Mental health and post-traumatic stress disorder in firefighters: an integrated analysis from an action research study

Abstract

IntroductionThe presence of post-traumatic stress disorder (PTSD) symptomatology in firefighters is an ever-pressing issue that requires close attention for adequate interventions. The present study investigated PTSD and global psychopathology prevalence in a sample of highly risk-exposed Portuguese firefighters, collected after the widespread deadly wildfires in 2017 that ravaged the country. Following an action research approach, the aim of this study was to depict this sample and examine the impact of cumulative adverse experiences on their mental health, which is a phenomenon worth attention.MethodFrom an initial sample of 283 firefighters who manifested interest in participating, a total of 139 firefighters from the Coimbra District, of whom 130 unequivocally experienced a potentially traumatic/adverse event as a firefighter, completed BSI (to obtain indicators on psychopathology), QEPAT (an inventory of adverse events possibly experienced as a firefighter), and PCL-5 (a measure of PTSD symptomatology) through an online survey during the year 2018 by the Regional Medical Organization, as proposed and supervised by the local Centre for Prevention and Treatment of Psychological Trauma (CPTTP).ResultsWe found a global prevalence of 8.6% of possible PTSD and 14.4% of possible psychopathology (n = 139). When considering only firefighters who unequivocally reported a potentially traumatic/adverse event as a firefighter (n = 130), 9.2% present possible PTSD, and 13.8% present possible global psychopathology. This sample experienced a mean of 28 adverse events during firefighting work. Linear regressions (n = 118) demonstrated that the perceived severity of the most traumatic event reported and the experience of more adverse events were both related to an increase in PTSD symptomatology. Global psychopathology was associated with PCL-5 scores, with an emphasis on paranoid ideation, hostility, depression, anxiety, and phobic anxiety.DiscussionThe severe wildfires of 2017 did not impact PTSD scores in this sample (collected the year after), suggesting that cumulative adverse events are more important than particular episodes. However, the number of reported events was related to PTSD scores. These results can be used to develop interventions that target all firefighters by addressing risk and protective factors. This action research study motivated specialized aid for firefighters involved in this study.

Neural underpinnings of ethical decisions in life and death dilemmas in naïve and expert firefighters

“…Finally, we speculate that correlations of changes in bold activity with behaviour may reflect mechanisms of plasticity that if maladaptive may eventually lead to post-traumatic stress disorder 67 . This would be consistent with the notion that firefighters are a population at risk for post-traumatic stress disorder and psychopathology 12 .…”

“…It is well known that firefighters are a population at special risk of developing post-traumatic stress disorder and other stress-related disorders 11 . In fact, in a recent study, a global prevalence of 8.6% possible post-traumatic stress disorder and 14.4% of possible psychopathology was found in a sample of 139 firefighters 12 . This implies that coping abilities are continuously challenged which might potentially impact on decision-making.…”

Longitudinal assessment of psychological distress and its determinants in a sample of firefighters based in Montreal, Canada

“…Regarding the first objective, 20.7% of participants experienced a clinical distress for at least 1 week, that in many cases consisted of depressive symptoms combined with anxiety and post-traumatic symptoms that frequently crossed the cutoff within the first 4 weeks of monitoring and tended to resolve by the end of the observation period. These results provide a further estimate of firefighters' mental health problems, adding to both studies that have estimated higher rates (Carleton et al, 2018;Theleritis et al, 2020) and those that identify lower rates (Oliveira et al, 2023). some hypotheses can be developed to explain the differences with previous studies.…”