TY - JOUR
T1 - Cumulative exposure to work-related traumatic events and current post-traumatic stress disorder in New York City's first responders
AU - Geronazzo-Alman, Lupo
AU - Eisenberg, Ruth
AU - Shen, Sa
AU - Duarte, Cristiane S.
AU - Musa, George J.
AU - Wicks, Judith
AU - Fan, Bin
AU - Doan, Thao
AU - Guffanti, Guia
AU - Bresnahan, Michaeline
AU - Hoven, Christina W.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background and objectives Cumulative exposure to work-related traumatic events (CE) is a foreseeable risk for psychiatric disorders in first responders (FRs). Our objective was to examine the impact of work-related CE that could serve as predictor of posttraumatic stress disorder (PTSD) and/or depression in FRs. Design Cross-sectional examination of previous CE and past-month PTSD outcomes and depression in 209 FRs. Methods Logistic (probable PTSD; probable depression) and Poisson regressions (PTSD score) of the outcomes on work-related CE indexes, adjusting for demographic variables. Differences across occupational groups were also examined. Receiver operating characteristic analysis determined the sensitivity and specificity of CE indexes. Results All indexes were significantly and differently associated with PTSD; associations with depression were non-significant. The index capturing the sheer number of different incidents experienced regardless of frequency (‘Variety’) showed conceptual, practical and statistical advantages compared to other indexes. In general, the indexes showed poor to fair discrimination accuracy. Conclusions Work-related CE is specifically associated with PTSD. Focusing on the variety of exposures may be a simple and effective strategy to predict PTSD in FRs. Further research on sensitivity and specificity of exposure indexes, preferably examined prospectively, is needed and could lead to early identification of individuals at risk.
AB - Background and objectives Cumulative exposure to work-related traumatic events (CE) is a foreseeable risk for psychiatric disorders in first responders (FRs). Our objective was to examine the impact of work-related CE that could serve as predictor of posttraumatic stress disorder (PTSD) and/or depression in FRs. Design Cross-sectional examination of previous CE and past-month PTSD outcomes and depression in 209 FRs. Methods Logistic (probable PTSD; probable depression) and Poisson regressions (PTSD score) of the outcomes on work-related CE indexes, adjusting for demographic variables. Differences across occupational groups were also examined. Receiver operating characteristic analysis determined the sensitivity and specificity of CE indexes. Results All indexes were significantly and differently associated with PTSD; associations with depression were non-significant. The index capturing the sheer number of different incidents experienced regardless of frequency (‘Variety’) showed conceptual, practical and statistical advantages compared to other indexes. In general, the indexes showed poor to fair discrimination accuracy. Conclusions Work-related CE is specifically associated with PTSD. Focusing on the variety of exposures may be a simple and effective strategy to predict PTSD in FRs. Further research on sensitivity and specificity of exposure indexes, preferably examined prospectively, is needed and could lead to early identification of individuals at risk.
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U2 - 10.1016/j.comppsych.2016.12.003
DO - 10.1016/j.comppsych.2016.12.003
M3 - Article
C2 - 28161583
AN - SCOPUS:85011659734
SN - 0010-440X
VL - 74
SP - 134
EP - 143
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
ER -