A Cognitive Behavioral Model of First Responder Posttraumatic Stress Disorder

Abstract

First responders face significant risks with respect to their mental health including exposure to traumatic events and subsequent development of posttraumatic stress disorder (PTSD). There are many established psychological treatment guidelines for PTSD, but there are reasons to believe that first responders differ significantly from the general population and would benefit from a targeted approach to treatment planning. The authors present a cognitive behavioral model of first responder PTSD, which integrates important factors related to this population as well as an illustrative case study. This model may be useful in identifying stuck points, maintenance factors, and targets for psychological treatment.

The effects of emergency medical service work on the psychological, physical, and social well-being of ambulance personnel: a systematic review of qualitative research

“…However, they are arguably 'the forgotten profession' within the healthcare system. Their contribution to the health and wellbeing of the community and to healthcare is overshadowed by more dominant dialogues and debates about community services, acute care and hospital emergency department tensions and resource demands [1][2][3][4].…”

“…In Australia, the nature of ambulance work, the uncontrolled and often unpredictable environments, the everyday experience of trauma, and the cumulative nature of that trauma all play a key role in the development and impact of mental distress and psychological injury [3][4][5]. In addition to the nature of the work, organisational and occupational factors such as workload, work demands, shift work, limited time for debriefing or downtime, the hierarchical nature of supervision, and the lack of recognition are clearly shown to have effects on the well-being of ambulance personnel that are as significant as, if not greater than, the nature of the work itself [3,5,6]. This paper examines the peer-reviewed qualitative research to outline the effect of emergency medical response work on the psychological, psychosocial, and physical health of paramedics, ambulance officers, ambulance volunteers, and call-takers.…”

Effect of selected factors related to emotions and general health on the health behaviours of paramedics

“…For each subscale, six questions were defined, where participants could identify their behaviour on a five-point (1-5) Likert scale. Furthermore, stens (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) were also defined to score the total results obtained separately for men and women. The reliability of the tool was examined through calculating Cronbach's alpha, which was equal to 0.90 for the overall questionnaire, 0.82 for the positive mental attitude subscale, 0.68 for the prophylactic behaviour subscale, 0.82 for the heathy eating subscale and 0.65 for the health practices subscale (Tab.…”

“…life-threatening situations, as well as serious injuries and death. The daily experiencing of trauma and accumulation of stressogenic events play a significant role in the development of mental disorders or injuries, including Post Traumatic Stress Disorder (PTSD) [7,8,9,10].…”

Spirituality in the line of duty: Perspectives from first responders with acute posttraumatic stress disorder and alcohol use disorder.

“…Experiencing frequent PTEs in the context of barriers to care and unique cultural considerations among first responders (Bowers et al, 2022; Jones et al, 2020; Lanza et al, 2018) have led to critical unmet mental health needs among this population (Substance Abuse & Mental Health Services Administration, 2018). First responders have an elevated risk of suicide as well as particularly high risk of experiencing posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD, Cheng et al, 2018). Specifically, estimates of PTSD and AUD among first responders range from 15% to 26% and 34% to 58%, respectively (Jones, 2017; Jones et al, 2018; Kessler et al, 2005), with an overlap of these disorders being up to 46% (Kaufman et al, in press).…”