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The Relationship Between PTSD Arousal Symptoms and Depression Among Mothers Exposed to the World Trade Center Attacks

Rubacka, Joseph M. MA*; Schmeidler, James PhD*; Nomura, Yoko PhD, MPH*; Luthra, Rohini PhD*; Rajendran, Khushmand MSW*; Abramovitz, Robert MD; Chemtob, Claude M. PhD*‡

The Journal of Nervous and Mental Disease: June 2008 - Volume 196 - Issue 6 - p 504-507
doi: 10.1097/NMD.0b013e3181775f05
Brief Report

Posttraumatic stress disorder (PTSD) is associated with greater risk of developing comorbid depression. However, little is known about the relationship between specific PTSD symptom clusters and comorbid depression. Approximately 4 years after the World Trade Center (WTC) attacks, we examined the association between PTSD symptom clusters and depression severity among 64 mothers directly exposed to the WTC attacks. Severity scores were computed for each PTSD symptom cluster by summing symptom frequency. Partial correlations with depression severity were calculated separately for PTSD symptom clusters, controlling for demographic variables, time elapsed since the attacks, WTC attack exposure, meeting PTSD criterion A, and the other cluster scores. Higher arousal symptom cluster scores were significantly correlated with persistent depression, but the re-experiencing and avoidance symptom clusters were not. Subsequent analyses isolating shared symptoms of PTSD and depression from those unique to PTSD suggest a complex interrelationship among symptoms of arousal, numbing, and depression.

*Department of Psychiatry, Mount Sinai School of Medicine, New York, New York; †Jewish Board of Family and Children's Services, New York, New York; and ‡Department of Pediatrics, Mount Sinai School of Medicine, New York, New York.

This study was partially supported by NIMH (R24 MH063910-04) (to C.M.C.) and by grants from the New York Times Foundation September 11 Fund, National Philanthropic Trust/September 11th Children's Fund, United Jewish Communities, UJA Federation of New York, the UBS September 11 Fund, the Robin Hood Foundation, the Picower Foundation, an anonymous donor, the American Red Cross, Andor Capital Management, and, Strook, Strook and Lavan LLP. Funders had no role in the design or conduct of the study.

Send reprint requests to Claude M. Chemtob, Child and Family Resilience Program, The Mount Sinai School of Medicine, One Gustave Levy Place, Box 1230, New York City, NY 10028. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.