Psychological interventions for posttraumatic stress injuries among public safety personnel: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various posttraumatic stress injuries (PTSIs). There are many evidence-based psychological interventions for PTSI, but whether the interventions benefit PSP despite the repeated PPTE exposures remains unclear.Objectives The current study assessed the effectiveness and acceptability of psychological interventions of PTSI among PSP.Methods A systematic review and random-effects meta-analysis were performed on the effectiveness and acceptability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, posttraumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen’s d) and rate ratios (RR) to measure pooled effect sizes across studies. Heterogeneity was quantified using I2, and publication bias was evaluated using Egger’s test.Results The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioural therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counselling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d=-1.23), anxiety (d=-0.76), and depression (d=-1.10). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d=-1.29), anxiety (d=-0.82), and depression (d=-0.46). There were no statistically significant differences in dropout rates (RR = 1.00), suggesting high acceptability across interventions.Conclusions There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies with PSP indicates a need for additional research into treating PTSI among PSP.PROSPERO: CRD42019133534.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.018 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.016 | 0.021 |
| Bibliometrics | 0.006 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".