The mental health burden identified in this study plays an important role for emergency responders after terrorist attacks. Differences between occupational groups may be attributable to differences in tasks that responders perform during acute incidents. The presence of these differences 3 months after the incident suggests that these are at least medium-term conditions. This study may inform the development of treatments and policies and it thus recommended to develop a multi-level assessment and treatment programme that is gender- and occupation-specific.

In a pilot study, female emergency personnel showed increased paranoid ideation following a terror attack. This newly designed confirmatory study aims to replicate these previously found gender-specific results and investigate the progression of effects after 2 years. Participants were exposed and unexposed emergency personnel (n = 120). Exposed female versus exposed male personnel showed higher paranoid ideation at both time points. There was a group × time interaction effect in paranoid ideation: paranoid ideation increased over time in the exposed versus the unexposed female group. The same effect was observed with exposed female emergency personnel showing a significant 2-year post-deployment increase compared with the total group including unexposed female as well as exposed and unexposed male emergency personnel. There is, as yet, no conclusive explanation for this difference. Sexual harassment in a male-dominated profession may be a vulnerability factor. Differentiated preparation and follow-up for emergency responders is recommended moving towards health-related equality.

In aging humans, aerobic exercise interventions have been found to be associated with more positive or less negative changes in frontal and temporal brain areas, such as the anterior cingulate cortex (ACC) and hippocampus, relative to no-exercise control conditions. However, individual measures such as gray-matter (GM) probability may afford less reliable and valid conclusions about maintenance or losses in structural brain integrity than a latent construct based on multiple indicators. Here, we established a latent factor of GM structural integrity based on GM probability assessed by voxel-based morphometry, magnetization transfer saturation, and mean diffusivity. Based on this latent factor, we investigated changes in structural brain integrity during a six-month exercise intervention in brain regions previously reported in studies using volumetric approaches. Seventy-five healthy, previously sedentary older adults aged 63–76 years completed an at-home intervention study in either an exercise group (EG; n = 40) or in an active control group (ACG; n = 35). Measures of peak oxygen uptake (VO2peak) taken before and after the intervention revealed a time-by-group interaction, with positive average change in the EG and no reliable mean change in the ACG. Significant group differences in structural brain integrity changes were observed in the right and left ACC, right posterior cingulate cortex (PCC), and left juxtapositional lobule cortex (JLC). In all instances, average changes in the EG did not differ reliably from zero, whereas average changes in the ACG were negative, pointing to maintenance of structural brain integrity in the EG, and to losses in the ACG. Significant individual differences in change were observed for right ACC and left JLC. Following up on these differences, we found that exercising participants with greater fitness gains also showed more positive changes in structural integrity. We discuss the benefits and limitations of a latent-factor approach to changes in structural brain integrity, and conclude that aerobic fitness interventions are likely to contribute to brain maintenance in old age.

Objective:The most common crisis intervention used with German rescue workers is Critical Incident Stress Management (CISM). Results regarding its effectiveness are inconsistent. A negative reinforcement of avoidance, due to premature termination of strong emotions during the Critical Incident Stress Debriefing (CISD), may explain this. The effectiveness of the CISD after terror attacks in Germany has not yet been investigated.Methods:All emergency responders deployed at the terror attack on Breitscheidplatz in Berlin were invited to take part in the study; 37 of the N = 55 participants had voluntarily participated in CISD; 18 had not.Results:Participants with CISD showed lower quality of life in psychological health and higher depressive symptomatology. Of these, females had lower quality of life in social relationships, whereas males showed more posttraumatic stress symptoms. Emergency responders from non-governmental organizations had higher phobic anxiety. Emergency medical technicians showed more somatic and depressive symptoms.Conclusion:There is no conclusive explanation for why rescue workers with CISD score worse on certain measures. It is possible that CISD has a harmful influence due to negative reinforcement, or that there was a selection effect. Further research differentiating occupational group, sex, and type of event is necessary.

Emergency service personnel who respond to terrorist attacks may experience persistent stress following the event. This occupational stress must be examined in order to develop occupation-specific response preparation and follow-up measures. An explorative pilot study examined the occupational stress-related effects of the 2016 terrorist attack on Breitscheidplatz in Berlin on emergency service personnel. The present study examines whether the results of the pilot study can be replicated and whether the effects changed after 2 years. The participants were 60 emergency personnel (including 11 police officers and 24 firefighters) who were deployed to the attack, and a control group of 60 personnel (including 37 police officers and 21 firefighters) who were not deployed. Data on stress, quality of life, and current mental state were gathered 3 to 4 months after the attack and 18 to 21 months after the first survey. The data showed that police officers who responded to the attack had significantly higher levels of aggression and hostility at both time points, and firefighters had significantly lower levels of environmental quality of life at both time points. Quality of life in terms of physical health for firefighters could not be replicated. Due to the different types of stress experienced by emergency service personnel, a differentiated approach is necessary. More specific preparation and follow-up measures are necessary to counteract persistent stress. Further research in this area could lead to specific predeployment and postdeployment training measures.