;3. Department of Psychology, University of Minnesota, Minneapolis, MN 55455, USA;4. Laboratory of Epidemiology and Biometry, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA;5. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA;6. New York State Psychiatric Institute, New York, NY 10032, USA;1. Institute of Pharmaceutical Science and Technology, Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan;2. Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan;3. Department of Food Science and Technology, Central Taiwan University of Science and Technology, Taichung, Taiwan;4. Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan;5. Department of Medical Laboratory Science and Biotechnology, Central Taiwan University of Science and Technology, Taichung, Taiwan;1. Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, South Africa;2. South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa;3. KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya;4. Department of Psychiatry, University of Oxford, UK;5. Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK;6. Statistical Consulting Service, Department of Statistical Science, University of Cape Town, South Africa;7. Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa;8. South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, South Africa;1. IOBA (Institute of Applied OphthalmoBiology), University of Valladolid, Valladolid, Spain;2. CIBER-BBN (Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine), Spain;3. ImmunEyez LLC, USA;4. VISION R&D, Valladolid, Spain;5. University College London, UCL, London, UK;6. Baylor College of Medicine, Houston, TX, USA;1. Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA;2. National Center for PTSD, White River Junction, VT, USA;3. VA San Diego Healthcare System, San Diego, CA, USA;4. Department of Psychiatry, University of California, San Diego, CA, USA;5. VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA;6. VA Connecticut Healthcare System, West Haven, CT, USA;7. National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA;8. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA |
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| Abstract: | On September 11, 2001, a terrorist attack occurred in the U.S. (9/11). Research on 9/11 and psychiatric outcomes has focused on individual disorders rather than the broader internalizing (INT) and externalizing (EXT) domains of psychopathology, leaving unknown whether direct and indirect 9/11 exposure differentially impacted these domains rather than individual disorders. Further, whether such effects were exacerbated by earlier childhood maltreatment (i.e. stress sensitization) is unknown. 18,713 participants from a U.S. national sample with no history of psychiatric disorders prior to 9/11 were assessed using a structured in-person interview. Structural equation modeling conducted in a sample who endorsed no psychiatric history prior to 9/11, indicated that indirect exposure to 9/11 (i.e. media, friends/family) was related to both EXT (alcohol, nicotine, and cannabis dependence, and antisocial personality disorder) and INT (major depression, generalized anxiety, and post-traumatic stress disorder (PTSD)) dimensions of psychopathology (EXT: β = 0.10, p < 0.001; INT: β = 0.11, p < 0.001) whereas direct exposure was associated with the INT dimension only (β = 0.11, p < 0.001). For individuals who had experienced childhood maltreatment, the risk for EXT and INT dimensions associated with 9/11 was exacerbated (Interactions: β = 0.06, p < 0.01; β = 0.07, p < 0.001, respectively). These findings indicate that 9/11 impacted latent liability to broad domains of psychopathology in the US general population rather than specific disorders with the exception of PTSD, which had independent effects beyond INT (as indicated by a significant (p < 0.05) improvement in modification indices). Findings also indicated that childhood maltreatment increases the risk associated with adult trauma exposure, providing further evidence for the concept of stress sensitization. |
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| Keywords: | 9/11 World Trade Center Child abuse Child neglect Externalizing Internalizing Stress sensitization Psychopathology Substance use NESARC |
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