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Medscape
a day ago
- Health
- Medscape
Landmark 20-Year Study Reshapes Understanding of PTSD
A large 20-year study — the longest and most detailed of its kind — shows that posttraumatic stress disorder (PTSD) symptoms can endure for decades, challenging conventional timelines for recovery and offering new insights to guide future treatment. Researchers analyzed data from the World Trade Center Health Program (WTCHP), which is administered by the US CDC's National Institute for Occupational Safety and Health (NIOSH), and found symptoms of PTSD persisted for as long as two decades in 10% of first responders involved in the World Trade Center disaster of September 2001. Participation in the WTCHP is voluntary, but those who enroll receive free assessments, monitoring, and treatment, including psychiatric and behavioral healthcare. It is the longest and most detailed analysis of PTSD and includes 81,298 observations from 12,822 WTC responders. Participants entered the WTCHP at different timepoints and were assessed annually. Not every enrollee was assessed every year, but the sheer number of participants and observations 'just provides much greater density of data over that 20-year course than any previous study,' lead author Frank D. Mann, PhD, told Medscape Medical News . The study was published online on May 27 in Nature Mental Health . Filling the PTSD Knowledge Gap Most PTSD research has focused on the short term, with limited insight into how symptoms evolve over the long haul. Without long-term data, it's been difficult to understand whether PTSD resolves, persists, or worsens — hindering efforts to guide treatment and support. This study aimed to fill that gap by tracking symptom patterns over two decades. Responders were assessed regularly using the PTSD Checklist for a Specific Stressor, a standardized tool that measures symptom severity on an 85-point scale. On average, each participant completed 6.3 assessments over the course of the study. A score of ≥ 44 was considered indicative of clinically elevated PTSD symptoms. Between 2002 and 2022, the crude prevalence of elevated symptoms ranged from 8% to 15%. At the same time, 16%-34% of responders each year reported little to no symptoms, scoring at or near the minimum on the scale. The researchers found that symptom trajectories varied widely. Nearly as many participants experienced worsening symptoms as those who improved. As a result, the overall population average remained relatively flat over the 20-year period. Among responders who met the threshold for PTSD, the median time to symptom improvement was 8.9 years — and by year 20, about 76% had shown improvement. New Insights Mann, a senior research scientist at Stony Brook University Renaissance School of Medicine, Stony Brook, New York, said the study not only reinforced existing knowledge about PTSD in responders but also uncovered new insights. Most notably, it showed that PTSD symptoms tended to peak around a decade after 9/11 — significantly later than delayed-onset patterns reported in previous trauma studies. He also noted a surprising outcome — the top 10% of responders who experienced worsening symptoms over the long term accounted for the majority of mental health costs. These individuals, Mann said, represent a critical gap in care, with current interventions proving largely ineffective for them. Mann suggested that ongoing trauma exposure — especially for responders still in high-risk jobs — and potential genetic susceptibility may contribute to late-emerging or persistent symptoms. 'These individuals are an urgent priority for health systems, as available resources have not been effective for them,' the study authors wrote. Mann and his colleagues also found that occupation offered the strongest protection against developing PTSD. Police officers and firefighters benefit from training designed to help them cope with trauma, and repeated exposure may build a degree of resilience. In contrast, responders without such training — like construction workers — faced a 50%-55% higher risk of developing PTSD symptoms. Mann emphasized that occupational status was a more powerful predictor of PTSD risk than the severity of the traumatic exposures themselves. A Valuable Contribution Commenting on the research for Medscape Medical News, Sandra Lowe, MD, medical director of the Mount Sinai WTCMH program, noted that while the study largely confirms what has been known about responders — such as the significant variability in symptom trajectories over time — it still makes a valuable contribution. 'Extending observations for up to 20 years is rare in any study, especially in a cohort this large,' said Lowe, an associate professor of psychiatry at the Icahn School of Medicine at Mount Sinai, New York City, who was not involved in the study. Also commenting, James West, MD, chair of the American Psychiatric Association's Committee on the Psychiatric Dimensions of Disaster, described the finding that 10% of responders continued to experience symptoms two decades after exposure as 'sobering.' However, he emphasized that it aligns with observations in the disaster recovery community, where the psychological impact 'goes way beyond what most people see as the immediate aftermath and recovery.' West stressed the urgent need to develop effective treatments that enable those affected to live fuller, less impaired lives. 'We still need to be finding the effective treatments that can help these people live fuller lives without impairment from their trauma symptoms,' said West. Lowe pointed out that the symptom peak around 10 years post-exposure is often linked to external factors. Some responders who had been managing symptoms might lose resilience due to major life changes such as retirement. 'One of the things that was able to keep them engaged is now lost,' she said. 'They begin to spend more time reflecting on recollections, and symptoms can worsen.' West agreed, adding that retirement or job loss often leads to symptom increases because it removes a primary coping mechanism. Both Lowe and Mann also highlighted that 9/11 memorial events can trigger new symptoms or exacerbate existing ones. Lowe noted that responders with stronger coping skills tended to fare better over time. Effective coping strategies include maintaining regular schedules — especially for eating and sleeping — leading a structured life, and employing stress management techniques like meditation, yoga, or enjoyable hobbies. Social connection and being part of a community are also critical for resilience. She added that clinicians should always inquire about trauma history. Lowe, West, and Mann all pointed out that PTSD is often accompanied by physical health issues, particularly cardiovascular problems, which tend to be worse in those with the disorder. Responders with stronger coping skills tended to do better over time, said Lowe. Coping skills that can help make a difference include having a regular schedule, especially for eating and sleeping; having a structured life; and stress management tools, such as meditation or yoga or an enjoyable hobby. Social connection — being part of a community — is also critical, Lowe said. Clinicians should always inquire about trauma, she said. Lowe, West, and Mann all noted that people with PTSD often have physical illness and that cardiovascular outcomes in particular are worse for those individuals. WTCHP Future Uncertain However, despite advances in understanding PTSD and the importance of ongoing care, the future of the program supporting World Trade Center responders remains uncertain. Some 140,000 people are now enrolled in the WTCHP, which was established as a federal program in 2010. Congress has generally reauthorized the program whenever its funding came up for renewal. However, earlier this year, the Trump administration dismissed two thirds of the NIOSH workforce, including John Howard, MD, the administrator of the WTCHP. In response, members of Congress and advocates for 9/11 survivors urged the US Department of Health and Human Services (HHS) to reinstate Howard and the affected employees. Howard is listed as back on the job has since returned to his position, and HHS reportedly reinstated hundreds of NIOSH workers in May. An HHS spokesperson told Medscape Medical News that the WTCHP continues to provide services and is actively 'accepting, reviewing, and processing new enrollment applications and certification requests.' Meanwhile, the Trump administration's fiscal year 2026 budget proposal seeks to reduce CDC funding by $3.5 billion — approximately 40% — with a shift in focus toward infectious diseases. It remains unclear how the WTCHP will be affected by this new direction. Mann said he is not involved in the program's funding details but added, 'Presumably, as long as some funding continues to keep the program alive, we will continue monitoring responders and providing free treatment until the very last World Trade Center responder passes.' The study was partially funded through National Institutes of Health and CDC grants, the SUNY Research Foundation, and the CDC's World Trade Center Health Program. Mann, Lowe, and West reported having no relevant financial relationships.
Yahoo
2 days ago
- Health
- Yahoo
HHS brings back hundreds of staff following force reduction in latest rehiring move
FIRST ON FOX: The Department of Health and Human Services (HHS) is rehiring more than 450 previously fired employees belonging to multiple divisions within the agency's Centers for Disease Control and Prevention (CDC), according to an HHS official familiar with the matter. The rehired workers come from four different operational divisions within the CDC: the National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention (NCHHSTP); the National Center for Environmental Health (NCEH); the Immediate Office of the Director (IOD), and the Global Health Center (GHC). The move to bring these employees back follows the Trump administration's sweeping efforts to reorganize HHS and its sub-agencies during its first few months, which reports said included as many as 10,000 layoffs at various health agencies. It also follows multiple actions by the Trump administration following those layoffs to rehire some of the HHS staffers who were initially let go, such as those within the CDC's World Trade Center Health Program (WTCHP), the National Institute for Occupational Safety and Health (NIOSH) and the National Institutes of Health. Hhs Says It Will Cut Workforce By 10K, Saving $1.8B Annually "Personnel that should not have been cut, were cut," HHS Secretary Robert F. Kennedy Jr. told CBS News in April. "We're reinstating them. And that was always the plan. Part of the – at DOGE, we talked about this from the beginning, is we're going to do 80% cuts, but 20% of those are going to have to be reinstated, because we'll make mistakes." NCHHSTP will see the greatest number of its workers rehired out of the four divisions, with 214 returning. This HHS division consists of several smaller groups, including the Division of HIV Prevention, which media reports said was cut in half by the Trump administration. Read On The Fox News App NCEH will see the next greatest number of returned employees, with 158 coming back. NCEH consists of multiple groups, including one titled the Division of Environmental Health Science and Practice, which the Trump administration initially eliminated altogether as part of its reforms. How A Doge Review Can Actually Improve The Programs That Fight Hiv/aids IOD will see the third most returning with 71 and CDC's Global Health Center will see the fewest employees return out of the four divisions with 24 rehired workers. HHS is just one of several agencies that have rehired employees following reductions in force spurred by the Department of Government Efficiency (DOGE). The Internal Revenue Service, the Food and Drug Administration, the State Department, and the Department of Housing and Urban Development have all taken actions to rehire employees who were initially fired as a result of the reduction in force, per the Washington Post. "Under Secretary Kennedy's leadership, the nation's critical public health functions remain intact and effective. The Trump administration is committed to protecting essential services – whether it's supporting coal miners and firefighters through NIOSH, safeguarding public health through lead prevention, or researching and tracking the most prevalent communicable diseases," HHS spokesperson Andrew Nixon said. "HHS is streamlining operations without compromising mission-critical work. Enhancing the health and well-being of all Americans remains our top priority."Original article source: HHS brings back hundreds of staff following force reduction in latest rehiring move
Yahoo
07-05-2025
- Health
- Yahoo
Trump admin reinstates 9/11 survivors program staff following HHS reorganization
FIRST ON FOX: The Trump administration's Health and Human Services Department (HHS) sent out reinstatement notices to staff members who were part of a federal healthcare program for 9/11 survivors, following a reduction in force at HHS and its subagencies as part of Trump's efforts to optimize the federal government. The administration announced in mid-February that the Centers for Disease Control and Prevention (CDC) would face cuts that would reduce the agency's workforce by roughly one-tenth. As part of that reduction in force, 16 workers at the World Trade Center Health Program (WTCHP) were let go, an HHS official confirmed. The move spurred concern from both Democrats and Republicans. Trump Foe Letitia James Leading Charge On New Multistate Lawsuit Over Hhs Cuts Images of New York City on Sept. 11, 2001 New York Republican Rep. Mike Lawler, whose district in the Hudson Valley is home to many 9/11 first responders, reportedly indicated after the cuts that he was actively communicating with the Trump administration about them. "This political chaos is jeopardizing the healthcare of heroes," Sen. Chuck Schumer, D-N.Y., added in a Sunday statement about the 16 fired WTCHP workers. Read On The Fox News App After political pressure in early April, the Trump administration eventually restored WTCHP Administrator Dr. John Howard to his role as head operator of the program, according to Lawler, and today all the staff members at WTCHP who were let go as part of the administration's DOGE efforts have been reinstated. One of the 16 total staffers who were swept up in the cuts had already accepted a resignation buyout offered by the Trump administration. HHS Secretary Robert F. Kennedy and President Donald Trump "We appreciate the department's swift action to address these notices and return critical program staff to work to help assist and provide ongoing services," Howard said in a statement to Fox News Digital. "We're ready to serve the more than 133,000 responders and survivors of the 9/11 attacks who are served by this program along with other critical programs in NIOSH." New Hhs Report Sheds Additional Light On Risks Of Gender-affirming Care For Minors The federal program, which is housed within the (Cdc), was established by Congress in 2010 as part of the James Zadroga 9/11 Health and Compensation Act of 2010. It is operated by the CDC's National Institute of Occupational Safety and Health. CDC sign, blue sky trees behind it The program was developed to provide healthcare services to 9/11 victims, first responders and others involved in support services during the attacks who were exposed to harmful contaminants that day, as many were forced to inhale toxic dust and debris as they attempted to save lives. The program, which was extended in 2015, is slated to run until 2090 and aims to ensure that patients directly affected by the 9/11 attacks in New York, the Pentagon and in Shanksville, Pennsylvania, have zero out-of-pocket costs for any health complications that came as a result of the 9/11 attacks. "The chaos we see throughout the administration we're seeing 10 times over at the World Trade Center program," Schumer said over the weekend ahead of the reinstatements, according to New York's Spectrum News NY1. "We hear people are being fired, then we hear they're being restored; then we hear they're being fired, then they're being restored." Original article source: Trump admin reinstates 9/11 survivors program staff following HHS reorganization
Fox News
06-05-2025
- Health
- Fox News
Trump admin reinstates 9/11 survivors program staff following HHS reorganization
FIRST ON FOX: The Trump administration's Health and Human Services Department (HHS) sent out reinstatement notices to staff members who were part of a federal healthcare program for 9/11 survivors, following a reduction in force at HHS and its subagencies as part of Trump's efforts to optimize the federal government. The administration announced in mid-February that the Centers for Disease Control and Prevention (CDC) would face cuts that would reduce the agency's workforce by roughly one-tenth. As part of that reduction in force, 16 workers at the World Trade Center Health Program (WTCHP) were let go, an HHS official confirmed. The move spurred concern from both Democrats and Republicans. TRUMP FOE LETITIA JAMES LEADING CHARGE ON NEW MULTISTATE LAWSUIT OVER HHS CUTS New York Republican Rep. Mike Lawler, whose district in the Hudson Valley is home to many 9/11 first responders, reportedly indicated after the cuts that he was actively communicating with the Trump administration about them. "This political chaos is jeopardizing the healthcare of heroes," Sen. Chuck Schumer, D-N.Y., added in a Sunday statement about the 16 fired WTCHP workers. After political pressure in early April, the Trump administration eventually restored WTCHP Administrator Dr. John Howard to his role as head operator of the program, according to Lawler, and today all the staff members at WTCHP who were let go as part of the administration's DOGE efforts have been reinstated. One of the 16 total staffers who were swept up in the cuts had already accepted a resignation buyout offered by the Trump administration. "We appreciate the department's swift action to address these notices and return critical program staff to work to help assist and provide ongoing services," Howard said in a statement to Fox News Digital. "We're ready to serve the more than 133,000 responders and survivors of the 9/11 attacks who are served by this program along with other critical programs in NIOSH." NEW HHS REPORT SHEDS ADDITIONAL LIGHT ON RISKS OF GENDER-AFFIRMING CARE FOR MINORS The federal program, which is housed within the (CDC), was established by Congress in 2010 as part of the James Zadroga 9/11 Health and Compensation Act of 2010. It is operated by the CDC's National Institute of Occupational Safety and Health. The program was developed to provide healthcare services to 9/11 victims, first responders and others involved in support services during the attacks who were exposed to harmful contaminants that day, as many were forced to inhale toxic dust and debris as they attempted to save lives. The program, which was extended in 2015, is slated to run until 2090 and aims to ensure that patients directly affected by the 9/11 attacks in New York, the Pentagon and in Shanksville, Pennsylvania, have zero out-of-pocket costs for any health complications that came as a result of the 9/11 attacks. CLICK HERE TO GET THE FOX NEWS APP "The chaos we see throughout the administration we're seeing 10 times over at the World Trade Center program," Schumer said over the weekend ahead of the reinstatements, according to New York's Spectrum News NY1. "We hear people are being fired, then we hear they're being restored; then we hear they're being fired, then they're being restored."
Yahoo
05-05-2025
- Health
- Yahoo
Schumer, Gillibrand slam Trump and RFK Jr. over cut 9/11 program: ‘Political chaos is jeopardizing healthcare of heroes'
New York Dem Sens. Chuck Schumer and Kirsten Gillibrand on Sunday blasted what they called a 'cruel' effort by President Trump and Robert F. Kennedy Jr. to dismantle the World Trade Center Health Program. The pols said at a press conference that 16 more doctors and staff tied to the program were abruptly fired Friday night. Schumer, the Senate's minority leader, said the late-night firings of WTCHP nurses, scientists and administrative officials exposed the Trump administration's intent to gut the program, which provides medical treatment and research for more than 137,000 responders and survivors of the 9/11 terrorist attacks. 'Donald Trump and [his Health and Human Services Secretary] RFK revealed their true intentions Friday night when they fired another 16 [workers]. … They seem to do these things late at night on weekends so nobody would know,' Schumer said, standing beside Gillibrand and 9/11 advocates. 'This political chaos is jeopardizing the healthcare of heroes,' he said. Schumer said he spoke to two long-time WTCHP staffers — a doctor and an intake worker — who were booted in the latest round of recent program cuts. 'They did so much to help those who rushed to the Towers, and on Friday night, when they got home, they were told they were fired,' Schumer said. The WTCHP, created in 2005, is now floundering because of staff cuts, leading to delayed cancer treatments for survivors, Schumer said. 'People who are in the middle of being treated for serious cancers are not getting the treatment anymore,' he told reporters. Mariama James, 53, and her three children belong to the WTCHP program. She has already lost both of her parents to 9/11-related cancer. 'We are being lied to constantly,' she said about Trump's and RFK Jr.'s response to the program. 'My 23-year-old has worn a heart monitor for the past two weeks. I don't have time for people to lie to me anymore,' James said. She said 800 survivors and first responders could not get certified to join the program in April because of the issues. Gillibrand echoed the outrage, saying bipartisan work had gone into building the program based on scientific evidence that linked 9/11 survivors to cancer and lung conditions. 'This is not a political issue. It's about keeping people alive,' she said. The lawmakers vowed not to vote for any federal budget that wouldn't fully fund the program. Schumer accused New York House Republicans of allowing themselves to be 'played and lied to' by promises that the program's funding would be restored and demanded they use their leverage in upcoming budget negotiations to force the Trump administration to reverse course. 'They've got to up the ante,' he said. 'Do not vote for a budget that doesn't restore this program.'
