Social integration buffers stress in New York police after the 9/11 terrorist attack

Abstract

Being socially integrated is regarded as a protective factor enabling people to cope with adversity. The stress-buffering effect reflects an interaction between stress and a social coping resource factor on subsequent outcomes. This study, based on 2943 police officers, examines mental health outcomes among officers who responded to the 9/11 terrorist attack on the World Trade Center. The Wave 1 data collection took place between September 2003 and November 2004 with a follow-up study (Wave 2) conducted from November 2006 through December 2007. A moderated mediation model was specified that uses event exposure as a distal predictor, earlier stress response as a mediator, and later stress response as an outcome, and social integration as a moderator of this relationship. The mediation hypothesis was confirmed, and moderation occurred at two stages. First, there was a multiplicative relationship between exposure levels and social integration: The higher the exposure level, the more stress responses occur, but this effect was buffered by a high level of social integration. Second, Wave 1 stress interacted with social integration on Wave 2 stress: The more the police officers were socially integrated, the lower the Wave 2 stress, which happened in a synergistic manner. The findings contribute to the understanding of mediating and moderating mechanisms that result in health outcomes such as posttraumatic stress disorder or resilience.

Keywords:

• resilience
• social integration
• trauma
• posttraumatic stress disorder
• stress buffer

Acknowledgments

We would like to thank the WTCHR police agency enrollees who responded for this follow-up of the 9/11/01 disaster. This publication was supported by Cooperative Agreement Numbers 2U50OH009739 and 1U50OH009739 from CDC-NIOSH, and U50/ATU272750 from CDC-ATSDR which included support from CDC-NCEH, and the New York City Department of Health and Mental Hygiene (NYC DOHMH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. We also thank Dr. Mark Farfel for his review of this manuscript.