Date of Degree

2-2018

Document Type

Dissertation

Degree Name

Ph.D.

Program

Social Welfare

Advisor

Harriet Goodman

Committee Members

Martha Bragin

Irwin Epstein

Adriana Feder

Rufina Lee

Subject Categories

Clinical and Medical Social Work | Psychiatric and Mental Health | Psychological Phenomena and Processes | Social Psychology | Social Work

Abstract

Thousands of first responders are estimated to have endured extremely distressing experiences during their recovery efforts at the 9/11 World Trade Center (WTC) site. While the effects of 9/11 continue to be studied, few studies have examined how rescue and recovery workers have been coping since 9/11 and how their coping is associated with their psychological well-being. Moreover, we do not know how distinct coping patterns may be associated with post-traumatic growth, experiences of positive emotion, or quality of life among WTC responders.

This study compared coping differences among Hispanic, Non-Hispanic White, and Non-Hispanic Black first responders. In addition, it examined the relationship between their coping, Post-Traumatic Stress Disorder (PTSD) symptoms, and psychological well-being. I also examined these associations in Hispanic responders by language preference and US nativity as proxies of acculturation.

Data from a cohort of 4,148 WTC responders who attended monitoring visits at the Mount Sinai WTC Health Program (WTC-HP) and who participated in a web-based survey administered by the Mount Sinai WTC Mental Health Program research team were used for secondary data analyses. More specifically, I utilized multiple regression analyses to compare differences in coping among Hispanics, Non-Hispanic Whites, and Non-Hispanic Blacks, while controlling for WTC-related trauma exposure, demographics, and clinical and psychosocial characteristics. Data were also used to examine the relationship between the responders’ coping, PTSD symptoms, and psychological well-being. Further, I used the data to examine differences in coping and well-being (e.g., post-traumatic growth, positive affect, and quality of life) in Hispanic responders by language preference and US nativity. Last, I tested a moderation effect to examine the relationship between active coping, PTSD symptom levels, and well-being among Hispanic responders by their level of acculturation using language preference and US nativity as proxies.

Key findings suggested broad similarities in coping between Hispanic and Non-Hispanic Black first responders, significant differences in coping among Hispanics, and the prevalence of post-traumatic growth in Hispanic responders. Further, the results revealed a moderating effect of US nativity on the Hispanic responders’ experiences of positive affect and quality of life.

This study’s results are consistent with other study findings that show Hispanic ethnicity is associated with higher PTSD symptom levels in 9/11 first responders. However, the study findings also show that positive religious coping and active coping are strongly associated with post-traumatic growth in Hispanic first responders. Further, positive religious coping and perceived social support are strongly associated with Hispanic responders experiencing positive affect and reporting a higher quality of life. Finally, the study findings demonstrate that US nativity among Hispanic responders moderates the relationship between active coping and positive affect and between active coping and quality of life, suggesting that Hispanic responders who are born abroad and use active coping report higher rates of positive affect and quality of life than those who are US born. Clinical and policy implications of these findings are of importance in designing programs for this population.

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