Table 2.
Overview of all exposure–outcome effect sizes from qualitative analyses, with exposures categorised according to DSM-5 criteria
| DSM-5 criterion | Exposure category | Exposure | Effect size (OR (95% CI)) |
| Direct exposure | Undergoing an event | Work-related threats20 | 1.10 (1.04 to 1.15) |
| Work-related violence20 | 1.02 (0.98 to 1.06) | ||
| Previous disaster experience23 | 1.4 (1.2 to 1.6) | ||
| One injury sustained during the 9/11 attacks29 | 1.1 (0.6 to 2.0) | ||
| Two or more injuries sustained during the 9/11 attacks29 | 1.4 (0.6 to 3.4) | ||
| Participation in abusive violence33 | 3.32 (1.81 to 6.08) | ||
| Robberies during working life34 | 1.18 (0.97 to 1.44) | ||
| Physical contacts with robbers34 | 0.86 (0.32 to 2.28) | ||
| Scuffle (taking part or being present)34 | 1.92 (0.63 to 5.79) | ||
| Being injured during the robbery34 | 1.28 (0.31 to 5.21) | ||
| Discharged weapon on deployment36 | 1.48 (0.61 to 3.60) | ||
| Experience of life-threatening danger42 | 4.32 (2.89 to 6.48) | ||
| Major property loss42 | 3.45 (2.28 to 5.23) | ||
| Escape from tsunami42 | 5.65 (3.27 to 9.74) | ||
| Life threatening war45 | 1.91 (1.07 to 3.24) | ||
| Conflict with passengers46 | 3.21 (1.14 to 9.03) | ||
| Felt in great danger of being killed48 | 3.44 (2.50 to 4.72) | ||
| Exposure to blast50 | 4.72 (2.9 to 7.7) | ||
| Encountering explosive devices54 | 1.26 (0.95 to 1.66) | ||
| Cumulative exposure | Prolonged work at the WTC site23 | 2.0 (1.7 to 2.3) | |
| Length of deployment37 | 0.97 (0.92 to 1.03) | ||
| ≥5 critical cases per call for traumatic surgeons43 | 7 (1.1 to 8) | ||
| ≥7 call duties a month for traumatic surgeons43 | 3.8 (0.9 to 7.2) | ||
| ≥15 operative cases per month43 | 2.8 (0.4 to 3.2) | ||
| Cumulative years deployed in navy47 | 2.04 (1.93 to 2.15) | ||
| Cumulative years deployed in army47 | 1.74 (1.71 to 1.76) | ||
| No of combat exposures48 | 1.62 (1.46 to 1.79) | ||
| Two combat exposure deployment48 | 1.37 (1.17 to 1.61) | ||
| Three combat exposure deployment48 | 1.30 (0.94 to 1.82) | ||
| Two deployments48 | 1.00 (1.00 to 1.01) | ||
| Three deployments48 | 1.00 (0.99 to 1.01) | ||
| One exposure (compared with no exposure)50 | 4.67 (3.1 to 7.1) | ||
| Two or more deployments (compared with no exposure)50 | 6.15 (4.4 to 8.7) | ||
| Deployment length 1–3 months53 | 1.53 (1.37 to 1.70) | ||
| Deployment length ≥3 months53 | 2.64 (2.33 to 2.99) | ||
| Low frequency of violence (compared with no violence)55 | 4.0 (1.0 to 16.3) | ||
| Medium frequency of violence (compared with no violence)55 | 5.9 (1.4 to 24.2) | ||
| High frequency of violence (compared with no violence)55 | 6.5 (1.6 to 25.6) | ||
| Exposure severity | Combat exposure scale33 | 1.98 (1.50 to 2.62) | |
| Severity of battles45 | 1.01 (0.67 to 1.35) | ||
| Max. mild violence (compared with no violence)55 | 3.8 (0.3 to 46.2) | ||
| Max. threats of violence (compared with no violence)55 | 5.4 (1.2 to 24.2) | ||
| Max. moderate violence (compared with no violence)55 | 2.6 (0.6 to 10.8) | ||
| Max. severe violence (compared with no violence)55 | 6.5 (1.6 to 26.0) | ||
| Witnessing the trauma | Perceived life threat56 | 1.01 (0.63 to 1.64) | |
| Observation of abusive violence33 | 8.36 (4.56 to 15.35) | ||
| Presence during attack38 | 9.3 (6.1 to 14.2) | ||
| Witnessing of plant explosions42 | 2.09 (1.43 to 3.06) | ||
| Person under train experience46 | 1.54 (0.52 to 4.55) | ||
| One person under train experiences46 | 1.77 (0.31 to 4.47) | ||
| Two or more person under train experiences46 | 2.36 (0.57 to 9.70) | ||
| Sudden train stop46 | 3.66 (0.82 to 16.4) | ||
| Near train accident46 | 8.81 (1.96 to 39.3) | ||
| Damage to train46 | 1.71 (0.48 to 6.14) | ||
| Colleague exposed | Person under train experience of colleague46 | 0.55 (0.12 to 2.47) | |
| Indirect exposure to aversive details | Aftermath of battle37 | 1.03 (1.00 to 1.06) | |
| Morning of 9/11 (compared with >3 days)27 | 4.0 (2.5 to 6.6) | ||
| Afternoon of 9/11 (compared with >3 days)27 | 2.1 (1.3 to 3.3) | ||
| Day 2 (compared with >3 days)27 | 1.4 (0.9 to 2.4) | ||
| Morning of 9/11 (compared with >3 days)23 | 2.0 (1.3 to 2.9) | ||
| Afternoon of 9/11 (compared with >3 days)23 | 1.1 (0.8 to 1.5) | ||
| Exposure to aftermath of battle56 | 1.81 (1.08 to 3.06) | ||
| Other exposures | Stress | High deployment stress21 | 3.52 (2.94 to 4.21) |
| Deployment concerns summary score28 | 1.01 (0.98 to 1.04) | ||
| Worried by other issues related to robbery34 | 2.64 (0.95 to 7.36) | ||
| Unit cumulative high deployment stress rate (marine)47 | 1.04 (1.03 to 1.05) | ||
| Unit cumulative high deployment stress rate (army)47 | 1.05 (1.04 to 1.06) | ||
| Time since event | Months since most recent deployment28 | 1.00 (0.98 to 1.02) | |
| Time since return from deployment (up to 2 years)32 | 1.18 (0.75 to 1.86) | ||
| Time since return from deployment (up to 3 years)32 | 1.80 (1.05 to 3.10) | ||
| Time since return from deployment (up to 4 years)32 | 1.88 (0.98 to 3.62) | ||
| Time since return from deployment (up to 5 years)32 | 1.53 (0.92 to 2.55) | ||
| Time since return from deployment (up to 6.5 years)32 | 1.89 (0.99 to 3.60) | ||
| Dwell to deployment ratio (1:1 vs <1:1)48 | 0.83 (0.60 to 1.13) | ||
| Dwell to deployment ratio (2:1 vs <1:1)48 | 0.47 (0.32 to 0.70) | ||
| Other | Supervising responsibilities23 | 2.2 (1.7 to 2.9) | |
| Discrimination/slurs42 | 5.72 (3.37 to 9.71) | ||
| Duties with radiation exposure risk53 | 1.08 (0.97 to 1.20) |
OR with 95% CI are shown.
DSM-5, Diagnostic and Statistical Manual of Mental Disorders, fifth edition; WTC, World Trade Center.