Treating posttraumatic stress disorder in first responders: a systematic review

Details

• Personal Author:
  Evces M ; Haugen PT ; Weiss DS
• Description:
  First responders are generally considered to be at greater risk for full or partial posttraumatic stress disorder (PTSD) than most other occupations because their duties routinely entail confrontation with traumatic stressors. These critical incidents typically involve exposure to life threat, either directly or as a witness. There is a substantial literature that has examined the risk factors, symptom presentation, course, and comorbidities of PTSD in this population. However, to our knowledge, there are no systematic reviews of treatment studies for first responders. We conducted a systematic review of the PTSD treatment literature (English and non-English) in order to evaluate such treatment proposals based on what is known about treating PTSD in first responders. We especially sought to identify randomized controlled trials (RCTs) whose primary outcome was PTSD. Our search identified 845 peer-reviewed articles of which 0.002% (n=2) were bona fide RCTs of PTSD treatment in first responders. Both studies tested a psychosocial treatment. We did not locate a single psychopharmacologic RCT for PTSD in first responders. An additional 2 psychosocial studies and 13 case or observational studies comprised the remaining extant literature. Though both RCTs showed significant large treatment effects (d=1.37; h=0.92), the literature is startlingly sparse and is not sufficient for evidence-based recommendations for first responders. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Emergencies Emergency Responders Firefighters Law Enforcement Mental Disorders Mental Health Occupational Health Risk Assessment Risk Factors Safety Stress, Psychological

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• Keywords:
  Emergency-responders Emergency-response Emotional-stress Fire-fighters Job-stress Medical-care Medical-treatment Mental-disorders Mental-health Mental-stress Paramedical-services Police-officers Psychological-disorders Psychological-reactions Psychological-stress Risk-factors Sociological-factors Stress Traumatic-injuries

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• ISSN:
  0272-7358
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  370-380
• Volume:
  32
• Issue:
  5
• NIOSHTIC Number:
  nn:20041710
• Citation:
  Clin Psychol Rev 2012 Jul; 32(5):370-380
• Contact Point Address:
  Peter T. Haugen, World Trade Center Health Program NYU School of Medicine Clinical Center of Excellence at Bellevue Hospital Center, Bellevue Hospital Center, Room A720, 462 First Ave., New York, NY 10016, USA
• Email:
  peter.haugen@nyumc.org
• Federal Fiscal Year:
  2012
• NORA Priority Area:
  Services
• Performing Organization:
  New York University School of Medicine
• Peer Reviewed:
  False
• Start Date:
  20040831
• Source Full Name:
  Clinical Psychology Review
• End Date:
  20110630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4c7e31383b3ae33650cfa8d2b168ad4a0a815bcc2cac7e0bd76f10c589b9eaaf18430c96cdf729dcd7ed02349b82a33729ebfd2a0b2fbcf75c60e9d677d6257a
• Download URL:
  https://stacks.cdc.gov/view/cdc/194201/cdc_194201_DS1.pdf
• File Type:
  [PDF - 606.20 KB ]