Rescuers at Risk: Posttraumatic Stress Symptoms Among Police Officers, Fire Fighters, Ambulance Personnel, and Emergency and Psychiatric Nurses

Abstract

Emergency personnel and rescue workers may be at a risk of posttraumatic stress symptoms (PTSS) due to exposure to trauma and work-related stressors. Though rescuers of different professions are often engaged in the same type of emergency, they have different tasks and responsibilities and receive different training in coping with traumatic events and stress; hence, we speculated that the salience of identified risk factors for PTSS vary across their respective professions. The present cross-sectional survey aimed to identify influencing variables on PTSS, well-being, and suicidal ideation that can act differently across professions of rescue workers and emergency personnel. In this anonymous online study, data from 1,002 rescue workers and emergency personnel in Switzerland, were collected: 499 police officers, 239 firefighters, 97 ambulance personnel, and 85 emergency and 82 psychiatric nurses. PTSS, coping strategies, well-being, suicidal ideation, previously experienced and work-related trauma, and self-efficacy were measured and analyzed using multiple regression and structural equation modeling (SEM). The prevalence of suspected posttraumatic stress disorder varied across the professions, ranged from 8% (firefighters) to 22% (psychiatric nurses), and was associated with psychological strain and suicidal ideation. The SEM showed that dysfunctional coping strategies, self-efficacy, previously experienced and work-related trauma, years on job, and female sex explained up to 78% of PTSS and that PTSS itself explained up to 68% of the psychological strain experienced in the different professions. Independent of the profession, dysfunctional coping such as alcohol use, avoidance, and distraction, as well as work-related trauma were the most robust predictors of PTSS. However, while self-efficacy was a risk factor for police officers, firefighters and ambulance personnel, it was a protective factor for emergency and psychiatric nurses. Furthermore, female sex was only a risk factor for ambulance personnel and emergency nurses. In agreement with prior research, emergency personnel and rescuers exhibited enhanced prevalence of PTSS and suspected PTSD, leading to significant psychological strain and suicidal ideation. However, risk factors varied across the professions. Thus, the development of profession-specific trainings to improve self-efficacy and coping with work-related stressors to reduce PTSS, and enhance quality of life, is needed for individuals in such high-risk professions.Clinical Trial Registration:ClinicalTrials.gov Nr. NCT03842553.

The impact of the traditional male role norms on the posttraumatic stress disorder among Polish male firefighters

“…Sixth, the study did not take into consideration other potential mental health issues of the respondents, drug and alcohol use and other adverse experiences, e.g., those from the childhood. They might potentially increase the reported levels of PTSD symptomatology [ 11 , 26 – 29 ].…”

“…Firefighters are first responders, together with police officers, paramedics and others [ 1 ], who in their daily work are exposed to potentially traumatic events, which puts them at elevated risk of developing symptoms of posttraumatic stress disorder (PTSD) or even developing the full diagnosis [ 2 ]. The available data show that the rates of PTSD among firefighters are between 0% and 57% [ 3 – 11 ].…”

“…Among risk factors against PTSD among firefighters, there are maladaptative coping styles [ 11 – 15 ], alienation, feelings of insecurity and lack of personal control [ 16 ], high neuroticism, and fear of dying on duty [ 17 ], anxiety sensitivity [ 18 , 19 ], negative emotionality [ 20 ], burnout [ 21 , 22 ], length of service and lower rank [ 10 , 14 , 23 – 25 ], previous high exposure to traumatic events and previous psychopathology [ 11 , 26 – 29 ], elevated startle response [ 30 ], increased tendency to catastrophize [ 31 ], high hostility and low self-efficacy [ 3 ], negative self-appraisals [ 14 , 32 ], occupational stress, lack of social support and shift work [ 10 , 33 – 35 ], external locus of control in the workplace, low education and low resilience [ 24 , 36 ], and high social introversion and masculinity [ 37 ]. These risk factors seem to fall into three broad categories—intrapersonal [ 11 – 22 , 27 – 31 , 36 ], workplace-related [ 10 , 11 , 14 , 23 – 26 ] and social [ 10 , 16 , 33 – 35 ].…”

“Hang in There!”: Mental Health in a Sample of the Italian Civil Protection Volunteers during the COVID-19 Health Emergency

“…With regard to the environmental factors that influence the way to react to an emergency, it has been found how the ability to resolve conflicts or potential conflicts within the organization, improving the interest levels of volunteers, the implementation of recruitment and retention policies for volunteer into the team, adequate education and training, promoting social interaction skills, strengthening teamwork and building an effective team can make a difference [33,34]. It has been highlighted that often volunteers, compared to professional rescuers, have lower levels of training and resources available; consequently, they are more exposed to the risk of experiencing problems related to stress [35,36].…”

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

“…One of the mental disorders that may arise from occupational trauma is posttraumatic stress disorder (PTSD). PTSD prevalence in first responders differs considerably across studies and may vary as widely as from 0 to 46% (Soravia et al, 2021). Importantly, PTSD is not the only potential sequel of occupational trauma.…”