Coping among public safety personnel: A systematic review and meta–analysis

Abstract

Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta‐analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated‐measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized‐control trials, within‐subject interventions and observational studies. Effect sizes (Cohen's d ) at follow‐up were described in 11 studies. Separate meta‐analyses reveal small ( d < 0.2) but non‐significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow‐up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.

Psychological interventions for posttraumatic stress injuries among public safety personnel: a systematic review and meta-analysis

“…Random-effects meta-analysis models were created to pool effect sizes for each psychotherapy's effectiveness and acceptability, and the results were graphed using Forest plots. The speci c methods have been previously described [57][58][59][60][61][62]. The I 2 statistic was used to quantify heterogeneity; values greater than 50% indicated high variance [63].…”

Self-Reported Coping Strategies for Managing Work-Related Stress among Public Safety Personnel

“…Research exploring the desire, benefits, and drawbacks of developing and delivering psychoeducation to persons with mental health challenges may be important for designing PSP-specific educational resources. A meta-analysis on 36 studies found small to moderate program effect sizes for reductions in PTSI symptoms in public safety and frontline healthcare professionals and for promoting measures of well-being [ 21 ].…”

“…Researchers often operationalize coping research by examining various coping strategies (i.e., behaviours, skills, or ways of regulating thoughts and emotions) that enable recognizing and responding to operational and organizational stressors [ 21 ]. Contemporary definitions of coping strategies describe a suite of self-regulatory techniques that either confront the situation or stressor (approach strategies) or avoid the situation or stressor (avoidance strategies) [ 22 ].…”

“…There are many terms used in the literature to describe approach and avoidance strategies. Approach coping terms can include positive, adaptive, engagement, and approach coping; avoidance coping terms can include negative, maladaptive, disengagement, and avoidant coping [ 15 , 21 ].…”

“…Despite growing interest in supporting PSP mental health and well-being, there is very little research on the strategies PSP use to cope with PPTEs. A recent structured review and meta-analysis [ 21 ] found no clear evidence of a universally effective approach to develop or enhance adaptive coping strategies in PSP populations. Indeed, there are also very few measurement tools specific to PSP coping and mental health [ 31 ].…”