No abstract

Objective: Studies suggest that physical activity (PA) improves psychological recovery in traumaexposed populations like first responders. However, trauma exposure varies among first responders in relation to their unique service roles and duties. The purpose of this study was to examine the interaction effect of service role (traditional vs. emotional support first responders) and PA on mental health outcomes. Method: Traditional (n ϭ 133) and emotional support (n ϭ 31) first responders completed assessments of physical activity level, along with mental health outcome measures (posttraumatic stress disorder, secondary traumatic stress [STS], burnout, compassion satisfaction, and depression, anxiety, and stress [DAS]). Multiple regression models, controlling for social desirability and stress exposure, were used to examine service role as a moderator of the relationship between PA and mental health outcomes. Results: First responder role (traditional vs. emotional support) moderated the relationship between PA and STS (␤ ϭ .20, p ϭ .04) and DAS (␤ ϭ .24, p ϭ .01). Although not predictive for traditional first responders, higher PA was surprisingly associated with higher STS (trend level, ␤ ϭ .17, p ϭ .06) and DAS (␤ ϭ .19, p ϭ .03) for emotional support first responders. Conclusions: Findings revealed differential responding to PA among first responder subgroups, which suggests that first responders in different service roles may have unique patterns of response to stress. Clinical Impact StatementFindings suggest that the association between physical activity and mental health depends on the service role of the first responder. Those who primarily provide emotional support seem to engage in greater levels of physical activity while also displaying higher levels of psychological distress. It is possible that these first responders are engaging in physical activity as a means to cope with elevated psychological symptoms.

Mindful awareness (MA) and distress tolerance are emerging as robust predictors of mental health in populations with high levels of stress and trauma exposure, such as first responders. The combination of both protective factors may have potentiating benefits for mental health. First responders might especially benefit from high levels of MA if they are able to tolerate distressing present-moment experiences as needed. In this study, cross-sectional data were used to test whether distress intolerance (DI) moderated the relationship between MA and mental health. First responders (N = 176) completed an online assessment battery including measures of MA (Mindful Attention Awareness Scale), DI (Distress Intolerance Index), and mental health outcomes (i.e., Depression, Anxiety, and Stress Scale; Posttraumatic Stress Disorder [PTSD] Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th edition [DSM-5]; Secondary Traumatic Stress Scale; abbreviated Maslach Burnout Inventory; compassion satisfaction subscale of the Professional Quality of Life Scale; Satisfaction with Life Scale; and Brief Resilience Scale). Multiple regression models demonstrated that among first responders with higher DI, MA had a stronger association with lower anxiety and depression symptoms. Interactions between MA and DI were not significant for other outcome measures. However, higher MA and lower DI each independently predicted lower stress (lower posttraumatic stress, secondary traumatic stress, and general stress); higher MA independently predicted better occupational health (lower burnout and higher compassion satisfaction); and lower DI independently predicted positive mental health (greater resilience and life satisfaction). Results highlight the independent associations of high MA and low DI with first responders' mental health and underscore the importance of studying of interventions that promote both of these protective factors in first responders. Impact StatementAmong first responders, lower distress intolerance (DI) and higher mindful awareness (MA) both serve as important protective factors for mental health. Interventions that promote MA, while simultaneously reducing DI, could be especially beneficial for first responders and other populations with high levels of occupational stress and trauma exposure.