Cumulative exposure to work-related traumatic events and current post-traumatic stress disorder in New York City's first responders.
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.



Cross-sectional examination of previous CE and past-month PTSD outcomes and depression in 209 FRs.



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.



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.



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.
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: geronazl@nyspi.columbia.edu.
Lupo
L
Geronazzo-Alman
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: eisenbe@nyspi.columbia.edu.
Ruth
R
Eisenberg
The Center on Health, Aging, and Disability, University of Illinois at Urbana-Champaign, 1206 South 4th Street, Champaign, IL. Electronic address: sashen2@illinois.edu.
Sa
S
Shen
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: DuarteC@nyspi.columbia.edu.
Cristiane S
CS
Duarte
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: MUSAG@nyspi.columbia.edu.
George J
GJ
Musa
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: WicksJ@nyspi.columbia.edu.
Judith
J
Wicks
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: fanb@nyspi.columbia.edu.
Bin
B
Fan
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: DoanT@nyspi.columbia.edu.
Thao
T
Doan
Department of Psychiatry, McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA 02478.. Electronic address: gguffantimasetti@mclean.harvard.edu.
Guia
G
Guffanti
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: bresnah@nyspi.columbia.edu.
Michaeline
M
Bresnahan
Department of Psychiatry, New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032. Electronic address: HOVEN@nyspi.columbia.edu.
Christina W
CW
Hoven
D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D060731:Emergency Responders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D016273:Occupational Exposure; D011897:Random Allocation; D012042:Registries; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*