Methodological correlates of variability in the prevalence of posttraumatic stress disorder in high‐risk occupational groups: A systematic review and meta‐regression

Abstract

Background: Although numerous studies have reported on PTSD prevalence in high-risk occupational samples, previous meta-analytic work has been severely limited by the extreme variability in prevalence outcomes. Methods:The present systematic review and meta-regression examined methodological sources of variability in PTSD outcomes across the literature on high-risk personnel with a specific focus on measurement tool selection. Results:The pooled global prevalence of PTSD in high-risk personnel was 12.1% [6.5%, 23.5%], and was similar to estimates obtained in other meta-analytic work.However, meta-regression revealed that PTSD prevalence differed significantly as a function of measurement tool selection, study inclusion criteria related to previous traumatic exposure, sample size, and study quality. PTSD prevalence estimates also differed significantly by occupational group and over time, as has also been reported in previous work, though exploratory examination of trends in measurement selection across these factors suggests that measurement strategy may partially explain some of these previously reported differences.Conclusions: Our results highlight a pressing need to better understand the role of measurement strategies and other methodological choices in characterizing variable prevalence outcomes. Understanding the role of methodological variance will be critical for work attempting to reliably characterize prevalence as well as risk and protective factors for PTSD.

Work outcomes in public safety personnel after potentially traumatic events: A systematic review

“…In Canada, PSP occupations are currently defined as any occupation fulfilling duties related to public safety, 1 including but not limited to emergency responders, corrections, and individuals working in support of these fields, such as emergency dispatchers. * As an inherent feature of their occupational duties, PSP report much higher levels of exposure to potentially traumatic events (PTEs) than the general population, 2 where PTE is defined as direct or indirect experiences of actual or threatened death, serious injury, or violence, 3 and a wealth of converging evidence now suggests that PSP broadly demonstrate higher prevalence rates of posttraumatic stress disorder (PTSD) and other trauma-related symptoms including depression and anxiety disorders, among others, [4][5][6][7][8][9][10] though occupation-specific differences in prevalence have been observed. 4,10 However, there is little evidence to date on the impact of PTE exposure or trauma-related symptoms on occupational functioning in PSP.…”

“…* As an inherent feature of their occupational duties, PSP report much higher levels of exposure to potentially traumatic events (PTEs) than the general population, 2 where PTE is defined as direct or indirect experiences of actual or threatened death, serious injury, or violence, 3 and a wealth of converging evidence now suggests that PSP broadly demonstrate higher prevalence rates of posttraumatic stress disorder (PTSD) and other trauma-related symptoms including depression and anxiety disorders, among others, [4][5][6][7][8][9][10] though occupation-specific differences in prevalence have been observed. 4,10 However, there is little evidence to date on the impact of PTE exposure or trauma-related symptoms on occupational functioning in PSP. Further complicating this issue is the empirical difficulty of isolating unique, relative contributions of PTE and trauma-related symptoms to PSP wellbeing given the high rate of their co-occurrence and the related likelihood that these are not entirely orthogonal constructs when considering potential impacts on occupational functioning.…”

Diosgenin normalization of disrupted behavioral and central neurochemical activity after single prolonged stress

“…Symptoms associated with PTSD are dissociation, recurrent nightmares, recalls, intrusive thoughts, increased startle reaction, poor focus, interrupted sleep, and severely negative emotional states ( Sherin and Nemeroff, 2022 ). Globally, the prevalence of PTSD among those who were exposed to trauma has been estimated to be present in 5.6% of the general population ( White et al, 2023 ) while others have approximated it to be 9.2%–13.6% ( Atwoli et al, 2015 ). During the COVID-19 pandemic, the overall pooled estimated incidence rate of PTSD from a total of 24 countries was as high as 17.52% ( Yunitri et al, 2022 ).…”