Posttraumatic Stress Symptoms and Alcohol‐Related Outcomes Among Municipal Firefighters

Abstract

This study examined levels of posttraumatic stress symptoms (PTSS) and relationships between PTSS and alcohol-related outcomes in a near census of municipal firefighters. The study also assessed substance-use coping and drinking to cope as potential mediators of such outcomes. Firefighters (N = 740) completed measures that assessed PTSS, alcohol risk behaviors, alcohol problems, drinking motives, and coping with stress. Results showed that 32.4% of firefighters reported significant levels of PTSS using National Center for PTSD (2014) screening cutoff scores. Correlational analysis showed that PTSS was related to at-risk drinking (r = .18) and alcohol-related problems (r = .33), as well as use of maladaptive coping strategies (r = .58) and substance use coping (r = .40). Structural analyses comparing multiple alternative models suggested that a model that included substance use coping and drinking to cope as mediators of the association between PTSS and problem drinking provided the best fit to the data. Tests of multigroup invariance confirmed this model. Overall, PTSS were common in this population and they predicted maladaptive coping patterns and alcohol-related consequences. One implication of these findings is that fire departments might consider adding or enhancing screening and treatment options for PTS, alcohol misuse, or both.

Examination of a novel measure of trauma‐related drinking to cope

“…This difference between high rates of endorsement of general drinking to cope motives and lower endorsement of drinking to cope with PTSD symptoms specifically confutes the common misconception tainting the self-medication literature to date that drinking to cope with negative affect is synonymous with drinking to cope with traumarelated symptoms specifically. This finding suggests that it is possible the relationship between coping drinking motives and PTSD has been substantially overestimated by previous research (e.g., Grayson & Nolen-Hoeksema, 2005;Kaysen et al, 2007;McCabe, Mohr, Hammer, & Carlson, 2019;Tomaka, Magoc, Morales-Monks, & Reyes, 2017). Moreover, when comparing the frequency distributions of TRD and DMQ-Cope endorsement among PTSD and at-risk alcohol cases versus controls, the distributions of TRD and DMQ-Cope were substantially more dispersed among cases compared to controls, which demonstrated high positive skewness and kurtosis.…”

A Relational Model for Stress: A Systematic Review of the Risk and Protective Factors for Stress-Related Diseases in Firefighters

“…Most studies began by mentioning the scarcity of research on topics related to traumatic stress in firefighters. The analyzed articles varied in the focus chosen to address the consequences of repeated exposure to critical incidents, ranging from alcohol abuse [26,49] and suicidal ideation and behaviors [10,11,16,35] to the influence of social support and organizational belongingness [41], and post-traumatic growth [36,38]. Regardless of the approach, all studies agreed that professionals who work in crisis and catastrophe scenarios are continually exposed to potentially traumatic events, configuring a high-risk group for the development of stress-related diseases [14,15,25].…”

“…However, the gaps mentioned in most studies remain due to the lack of longitudinal studies comparing firefighter samples, including clinical monitoring, which does not allow the reliability of the prevalence rate of PTSD and other stress-related diseases among firefighters. The reasons for the use of cross-sectional research with self-report questionnaires are usually justified by being preliminary surveys aiming to encourage the discussion and interest of other researchers, advertising the need to replicate the research in larger samples, including control groups and with more appropriate techniques to the specificities intended to be investigated [10,11,13,16,20,35,41,49,54].…”

“…Studies have indicated that firefighters constitute a group with a high prevalence of alcohol abuse, of around 30%, suggesting that substance abuse is a maladaptive coping strategy. According to these findings, firefighters may cope with their pain by consuming alcohol, both as a means of relieving their symptoms and to effectively function during their next shift [26,35,49,50].…”

Behavioral Health of Gulf Coast Residents 6 Years After the Deepwater Horizon Oil Spill: The Role of Trauma History

“…Furthermore, the association between DHOS exposure and alcohol use has received little attention. There is a large body of literature showing that trauma exposure is a significant risk factor for alcohol abuse and dependence, [23][24][25][26] in part because individuals may habitually use alcohol to cope with traumarelated stress and other negative emotions, and their use of alcohol can become problematic over time. 25,27 We are aware of only one study that has examined alcohol use patterns in Gulf Coast residents following the DHOS.…”