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

Abstract

Firefighters are considered a high-risk group for the development of PTSD and other stress-related diseases. More than the exposure to potentially traumatic events, personal and occupational characteristics have been pointed out as interfering in the perception of stress, which may lead to the emergence of mental and physical symptoms. This study aimed to analyze the relationship between the main factors that contribute to stress-related diseases in firefighters. A systematic review was conducted in order to identify original articles focusing on risk and protective factors for stress in this population. Personality traits, training, experience in extreme situations and social and organizational support influence the perception of stress and, consequently, the choice of coping strategies, which may protect against or potentiate the stress reactions. The findings of this study allow us to draw a relational model that represents the dynamics among the factors related to stress in firefighters. The development of PTSD and other stress-related diseases depends on a host of pre-trauma and post-trauma factors and, although training is an important protective factor, being prepared to face extreme situations does not mean being immune to traumatic stress.

Dynamic Psychotherapy as a PTSD Treatment for Firefighters: A Case Study

“…The development of stress-related disorders is influenced by a set of factors such as personality traits, interpersonal relationships, working conditions, and mental and physical health issues [ 5 , 6 , 39 , 40 ]. These subjective and social factors interact with each other, affecting the perception of stress, which can be considered to be mainly responsible for stress in firefighters [ 2 ]. Considering the relevance of subjective appraisal, it seems to be reasonable to provide a treatment that is not focused on symptoms alone but on their meaning, which is the focus of psychodynamic models [ 2 , 41 ].…”

“…These subjective and social factors interact with each other, affecting the perception of stress, which can be considered to be mainly responsible for stress in firefighters [ 2 ]. Considering the relevance of subjective appraisal, it seems to be reasonable to provide a treatment that is not focused on symptoms alone but on their meaning, which is the focus of psychodynamic models [ 2 , 41 ].…”

“…Fortunately, a movement to raise awareness about the health of rescue workers (firefighters, emergency medical responders, police officers, etc.) was carried out by those who are concerned with the widespread psychological consequences of catastrophes [ 2 ].…”

“…“Firefighters are used to dealing with physical discomfort, unpredictability, the pressure and expectation of society and their departments, the fear of the victims and their own fears. However, being prepared to face extreme situations is not synonymous with being immune to traumatic stress” [ 2 ] (p. 80).…”

A systematic review of the factors that contribute towards mental health in the fire service

“…This rate is considered to be higher than the general population; 3.7% in males and 5.1% in females (NICE, 2020a, b). Indeed, three systematic reviews have examined traumatic stress and stress within the Fire Service (Fraess-Phillips et al ., 2017; Fisher and Etches, 2003; Becker and Quartilho, 2020). These three reviews offer a useful contribution to the literature, providing support for the relationship between fire service membership and post-traumatic stress and exploring the factors influencing the experience of stress in firefighters.…”