2215 – Cumulative exposure to work-related incidents and current posttraumatic stress disorder in new york city's first responders - 09/07/13
Doi : 10.1016/S0924-9338(13)77088-3
Résumé |
Introduction |
Several questions still exist in the literature on the relationship between cumulative exposure to work-related incidents and posttraumatic stress disorder (PTSD) in First Responders (FR).
Objectives |
To address three unanswered questions in the field.
(1) | Are different cumulative exposure scoring algorithms similarly related to PTSD? |
(2) | Is PTSD associated only with incidents rated as severe and traumatic? |
(3) | Can we identify cut-off scores of cumulative exposure that maximize sensitivity and specificity to predict PTSD? |
Aims |
To better characterize the relationship between cumulative exposure and PTSD in FR.
Methods |
The association between exposure and PTSD was examined with logistic and linear regression and with receiver operating characteristic analysis in 349 FR.
Results |
(1) | The strength of the association between PTSD and total cumulative exposure indexes varied across different scoring algorithms. |
(2) | Compared to total cumulative exposure indexes and to sub-scores of exposure to non-traumatic and/or less severe incidents, sub-scores indexing exposure to severe traumatic events only were more strongly and significantly associated with PTSD. |
(3) | The use of two cut-off scores maximizes sensitivity and specificity to predict PTSD. |
Conclusion |
(1) | The relationship between current PTSD and cumulative exposure is partially dependent on the approach used to quantify exposure. |
(2) | Focusing on the assessment of cumulative exposure to severe traumatic events is sufficient to predict PTSD, and might be more useful and effective in research and clinical decision-making. |
(3) | Sensitivity and specificity of exposure scores might help improve secondary prevention (early detection and effective intervention) of individuals at risk. |
© 2013
Elsevier Masson SAS. Tous droits réservés.
Vol 28 - N° S1
P. 1 - 2013 Retour au numéro
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