A prospective study of firefighters’ PTSD and depression symptoms: The first 3 years of service.

Abstract

Objective: Firefighters are an important sample of convenience to study traumatic exposure and symptom development. This study assessed trauma exposure inside and outside of fire service, diagnosed posttraumatic stress disorder (PTSD) and associated disorders using clinical interviews and self-report measures, then tested the hypothesis that trauma exposure would predict distress in firefighters over the first 3 years in service. Method: In total, 322 professional firefighter recruits were assessed during academy training and through their first 3 years of service. Diagnostic assessments were conducted by psychologists annually, and symptom checklists were completed by telephone every 4 months. Results: Firefighter recruits were exposed to approximately nine potentially traumatic events (PTEs) in the first 3 years of fire service, with 66% of these events occurring in the line of duty. Very few (3%) developed diagnoses of PTSD, major depression, or generalized anxiety disorder. Models of distress supported a trait model of distress. Distress was stable within individuals over time, and although those reporting more distress also reported more trauma exposure, variation in distress over time was not predicted by trauma exposure. Conclusions: Professional firefighters experience frequent exposure to potentially traumatic events during their early careers. This exposure, although large, does not result in a large proportion of mental health diagnoses. Distress was consistent and low, which provides evidence of the resilient nature of those selecting a career in emergency service. Future work is needed to understand the disconnection between the current rigorously collected prospective data and the existing literature regarding the increased risk of PTSD and associated disorders in fire service.

Emotional processing prospectively modulates the impact of anxiety on COVID-19 pandemic-related post-traumatic stress symptoms: an ERP study

“…Altogether, the above discussed findings indicate that, contrarily to the literature on risk factors for PTSS (e.g., Blanchard et al, 1994 ; Brady et al, 2000 ; Edmonsdson et al, 2014 ; Gulliver et al, 2021 ), pre-trauma anxiety and depressive symptoms did not have a direct effect in predicting PTSS. Instead, anxiety symptoms emerge as a relevant measure in the prediction of PTSS only when motivated attention to emotional stimuli is taken into account.…”

“…Several predictors of PTSD onset have been identified, including a family history of psychopathology, poor social support, maladaptive emotion regulation strategies, and prior depressive and anxiety symptoms ( Brewin et al, 2000 ; Breslau et al, 1991 ; Fauerbach et al, 1997 ; Larsson, Bäckström, & Johanson, 2008 ; North, Smith, & Spitznagel, 1994 ; Ozer et al, 2003 ; Powers et al, 2014 ; Wild et al, 2016 ; Shalev et al, 1998 ). Particularly, depressive and anxiety symptoms, repeatedly reported in individuals suffering from PTSD ( Armour et al, 2014 ; Brady et al, 2000 ), were suggested to prospectively increase the risk to develop PTSD following a traumatic event ( Blanchard et al, 1994 ; Brady et al, 2000 ; Edmonsdson et al, 2014 ; Gulliver et al, 2021 ). Although the underlying mechanism for this vulnerability is still unclear, it can be hypothesized that differential patterns of attentional processing of emotional (pleasant and unpleasant) content may represent a measure modulating the link between pre-trauma anxiety and depressive symptoms and PTSS onset ( Dickey et al, 2021 ; Lieberman et al, 2017 ).…”

PTSD symptoms, depressive symptoms, and subjective cognitive concerns in WTC‐exposed and non‐WTC‐exposed firefighters

“…To date, the literature about risk factors for PTSD in firefighters is mixed. Much of the research suggests that repeated exposure to stress increases the risk of developing stress‐related diseases 50–52 . However, there is also evidence to support the idea that professional or career firefighters have greater resilience to stress‐related diseases due to better training and experience compared to volunteers 51,52 .…”

“…Much of the research suggests that repeated exposure to stress increases the risk of developing stress-related diseases. [50][51][52] However, there is also evidence to support the idea that professional or career firefighters have greater resilience to stress-related diseases due to better training and experience compared to volunteers. 51,52 Our data show that PTSD and depressive symptom scores b Defined using participant responses to the question "In the past 12 months, how often have you had six or more drinks on one occasion?…”

Longitudinal Associations between Hair Cortisol, PTSD Symptoms, and Sleep Disturbances in a Sample of Firefighters with Duty-related Trauma Exposure

“…Despite these detrimental effects of occupational trauma, firefighters experience fewer posttrauma symptoms on average than individuals from the general population involved in the same incidents (Gulliver et al, 2021;Schnell et al, 2020). These effects may emerge because only individuals with high trait resilience choose this profession or due to specific characteristics of occupational trauma (e.g., psychological preparedness).…”