Table 2

Overview of all exposure–outcome effect sizes from qualitative analyses, with exposures categorised according to DSM-5 criteria

DSM-5 criterionExposure categoryExposureEffect size (OR (95% CI))
Direct exposureUndergoing an eventWork-related threats201.10 (1.04 to 1.15)
Work-related violence201.02 (0.98 to 1.06)
Previous disaster experience231.4 (1.2 to 1.6)
One injury sustained during the 9/11 attacks291.1 (0.6 to 2.0)
Two or more injuries sustained during the 9/11 attacks291.4 (0.6 to 3.4)
Participation in abusive violence333.32 (1.81 to 6.08)
Robberies during working life341.18 (0.97 to 1.44)
Physical contacts with robbers340.86 (0.32 to 2.28)
Scuffle (taking part or being present)341.92 (0.63 to 5.79)
Being injured during the robbery341.28 (0.31 to 5.21)
Discharged weapon on deployment361.48 (0.61 to 3.60)
Experience of life-threatening danger424.32 (2.89 to 6.48)
Major property loss423.45 (2.28 to 5.23)
Escape from tsunami425.65 (3.27 to 9.74)
Life threatening war451.91 (1.07 to 3.24)
Conflict with passengers463.21 (1.14 to 9.03)
Felt in great danger of being killed483.44 (2.50 to 4.72)
Exposure to blast504.72 (2.9 to 7.7)
Encountering explosive devices541.26 (0.95 to 1.66)
Cumulative exposureProlonged work at the WTC site232.0 (1.7 to 2.3)
Length of deployment370.97 (0.92 to 1.03)
≥5 critical cases per call for traumatic surgeons437 (1.1 to 8)
≥7 call duties a month for traumatic surgeons433.8 (0.9 to 7.2)
≥15 operative cases per month432.8 (0.4 to 3.2)
Cumulative years deployed in navy472.04 (1.93 to 2.15)
Cumulative years deployed in army471.74 (1.71 to 1.76)
No of combat exposures481.62 (1.46 to 1.79)
Two combat exposure deployment481.37 (1.17 to 1.61)
Three combat exposure deployment481.30 (0.94 to 1.82)
Two deployments481.00 (1.00 to 1.01)
Three deployments481.00 (0.99 to 1.01)
One exposure (compared with no exposure)504.67 (3.1 to 7.1)
Two or more deployments (compared with no exposure)506.15 (4.4 to 8.7)
Deployment length 1–3 months531.53 (1.37 to 1.70)
Deployment length ≥3 months532.64 (2.33 to 2.99)
Low frequency of violence (compared with no violence)554.0 (1.0 to 16.3)
Medium frequency of violence (compared with no violence)555.9 (1.4 to 24.2)
High frequency of violence (compared with no violence)556.5 (1.6 to 25.6)
Exposure severityCombat exposure scale331.98 (1.50 to 2.62)
Severity of battles451.01 (0.67 to 1.35)
Max. mild violence (compared with no violence)553.8 (0.3 to 46.2)
Max. threats of violence (compared with no violence)555.4 (1.2 to 24.2)
Max. moderate violence (compared with no violence)552.6 (0.6 to 10.8)
Max. severe violence (compared with no violence)556.5 (1.6 to 26.0)
Witnessing the traumaPerceived life threat561.01 (0.63 to 1.64)
Observation of abusive violence338.36 (4.56 to 15.35)
Presence during attack389.3 (6.1 to 14.2)
Witnessing of plant explosions422.09 (1.43 to 3.06)
Person under train experience461.54 (0.52 to 4.55)
One person under train experiences461.77 (0.31 to 4.47)
Two or more person under train experiences462.36 (0.57 to 9.70)
Sudden train stop463.66 (0.82 to 16.4)
Near train accident468.81 (1.96 to 39.3)
Damage to train461.71 (0.48 to 6.14)
Colleague exposedPerson under train experience of colleague460.55 (0.12 to 2.47)
Indirect exposure to aversive detailsAftermath of battle371.03 (1.00 to 1.06)
Morning of 9/11 (compared with >3 days)274.0 (2.5 to 6.6)
Afternoon of 9/11 (compared with >3 days)272.1 (1.3 to 3.3)
Day 2 (compared with >3 days)271.4 (0.9 to 2.4)
Morning of 9/11 (compared with >3 days)232.0 (1.3 to 2.9)
Afternoon of 9/11 (compared with >3 days)231.1 (0.8 to 1.5)
Exposure to aftermath of battle561.81 (1.08 to 3.06)
Other exposuresStressHigh deployment stress213.52 (2.94 to 4.21)
Deployment concerns summary score281.01 (0.98 to 1.04)
Worried by other issues related to robbery342.64 (0.95 to 7.36)
Unit cumulative high deployment stress rate (marine)471.04 (1.03 to 1.05)
Unit cumulative high deployment stress rate (army)471.05 (1.04 to 1.06)
Time since eventMonths since most recent deployment281.00 (0.98 to 1.02)
Time since return from deployment (up to 2 years)321.18 (0.75 to 1.86)
Time since return from deployment (up to 3 years)321.80 (1.05 to 3.10)
Time since return from deployment (up to 4 years)321.88 (0.98 to 3.62)
Time since return from deployment (up to 5 years)321.53 (0.92 to 2.55)
Time since return from deployment (up to 6.5 years)321.89 (0.99 to 3.60)
Dwell to deployment ratio (1:1 vs <1:1)480.83 (0.60 to 1.13)
Dwell to deployment ratio (2:1 vs <1:1)480.47 (0.32 to 0.70)
OtherSupervising responsibilities232.2 (1.7 to 2.9)
Discrimination/slurs425.72 (3.37 to 9.71)
Duties with radiation exposure risk531.08 (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 .