Post-traumatic stress disorder in volunteer firefighters: influence of specific risk and protective factors

Abstract

Background: Volunteer firefighters belong to a risk population regarding the development of posttraumatic stress disorder (PTSD). However, given the frequency of work-related trauma, PTSD prevalences seem relatively low. Protective factors appear to be effective and are the focus of this study. Objective: We investigated the PTSD-prevalence as well as the influence of trauma exposure and the impact of protective factors resilience and Sense of Coherence (SoC) on symptoms of PTSD in volunteer firefighters. Method: Data from 232 participants of an online questionnaire study were analysed using a path model approach. Results: 'The results suggest a possible prevalence of PTSD of 12.5% and 2.2% for partial PTSD based on self-report measures. SoC and trauma event load proved to be independent of each other, as no intercorrelations were found. But both directly predicted PTSD severity. Higher resilience scores predicted the participants' Sense of Coherence, but PTSD severity was only indirectly affected by resilience, which was entirely mediated by SoC. Further, although SoC and trauma load increase with age and years of job experience, it is only SoC that affects PTSD severity, not age or years of experience. Conclusions: The results emphasize that not only exposure to potentially traumatic events predicts the later probability of developing symptoms of PTSD, but that the integration of stressful experiences into the self-concept (associated with SoC) is essential for the development of PTSD. Future research should address the question of causality between SoC and PTSD, and consider which factors moderate the SoC.

Resilience and Post-traumatic Stress Disorder in the Swiss Alpine Rescue Association

“…In the present study, we found that sense of coherence mediated the association between the severity of PTSD symptoms and resilience, an effect that was also reported by Streb et al ( 16 ) in German paramedic personnel. Moreover, Schnell also identified sense of coherence as a valid predictor of the severity of PTSD symptoms in voluntary firefighters ( 17 ). These findings indicate that sense of coherence might be a valuable target for improving resilience as well as for protecting against PTSD symptoms.…”

“…To date, almost all studies exploring PTSD symptoms or health-promoting factors in this group have focused on professional rescue personnel, while data on voluntary rescue and emergency personnel are sparse ( 17 ). A recent study found that seasonal firefighters had a higher risk of developing PTSD than did professional firefighters ( 18 ).…”

No distance is too far between friends: associations of comfortable interpersonal distance with PTSD and anxiety symptoms in Israeli firefighters

“…In firefighters, reported rates of PTSD vary considerably across studies, ranging from 11% to 37% (Petrie et al, 2018 ). This variability could be related to several factors including – but not limited to – age, sex, training, mentorship system, previous traumatization, and the number of duty-related traumatic incidents (Armour, Fried, Deserno, Tsai, & Pietrzak, 2017 ; Schnell, Suhr, & Weierstall-Pust, 2020 ). Another emerging – yet scarcely studied – factor is the impact of trauma on social interactions (Pfaltz et al, 2019 ) and specifically on interpersonal distance regulation (IDR), which may facilitate the development of PTSD symptoms.…”

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

“…These effects may emerge because only individuals with high trait resilience choose this profession or due to specific characteristics of occupational trauma (e.g., psychological preparedness). However, although the majority of firefighters may be resilient, some do experience symptoms, warranting further research into the pathogenic processes underlying mental health problems following occupational trauma (Schnell et al, 2020). With respect to PTSD, current research points towards a critical role of endocrinological stress responses during and after trauma (van Zuiden et al, 2019).…”

“…Despite these detrimental effects of occupational trauma, firefighters experience fewer posttrauma symptoms on average than individuals from the general population involved in the same incidents (Gulliver et al, 2021;Schnell et al, 2020). These effects may emerge because only individuals with high trait resilience choose this profession or due to specific characteristics of occupational trauma (e.g., psychological preparedness).…”