Posttraumatic Stress Symptom Heterogeneity in World Trade Center Responders: Relations to Maladaptive Personality Traits

Background There has been growing interest in symptom heterogeneity in posttraumatic stress disorder (PTSD), yet examinations of personality variation across symptom typologies have been largely limited to veteran samples. Methods The present study expands this literature by examining self‐reported PTSD symptoms (PTSD Checklist for DSM‐IV) and potentially maladaptive personality traits (Millon Clinical Multiaxial Inventory‐III) in 516 treatment‐seeking World Trade Center (WTC) rescue, recovery, and cleanup workers (mean age = 51.1; 75% male). Results Latent class analysis identified five distinct PTSD symptom profiles: severe ( n = 216), low symptom ( n = 82), threat arousal ( n = 73), mild numbing‐hyperarousal ( n = 71), and avoidance‐numbing‐hyperarousal ( n = 68). PTSD symptom heterogeneity was meaningfully associated with distinct patterns of personality scale elevations and the total number of clinical elevations observed. Conclusions These findings underscore the need for assessment strategies that integrate personality profiles into conceptualization of PTSD subtypes and suggest that personality‐informed approaches may enhance treatment engagement or outcomes in populations with disaster‐related occupational trauma exposure.