Psychological interventions for post-traumatic stress injuries among public safety personnel: A systematic review and meta-analysis

“The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs.“

Article 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 post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear.

Objectives: The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs.

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, post-traumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen’s d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, 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 behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (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; 95% CI − 1.81, − 0.65; 7 studies; I² = 81%), anxiety (− 0.76; 95% CI − 1.28, − 0.24; 3 studies; I² = 47%), and depression (d = − 1.10; 95% CI − 1.62, − 0.58; 5 studies; I² = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = − 1.29 [− 2.31, − 0.27]), anxiety (d = − 0.82 [− 1.20, − 0.44]), and depression (d = − 0.46 [− 0.77, − 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions.

Conclusions: There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP.

Systematic review registration: PROSPERO: CRD42019133534.”

—Description from publisher

Article Access

Open Access 

Bahji, A., Di Nota, P. M., Groll, D., Carleton, R. N., & Anderson, G. S. (2022). Psychological interventions for post-traumatic stress injuries among public safety personnel: A systematic review and meta-analysis. BMC Systematic Reviews, 11:255. Open access: https://doi.org/10.1186/s13643-022-02112-1