Predictors of PTSD and other psychological symptoms in trauma-exposed firefighters

Information about the rate of posttraumatic stress signs in firefighters has been contradictory, with some studies indicating increased symptoms, while others suggest that this group is substantively resilient. Such ambiguous results are postulated to be due in part to variability in assessment methods, which led to the current study. Using a “gold-standard diagnostic interview” to measure for PTSD, this project investigated predictors of PTSD and other disorders. Self-report measures assessing exposure to potentially traumatic events (PTE), the level of perceived social support and occupational stress, presence of psychological symptoms of depression, anxiety and alcohol use, and type of coping style were measured.

Data were collected from a sample of 142 experienced, active-duty, urban, professional firefighters who reported exposure to one or more PTEs. Varying in rank, most participants were Caucasian males. On average, reported exposure was to 2 critical incidents in the past year, with an average of 17.2 (SD= 25.4) PTEs over the course of one’s career, and a rate of current PTSD at 4.2 percent. Relatively low rates of other psychological symptoms were observed.

Due to generally low rates of reported psychological symptoms, a composite symptom index was computed. Amount of trauma exposure was not a significant predictor of this symptom index. A series of hierarchical linear regression analyses were performed, finding that lower levels of perceived social support and higher levels of occupational stress predicted higher levels of PTSD and other psychological symptoms, more so than the quantity of PTEs experienced. In addition, coping style accounted for additional variance in symptoms and PTSD; specifically, a maladaptive style predicted higher symptom levels and positive coping predicted lower symptom levels. Lastly, the interaction between low levels of perceived social support and high levels of self-blame accounted for higher symptom levels, over and above the other predictors. Respondents in this “low perceived social support and high self -blame” subgroup reported the highest overall symptoms, and were more than others to meet criteria for current PTSD, identify clinically significant depressive symptoms and probable alcohol abuse.

The study concluded that firefighters seem to be more resilient to the development of psychological illness than community samples. Additionally, variables such as perceived social support might serve as buffers against risk factors such as occupational stress. This may be useful in the development of resilience training programs for this occupation.