The mental health of fire-fighters: An examination of the impact of repeated trauma exposure

Harvey, Samuel B; Milligan-Saville, Josie; Paterson, Helen M.; Harkness, Emily L.; Marsh, Annabel; Dobson, Mark G; Kemp, Richard I.; Bryant, Richard A.

doi:10.1177/0004867415615217

Cited by 142 publications

(133 citation statements)

References 46 publications

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“…First responders are identified as professionals who respond to emergency situations in order to provide safety and protection to citizens, property, and communities. First responder groups that have received notable empirical attention include police or law enforcement officers (e.g., Arble & Arnetz, ), fire fighters (e.g., Harvey et al, ), search and rescue personnel such as those in National Guard services (e.g., Sahker, Acion, & Arndt, ), ambulance personnel (emergency medical technicians and paramedics; e.g., Streb, Häller, & Michael, ), and military personnel (Jacobson, Donoho, Crum‐Cianflone, & Maguen, ). Although these professions are tasked with widely discrepant responsibilities and challenges, all first responder groups are engaged in uniquely demanding and dangerous work (Penalba, McGuire, & Leite, ) involving regular exposure to both physical and psychological stressors (e.g., Galloucis, Silverman, & Francek, ; McCaslin et al, ).…”

Section: A Model Of First Responder Coping: An Approach/avoidance Bifmentioning

confidence: 99%

Models of first responder coping: Police officers as a unique population

2018

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The term "first responders" refers to a range of professional occupations, including police officers, fire fighters, search and rescue personnel, ambulance personnel, and military personnel. Research by the present authors has developed empirical models of first responder coping, identifying 2 coping pathways with differential outcomes: approach and avoidance coping. The present investigation considers police officers as a unique group and measures the extent to which police officers differ from other first responders in coping behaviours following trauma, based upon a nationally representative survey of 917 Swedish police officers. Although the model of coping behaviours following trauma and the effects on well-being displayed several similarities between police officers and other first responders, there was compelling evidence to suggest that there are professionally bound aspects of psychological coping, resilience, and well-being that merit further exploration. Among police officers, for example, avoidant coping was related to worse well-being, and police officers reported greater consequence to well-being related to substance use than other first responders. The unique aspects of police officer coping in comparison with other first responder groups are explored.

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Section: A Model Of First Responder Coping: An Approach/avoidance Bifmentioning

confidence: 99%

Models of first responder coping: Police officers as a unique population

2018

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“…Emergency service personnel provide an ideal cohort for investigating the link between PTSD and physical health, as their work is both physically demanding and involves repeated exposure to traumatic events. This creates a substantial burden of physical and mental health problems that must be ameliorated to ensure that emergency service personnel can continue to play a vital role in protecting society (Harvey et al, 2016;LeMasters et al, 2006). Although several studies on PTSD and physical health have been undertaken with the military (e.g., Hoge, Terhakopian, Castro, Messer, & Engel, 2007), whose personnel are also subjected to repeated trauma exposure, there has been less research conducted within the emergency services.…”

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confidence: 99%

The Amplification of Common Somatic Symptoms by Posttraumatic Stress Disorder in Firefighters

Milligan-Saville

Paterson

Harkness

et al. 2017

Journal of Traumatic Stress

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Posttraumatic stress disorder (PTSD) in emergency service personnel and other trauma-exposed populations is known to be associated with a variety of physical health problems. However, little attention has been paid to the health of ageing emergency service personnel, who may be forced into early medical retirement because of a combination of these issues. Currently employed (N = 274) Australian firefighters completed a cross-sectional survey using validated, self-report measures of PTSD and somatic symptoms. Analyses examined the association between probable PTSD and a range of common somatic symptoms, and whether any association differed depending on the age of the firefighters. Firefighters with PTSD reported greater levels of neurological (p = .024), gastrointestinal (p = .015), and cardiorespiratory (p = .027) symptoms compared to those without PTSD. After adjusting for sex, age, and rank, linear regression analysis demonstrated that PTSD was significantly associated with increased total somatic symptom severity (p = .024), with PTSD accounting for 9.8% of the variance in levels of somatic symptoms. There was no interaction between age and the association between PTSD and somatic symptom severity. These results suggest that PTSD is associated with a significant increase in a wide range of somatic symptoms among firefighters, regardless of age. The implications for the identification and treatment of PTSD are discussed.

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“…High-risk populations such as war-affected people, refugees, firefighters, or police officers often experience traumatization sequentially (Harvey et al, 2015; Levy-Gigi, Richter-Levin, Okon-Singer, Keri, & Bonanno, 2015), which has a significant impact on the development of mental disorders, for example, PTSD, depression, and anxiety (Kartal & Kiropoulos, 2016; Pinto, Henriques, Jongenelen, Carvalho, & Maia, 2015; Stanley, Hom, & Joiner, 2016). Several studies have provided evidence that individuals suffering from PTSD in the aftermath of an initial trauma are vulnerable to increased PTSD symptoms after subsequently experiencing a new traumatic event (Bramsen, Van Der Ploeg, & Boers, 2006; Fossion et al, 2015; Hantman & Solomon, 2007; Kinzie, Boehnlein, Riley, & Sparr, 2002).…”

mentioning

confidence: 99%

“…Nonetheless, these populations are also confronted with a high level of stressful life events in the aftermath of their initial traumatic event (e.g., Harvey et al, 2015; Levy-Gigi et al, 2015). As Turner (2015) stated, the problems that refugees and asylum seekers face do not end with their arrival in a safe country.…”

mentioning

confidence: 99%

Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study

Schock

Böttche

Rosner

et al. 2016

European Journal of Psychotraumatology

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BackgroundA significant proportion of trauma survivors experience an additional critical life event in the aftermath. These renewed experiences of traumatic and stressful life events may lead to an increase in trauma-related mental health symptoms.MethodIn a longitudinal study, the effects of renewed experiences of a trauma or stressful life event were examined. For this purpose, refugees seeking asylum in Germany were assessed for posttraumatic stress symptoms (PTS), Posttraumatic Stress Diagnostic Scale (PDS), anxiety, and depression (Hopkins Symptom Checklist [HSCL-25]) before treatment start as well as after 6 and 12 months during treatment (N=46). Stressful life events and traumatic events were recorded monthly. If a new event happened, PDS and HSCL were additionally assessed directly afterwards. Mann–Whitney U-tests were performed to calculate the differences between the group that experienced an additional critical event (stressful vs. trauma) during treatment (n=23) and the group that did not (n=23), as well as differences within the critical event group between the stressful life event group (n=13) and the trauma group (n=10).ResultsRefugees improved significantly during the 12-month period of our study, but remained severely distressed. In a comparison of refugees with a new stressful life event or trauma, significant increases in PTS, anxiety, and depressive symptoms were found directly after the experience, compared to the group without a renewed event during the 12 months of treatment. With regard to the different critical life events (stressful vs. trauma), no significant differences were found regarding overall PTS, anxiety, and depression symptoms. Only avoidance symptoms increased significantly in the group experiencing a stressful life event.ConclusionAlthough all clinicians should be aware of possible PTS symptom reactivation, especially those working with refugees and asylum seekers, who often experience new critical life events, should understand symptom fluctuation and address it in treatment.Highlights of the articleWithin a longitudinal design, refugees currently in treatment are compared concerning symptom course after new traumatic or stressful events.New stressful life events and traumatic events increase posttraumatic, anxious, and depressive symptoms in the first 6 months after the events.Stressful and traumatic events overall did not show differential symptom exacerbations.Only avoidance symptoms were an exception; stressful life events were associated with an increase in PTS avoidance symptoms.Because reducing avoidance is the pivotal mechanism of psychotherapy with PTSD patients, clinicians should anticipate PTS symptom reactivation when patients are re-exposed to significant stressful stimuli, especially with asylum seekers and refugees, who often experience new stressful events.

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The mental health of fire-fighters: An examination of the impact of repeated trauma exposure

Cited by 142 publications

References 46 publications

Models of first responder coping: Police officers as a unique population

Models of first responder coping: Police officers as a unique population

The Amplification of Common Somatic Symptoms by Posttraumatic Stress Disorder in Firefighters

Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study

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