Investigating Strategies of Emotion Regulation As Mediators of Occupational Stressors and Mental Health Outcomes in First Responders

Abstract

The aim of this study was to investigate whether two emotion regulation strategies, expressive suppression or cognitive reappraisal, mediated the development of posttraumatic stress disorder (PTSD), major depression (MD), and generalized anxiety disorder (GAD) in first responders (FR) who experienced occupational stressors, using cross-sectional data. An aggregate of 895 first responders (M = 37.32, SD = 12.09, 59.2% male, 91.3% Caucasian) who were recruited through professional organizations and social media sites across North and South American states participated in an online Qualtrics survey. Bivariate correlation analyses demonstrated that occupational stressors were positively correlated with expressive suppression and each mental health outcome but were not significantly correlated with cognitive reappraisal. Mediation analyses demonstrated expressive suppression as a significant mediator between occupational stressors and PTSD, MD, and GAD symptoms, but not cognitive reappraisal. Even though these findings are in purview of a cross-sectional research design, they suggest the importance of practices that bolster first responders’ ability to use more effective and adaptive emotion regulation strategies such as emotion expression, effective communication, and cognitive reappraisal that might help enhance psychological resilience.

Network analysis of affect, emotion regulation, psychological capital, and resilience among Chinese males during the late stage of the COVID-19 pandemic

“…As mentioned above, the three nodes were directly connected with the dimensions of PsyCap and psychological resilience. These findings are consistent with previous studies reporting that positive affect and cognitive reappraisal have positive effects, whereas negative affect exerts adverse effects, on PsyCap and psychological resilience ( 32–35 , 77 , 78 , 98 , 99 ). The present study adds further evidence for this from a network-theory perspective.…”

“…In the affect and emotion regulation-psychological resilience network, certain relatively strong cross-community edges were found. STR “strength” was positively correlated with POA “positive affect” and CR “cognitive reappraisal,” but negatively correlated with NEA “negative affect” and ES “expressive suppression.” In general, previous studies have found that resilience is positively correlated with and fueled by positive affect and negatively correlated with negative affect ( 33–35 ), and that emotion expression and cognitive reappraisal can enhance psychological resilience ( 98 , 99 ). These findings further suggest that affect and emotion regulation relate to psychological resilience at the dimension level—a relationship that is commonly overlooked by previous sum-score analyses.…”

Adaptive and Maladaptive Cognitive-Emotional Strategies Associated With PTSD in First Responders

“…These studies also underscore the importance of considering the context in which these strategies are applied, as these may not reflect typical classifications of adaptive and maladaptive. That is, workplace norms and expectations required of first responders may involve a need to present a calm exterior when operating under high pressure environments, which may further encourage individuals to suppress their feelings to continue with their necessary duties 21,40,41 . First responders may also feel the need to suppress emotions in the presence of peers and supervisors in fear of being negatively evaluated by their colleagues 42 .…”

“…That is, workplace norms and expectations required of first responders may involve a need to present a calm exterior when operating under high pressure environments, which may further encourage individuals to suppress their feelings to continue with their necessary duties. 21,40,41 First responders may also feel the need to suppress emotions in the presence of peers and supervisors in fear of being negatively evaluated by their colleagues. 42 This highlights the metamorphoses and paradoxical nature of expressive suppression, where it is used adaptively in certain short-term situations in attempts to control outward displays of emotional experiences that may be too intense or unpleasant, 43 however, transmutes into a maladaptive response strategy with continued and persistent use over time.…”

“…Supporting this finding, a study of veterans in residential treatment for PTSD found that while both expressive suppression and cognitive reappraisal predicted PTSD symptom severity, change in expressive suppression but not cognitive reappraisal was found to significantly predict PTSD symptom severity at the point of discharge after adjusting for age, intake PTSD symptom severity and length of stay 20 . Another study in first responders found a significant positive association between expressive suppression and PTSD symptoms, and negative association with cognitive reappraisal 21 . However, when organizational stressors were considered, expressive suppression, and not cognitive reappraisal, acted as a mediator of occupational stressors on PTSD, as well as major depression and generalized anxiety disorder symptoms.…”