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Treating posttraumatic stress disorder in first responders: a systematic review.

Authors
Haugen-PT; Evces-M; Weiss-DS
Source
Clin Psychol Rev 2012 Jul; 32(5):370-380
NIOSHTIC No.
20041710
Abstract
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.
Keywords
Emergency-response; Emergency-responders; Emotional-stress; Job-stress; Mental-health; Mental-stress; Mental-disorders; Psychological-reactions; Psychological-stress; Psychological-disorders; Stress; Traumatic-injuries; Risk-factors; Medical-care; Medical-treatment; Sociological-factors; Police-officers; Fire-fighters; Paramedical-services
Contact
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
CODEN
CPSRDZ
Publication Date
20120701
Document Type
Journal Article
Email Address
peter.haugen@nyumc.org
Funding Type
Cooperative Agreement
Fiscal Year
2012
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U10-OH-008223
Issue of Publication
5
ISSN
0272-7358
Source Name
Clinical Psychology Review
State
NY
Performing Organization
New York University School of Medicine
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