# Post-Traumatic Growth and Quality of Life Among World Trade Center Health Registry Enrollees 16 Years After 9/11

## TL;DR

About one-third of people affected by 9/11 experienced post-traumatic growth, which improved their mental quality of life but not their physical health.

## Contribution

This study is the first to show that post-traumatic growth is linked to better mental quality of life in 9/11 survivors.

## Key findings

- 31% of enrollees experienced post-traumatic growth (PTG) after 9/11.
- PTG was significantly associated with improved mental quality of life but not physical quality of life.
- Physically injured individuals showed greater mental quality of life improvements from PTG.

## Abstract

Public health relevance—How does this work relate to a public health issue?
The prevalence of Post-Traumatic Growth in the World Trade Center Health Registry was 31%.Post-Traumatic Growth predicted mental but not physical Quality of Life.

The prevalence of Post-Traumatic Growth in the World Trade Center Health Registry was 31%.

Post-Traumatic Growth predicted mental but not physical Quality of Life.

Public health significance—Why is this work of significance to public health?
What is the prevalence of Post-Traumatic Growth in the World Trade Center Health Registry? The prevalence of Post-Traumatic Growth in the World Trade Center Health Registry is 31%.Does Post-Traumatic Growth predict Quality of Life? Post-Traumatic Growth predicts mental but not physical Quality of Life.

What is the prevalence of Post-Traumatic Growth in the World Trade Center Health Registry? The prevalence of Post-Traumatic Growth in the World Trade Center Health Registry is 31%.

Does Post-Traumatic Growth predict Quality of Life? Post-Traumatic Growth predicts mental but not physical Quality of Life.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Post-Traumatic Growth is common after a disaster and is associated with improved mental Quality of Life.Researchers should explore interventions to augment Post-Traumatic Growth.

Post-Traumatic Growth is common after a disaster and is associated with improved mental Quality of Life.

Researchers should explore interventions to augment Post-Traumatic Growth.

A recent study of World Trade Center Health Registry enrollees found that about one- third experienced post-traumatic growth (PTG) in the wake of the 9/11 attacks and that PTG was associated with social support and social integration. However, the implications of PTG for the enrollees’ overall quality of life are unknown. The present study investigated the prevalence of PTG and its association with the SF-12 physical and mental function quality of life scales in a sample of 2786 enrollees from the Registry’s Health and Quality of Life Study (HQoL) who completed the first four surveys, were older than 18 on 9/11, reported English as their primary spoken language, and provided consistent self-report of 9/11 physical injury at the Registry’s baseline and HQoL surveys. We employed multivariable linear regression to evaluate the association between PTG and the SF-12 physical and mental scales, controlling for sex, age, race, education, income, employment, social support, threatening events, post-9/11 mental health, number of post-9/11 physical health conditions, and drug/alcohol misuse. We found that 31% of the sample enrollees experienced PTG and that PTG exhibited a clinically and statistically significant association with the SF-12 mental scale but not the physical scale (physical: β = −0.01 (−0.61, 0.65), mental: β = 3.92 (2.89, 4.95)). Those who were physically injured during 9/11 showed larger improvements in mental function than those who were not. PTG has implications for the overall mental quality of life that should be further investigated.