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Riccardi E, Fontana L, Pacella D, Fusco F, Marinaro I, Costanzo G, Vassallo F, Triassi M, Iavicoli I. Impact of Covid-19 pandemic on psychological well-being of firefighters. Saf Health Work 2023:S2093-7911(23)00036-7. [PMID: 37361372 PMCID: PMC10268815 DOI: 10.1016/j.shaw.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/26/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023] Open
Abstract
Background Covid-19 pandemic represented a unique stressful event that affected the physical health and the psychological well-being (PWB) of individuals and communities. Monitoring PWB is essential to clarify the burden on mental health effects but also to define targeted psychological-supporting measures. This cross-sectional study evaluated the PWB of Italian firefighters during the pandemic. Methods Firefighters recruited during the pandemic period filled out a self-administered questionnaire the Psychological General Well-Being Index during the health surveillance medical examination. This tool is usually used to assess the global PWB and explores six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, working activities, Covid-19 and pandemic restrictive measures was also explored. Results A total of 742 firefighters completed the survey. The aggregate median PWB global score was in the "no distress" range (94.3±10.3) resulting higher than that observed in studies conducted using the same tool in the Italian general population during the same pandemic period. Similar findings were observed in the specific subdomains thus suggesting that investigated population was in good PWB condition. Interestingly, significantly better outcomes were detected in the younger firefighters. Conclusion Our data showed a satisfactory PWB situation in firefighters that could be related to different professional factors such as work organization, mental and physical training. In particular, our results would suggest the hypothesis that in firefighters, the maintaining of a minimum/moderate level of physical activity (consisting of even just going to work) might had a profoundly positive impact on psychological health and well-being.
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Affiliation(s)
- Elisabetta Riccardi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Luca Fontana
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Fabio Fusco
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ilaria Marinaro
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Costanzo
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Vassallo
- Regional Direction of Campania Firefighters, Via del Sole 10, 80138 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
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Fien S, Lawes JC, Ledger J, Drummond M, Simon P, Joseph N, Daw S, Best T, Stanton R, de Terte I. A preliminary study investigating the neglected domain of mental health in Australian lifesavers and lifeguards. BMC Public Health 2023; 23:1036. [PMID: 37259042 DOI: 10.1186/s12889-023-15741-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members. METHODS An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality. RESULTS A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed. CONCLUSION This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.
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Affiliation(s)
- Samantha Fien
- School of Health, Medical and Applied Sciences, Central Queensland University, Mackay, QLD, Australia.
- Research Cluster for Resilience and Wellbeing, Appleton Institute, Wayville, South, Australia.
- School of Health, Medical and Applied Sciences, Central Queensland University, Building 4, Room G.33, Mackay City Campus, Sydney Street, Mackay, Mackay, QLD, 4740 P +61 7, 4940 3430E, Australia.
| | - Jasmin C Lawes
- Surf Life Saving Australia, Bondi Beach, Sydney, NSW, Australia
| | - Jessica Ledger
- Surf Life Saving Australia, Bondi Beach, Sydney, NSW, Australia
| | - Murray Drummond
- College of Education, Psychology and Social Work, SHAPE Research Centre, Flinders University, Adelaide, Health, Australia
| | - Pamela Simon
- Surf Life Saving Australia, Bondi Beach, Sydney, NSW, Australia
| | - Nancy Joseph
- Surf Life Saving Australia, Bondi Beach, Sydney, NSW, Australia
| | - Shane Daw
- Surf Life Saving Australia, Bondi Beach, Sydney, NSW, Australia
| | - Talitha Best
- Research Cluster for Resilience and Wellbeing, Appleton Institute, Wayville, South, Australia
- School of Health, Medical and Applied Sciences, NeuroHealth Lab, Appleton Institute, Central Queensland University, Brisbane, QLD, Australia
| | - Robert Stanton
- Research Cluster for Resilience and Wellbeing, Appleton Institute, Wayville, South, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Ian de Terte
- School of Psychology, Massey University, Wellington, New Zealand
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Rudman JS, Farcas A, Salazar GA, Hoff JJ, Crowe RP, Whitten-Chung K, Torres G, Pereira C, Hill E, Jafri S, Page DI, von Isenburg M, Haamid A, Joiner AP. Diversity, Equity, and Inclusion in the United States Emergency Medical Services Workforce: A Scoping Review. PREHOSP EMERG CARE 2022; 27:385-397. [PMID: 36190493 DOI: 10.1080/10903127.2022.2130485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Emergency medical services (EMS) workforce demographics in the United States do not reflect the diversity of the population served. Despite some efforts by professional organizations to create a more representative workforce, little has changed in the last decade. This scoping review aims to summarize existing literature on the demographic composition, recruitment, retention, and workplace experience of underrepresented groups within EMS. METHODS Peer-reviewed studies were obtained from a search of PubMed, CINAHL, Web of Science, ProQuest Thesis and Dissertations, and non-peer-reviewed ("gray") literature from 1960 to present. Abstracts and included full-text articles were screened by two independent reviewers trained on inclusion/exclusion criteria. Studies were included if they pertained to the demographics, training, hiring, retention, promotion, compensation, or workplace experience of underrepresented groups in United States EMS by race, ethnicity, sexual orientation, or gender. Studies of non-EMS fire department activities were excluded. Disputes were resolved by two authors. A single reviewer screened the gray literature. Data extraction was performed using a standardized electronic form. Results were summarized qualitatively. RESULTS We identified 87 relevant full-text articles from the peer-reviewed literature and 250 items of gray literature. Primary themes emerging from peer-reviewed literature included workplace experience (n = 48), demographics (n = 12), workforce entry and exit (n = 8), education and testing (n = 7), compensation and benefits (n = 5), and leadership, mentorship, and promotion (n = 4). Most articles focused on sex/gender comparisons (65/87, 75%), followed by race/ethnicity comparisons (42/87, 48%). Few articles examined sexual orientation (3/87, 3%). One study focused on telecommunicators and three included EMS physicians. Most studies (n = 60, 69%) were published in the last decade. In the gray literature, media articles (216/250, 86%) demonstrated significant industry discourse surrounding these primary themes. CONCLUSIONS Existing EMS workforce research demonstrates continued underrepresentation of women and non-White personnel. Additionally, these studies raise concerns for pervasive negative workplace experiences including sexual harassment and factors that negatively affect recruitment and retention, including bias in candidate testing, a gender pay gap, and unequal promotion opportunities. Additional research is needed to elucidate recruitment and retention program efficacy, the demographic composition of EMS leadership, and the prevalence of racial harassment and discrimination in this workforce.
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Affiliation(s)
- Jordan S Rudman
- Harvard Affiliated Emergency Medicine Residency, Beth Israel Deaconess Medical Center, Boston, MA
| | - Andra Farcas
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO
| | - Gilberto A Salazar
- Department of Emergency Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - J J Hoff
- Department of Emergency Medicine, Duke University School of Medicine, Durham, NC
| | | | | | | | | | - Eric Hill
- Department of Emergency Medicine, Medical Center of Aurora, Aurora, CO
| | | | - David I Page
- Prehospital Care Research Forum, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA
| | | | - Ameera Haamid
- Section of Emergency Medicine, University of Chicago Medicine, Chicago, IL
| | - Anjni P Joiner
- Department of Emergency Medicine, Duke University School of Medicine, Durham, NC
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Solle NS, Santiago KM, Feliciano PL, Calkins MM, Fent K, Jahnke S, Parks N, Buren H, Grant C, Burgess JL, Caban-Martinez AJ. Perceptions of Work-Related Health and Cancer Risks Among Women Firefighters: A Qualitative Study. J Occup Environ Med 2021; 63:e846-e852. [PMID: 34538836 PMCID: PMC8814999 DOI: 10.1097/jom.0000000000002386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES We use a qualitative method to gain further insight into women firefighters' experiences, perceptions of cancer, health, and safety risks in the fire service. METHODS We conducted six focus groups with U.S. women firefighters. Participants engaged in a 60 to 75-minute, semi-structured discussion and completed a sociodemographic questionnaire. A qualitative descriptive approach was used to inductively create themes. Data collection concluded when saturation was met. RESULTS Forty-nine women firefighters participated. Qualitative results indicated the main health concerns include: occupational cancer risks including, risks related to hazardous exposures, sleep disruption and stress; and women's health concerns including, cancer, pregnancy and breastfeeding, and lack of resources. CONCLUSIONS Women firefighters are concerned about their risk for cancer due to their occupation and identify a lack of resources specific to health and safety needs of women firefighters.
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Affiliation(s)
- Natasha Schaefer Solle
- Department of Medicine, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Katerina M. Santiago
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Paola Louzado Feliciano
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
| | - Miriam M. Calkins
- Division of Field Studies and Engineering (DFSE), National Institute for Occupational Safety and Health, Cincinnati OH 45226, USA
| | - Kenny Fent
- Division of Field Studies and Engineering (DFSE), National Institute for Occupational Safety and Health, Cincinnati OH 45226, USA
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, Leawood, KS, USA
| | | | | | - Casey Grant
- Fire Protection Research Foundation, Quincy, MA 02169, USA
| | - Jefferey L. Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
- Sylvester Comprehensive Cancer Center, University of Miami, Leonard M. Miller School of Medicine, Miami, FL 33136 USA
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Kyron MJ, McEvoy PM, Gilbey D, Lin A, Mazza C, Rikkers W, Bartlett J, Lawrence D. Sexual orientation and prevalence of mental health difficulties among emergency services employees. J Affect Disord 2021; 287:240-246. [PMID: 33799043 DOI: 10.1016/j.jad.2021.02.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND LGBQ+ people (Lesbian, Gay, Bisexual, Queer) are at-risk of discrimination and developing mental health issues within general populations. Limited research has assessed their mental health in emergency services occupations, a population which are known to experience poorer mental health. The current study explores the extent to which sexual orientation is associated with higher rates of mental health issues among emergency personnel. METHODS A stratified random sample of employees from twenty-nine police (N = 8,088), ambulance (N = 3,473), and fire and rescue (N = 2,975) agencies from around Australia participated in a cross-sectional mental health survey (N = 14,536, male = 64.2%, 42.7% over 45 years of age, heterosexual = 92.7%). RESULTS Employees with a bisexual/pansexual orientation or those who were not sure about their sexual orientation were significantly more likely to report suicidal thoughts, suicide plans, psychological distress, and illicit drug use when compared with heterosexual employees. LGBQ+ employees reported significantly higher rates of lifetime suicide plans and attempts. Specifically, LGBQ+ fire and rescue personnel were roughly six times more likely to report lifetime suicide attempts, and approximately five times more likely to use illicit drugs weekly than their heterosexual colleagues in the fire and rescue sector. Female LGBQ+ personnel were significantly less likely to consume illicit drugs weekly and monthly than male LGBQ+ personnel. CONCLUSIONS Emergency services personnel are already at-risk of developing pervasive mental health difficulties. It is important that organisations foster positive working environments, particularly for LGBQ+ people who may be more marginalized within organisations.
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Affiliation(s)
- Michael J Kyron
- Graduate School of Education, The University of Western Australia, Australia; School of Psychological Science, The University of Western Australia, Australia; School of Psychology, Curtin University, Australia.
| | | | | | | | | | - Wavne Rikkers
- Graduate School of Education, The University of Western Australia, Australia
| | - Jennifer Bartlett
- Graduate School of Education, The University of Western Australia, Australia; Telethon Kids Institute, Australia
| | - David Lawrence
- Graduate School of Education, The University of Western Australia, Australia
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6
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Affiliation(s)
- Robert W O'Brien
- Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs, Washington, DC
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7
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Vigil NH, Beger S, Gochenour KS, Frazier WH, Vadeboncoeur TF, Bobrow BJ. Suicide Among the Emergency Medical Systems Occupation in the United States. West J Emerg Med 2021; 22:326-332. [PMID: 33856319 PMCID: PMC7972356 DOI: 10.5811/westjem.2020.10.48742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/02/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Suicide claimed 47,173 lives in 2017 and is the second leading cause of death for individuals 15–34 years old. In 2017, rates of suicide in the United States (US) were double the rates of homicide. Despite significant research funding toward suicide prevention, rates of suicide have increased 38% from 2009 to 2017. Recent data suggests that emergency medical services (EMS) workers are at a higher risk of suicidal ideation and suicide attempts compared to the general public. The objective of this study was to determine the proportionate mortality ratio (PMR) of suicide among firefighters and emergency medical technicians (EMT) compared to the general US working population. Methods We analyzed over five million adult decedent death records from the National Occupational Mortality Surveillance database for 26 states over a 10-year non-consecutive period including 1999, 2003–2004, and 2007–2013. Categorizing firefighters and EMTs by census industry and occupation code lists, we used the underlying cause of death to calculate the PMRs compared to the general US decedent population with a recorded occupation. Results Overall, 298 firefighter and 84 EMT suicides were identified in our study. Firefighters died in significantly greater proportion from suicide compared to the US.working population with a PMR of 172 (95% confidence interval [CI], 153–193, P<0.01). EMTs also died from suicide in greater proportion with an elevated PMR of 124 (95% CI, 99–153), but this did not reach statistical significance. Among all subgroups, firefighters ages 65–90 were found to have the highest PMR of 234 (95% CI, 186–290), P<0.01) while the highest among EMTs was in the age group 18–64 with a PMR of 126 (95% CI, 100–156, P<0.05). Conclusion In this multi-state study, we found that firefighters and EMTs had significantly higher proportionate mortality ratios for suicide compared to the general US working population. Firefighters ages 65–90 had a PMR more than double that of the general working population. Development of a more robust database is needed to identify EMS workers at greatest risk of suicide during their career and lifetime.
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Affiliation(s)
- Neil H Vigil
- University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona
| | - Samuel Beger
- University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona
| | - Kevin S Gochenour
- University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona
| | - Weston H Frazier
- University of Arizona College of Medicine-Phoenix, Department of Emergency Medicine, Phoenix, Arizona
| | | | - Bentley J Bobrow
- University of Texas Health Sciences Center of Houston, Department of Emergency Medicine, Houston, Texas
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Noor N, Pao C, Dragomir-Davis M, Tran J, Arbona C. PTSD symptoms and suicidal ideation in US female firefighters. Occup Med (Lond) 2020; 69:577-585. [PMID: 31064010 DOI: 10.1093/occmed/kqz057] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Little is known regarding the mental health of women firefighters. AIMS To identify demographic, work-related and mental health characteristics associated with post-traumatic stress disorder (PTSD) symptoms and lifetime suicidal ideation in female firefighters compared with male colleagues. METHODS Participants were firefighters (75 women and 2564 men) employed in a large urban fire department in the USA. Chi-square, correlations, t-tests and analyses of variance were conducted to examine the predictors of PTSD symptoms and lifetime suicide ideation in men and women. RESULTS Approximately 20% of women scored positively for PTSD and 30% reported lifetime suicidal ideation. Women with PTSD symptoms were more likely to be in their mid-career years (11-20) than in their first 10 years (87% versus 44%; χ2 = 8.77, P < 0.05) and to have received counselling (53% versus 14%; χ2 = 8.11, P < 0.01). Being single (73% versus 58%; χ2 = 6.02, P < 0.05), having a second job (68% versus 38%; χ2 = 5.79, P < 0.05) and having received counselling (41% versus 11%; χ2 = 8.51, P < 0.01) predicted suicide ideation. Depression and general stress positively predicted PTSD symptoms and suicide ideation. PTSD also predicted suicide ideation. CONCLUSIONS Compared to male firefighters, women were at high risk for PTSD symptoms and suicide ideation. Particularly for women, few socio-demographic and work-related variables were associated with these outcomes. Mental health variables predicted depression and suicide ideation for both gender groups. Therefore, in screening and intervention efforts, it may be most fruitful to focus on mental health risk correlates of PTSD and suicide ideation.
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Affiliation(s)
- N Noor
- The Menninger Clinic, Houston, TX, USA
| | - C Pao
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - M Dragomir-Davis
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
| | - J Tran
- Firefighter Support Network, Houston Fire Department, Houston, TX, USA
| | - C Arbona
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX, USA
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Stanley IH, Hom MA, Gallyer AJ, Gray JS, Joiner TE. Suicidal behaviors among American Indian/Alaska Native firefighters: Evidence for the role of painful and provocative events. Transcult Psychiatry 2020; 57:275-287. [PMID: 31088223 DOI: 10.1177/1363461519847812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Firefighters represent a group at elevated suicide risk. Identifying segments of the fire service at increased risk may facilitate the targeted provision of suicide prevention initiatives. Among the general population, American Indian/Alaska Native (AI/AN) individuals report higher rates of suicide attempts. This study sought to examine suicide attempt rates among AI/AN firefighters and to determine if greater exposure to painful and provocative events and/or fearlessness about death explains the relationship between AI/AN identity and suicidal behaviors. A total of 917 US firefighters completed a web-based mental health survey (6.2% AI/AN). Participants completed a modified version of the Self-Injurious Thoughts and Behaviors Interview-Short Form, the Painful and Provocative Events Scale, and the Acquired Capability for Suicide Scale-Fearlessness About Death scale. Bootstrap mediation analyses were conducted, controlling for years of service as a firefighter. Although AI/AN firefighters accounted for only 6.2% of the sample, they accounted for 34.4% of the career suicide attempts. AI/AN firefighters were 16.31 (95% CI = 7.96, 33.42) times more likely to report a career suicide attempt history than non-AI/AN firefighters, adjusting for years of service as a firefighter. Painful and provocative events, but not fearlessness about death, was a statistically significant mediator of the relationship between AI/AN identity and suicide attempts. Firefighters identifying as AI/AN represent a subgroup within the fire service at increased risk for suicide. Findings suggest that greater exposure to painful and provocative events among AI/AN firefighters may explain the elevated suicide risk among this population.
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10
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Chen X, Zhang L, Peng Z, Chen S. Factors Influencing the Mental Health of Firefighters in Shantou City, China. Psychol Res Behav Manag 2020; 13:529-536. [PMID: 32753981 PMCID: PMC7342484 DOI: 10.2147/prbm.s249650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Firefighters are routinely exposed to occupational stress and are therefore vulnerable to psychological problems. PATIENTS AND METHODS This study assessed the prevalence of mental health symptoms and potential contributing factors in a sample of firefighters in Shantou city, in the Guangdong Province of China. We conducted a cross-sectional survey with 335 firefighters, including 329 male and 6 female firefighters. We used a questionnaire which assessed anxiety and depression, as indicated by the Zung Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), as well as other mental health symptoms, using the Symptom Checklist-90 (SCL-90). Basic information and potential-related factors were also collected. RESULTS The average age of participants was 27.38 (SD ± 6.11) years. Assessed by the indexed score of different scales, SAS and SDS positive screening rates were 6.86% and 22.68%, respectively. SCL-90 scores indicated that 6.86% of participants had mental health symptoms. Logistic regression analysis showed that educational level, firefighter rank, and birth order were associated with mental health outcomes. Firefighters in Shantou were also shown to have better mental health outcomes than the Chinese military, but worse than the national population of firefighters. CONCLUSION These findings indicated the mental health of firefighters is not good. It is necessary to explore effective approaches to help preventing and treating mental disorder in firefighters.
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Affiliation(s)
- Xiaojun Chen
- Department of Hospital Office, The First Affiliated Hospital of Shantou University Medical College, Shantou, People’s Republic of China
| | - Lishao Zhang
- Department of Hospital Office, The First Affiliated Hospital of Shantou University Medical College, Shantou, People’s Republic of China
| | - Zhekuang Peng
- Department of Public Health, The Third Affiliated Hospital of SunYet-Sen University, Guangzhou, People’s Republic of China
| | - Shaoxing Chen
- Department of Hospital Office, The First Affiliated Hospital of Shantou University Medical College, Shantou, People’s Republic of China
- Correspondence: Shaoxing Chen Department of Public Health, The First Affiliated Hospital of Shantou University Medical College, 57# Changping Road, Shantou515041, People’s Republic of ChinaTel +86-754-88252184 Email
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11
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Stanley IH, Hom MA, Chu C, Dougherty SP, Gallyer AJ, Spencer-Thomas S, Shelef L, Fruchter E, Comtois KA, Gutierrez PM, Sachs-Ericsson NJ, Joiner TE. Perceptions of belongingness and social support attenuate PTSD symptom severity among firefighters: A multistudy investigation. Psychol Serv 2019; 16:543-555. [PMID: 29595287 PMCID: PMC6163099 DOI: 10.1037/ser0000240] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Firefighters experience high rates of posttraumatic stress disorder (PTSD). It is imperative to identify malleable factors that protect against the development of PTSD symptoms among this population. We examined whether perceptions of belongingness broadly (Study 1) and social support from supervisors, coworkers, and family/friends specifically (Study 2) are associated with lower PTSD symptom severity among firefighters. Study 1 included 840 U.S. firefighters (91.1% male); participants completed the Interpersonal Needs Questionnaire and PTSD Checklist-Civilian Version. Study 2 included 200 U.S. women firefighters exposed to a Criterion A traumatic event; participants completed the Generic Job Stress Questionnaire, Life Events Checklist for Diagnostic and Statistical Manual of Mental Disorders-5, and PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5. Linear regression analyses were conducted, adjusting for the number of years participants served as firefighters. Greater belongingness broadly (Study 1; b = -0.740, p < .001) as well as social support specifically (Study 2) from supervisors (b = -4.615, p < .001), coworkers (b = -4.465, p = .001), and family/friends (b = -3.206, p = .021) were associated with less severe PTSD symptoms. When all sources of social support were entered into a single model, only support from supervisors was significantly associated with lower overall PTSD symptom severity (b = -4.222, p = .004). Belongingness and social support may protect against the development of PTSD among firefighters. Supervisor social support may be particularly salubrious, suggesting that top-down mental wellness promotion within the fire service may be indicated to protect firefighters against PTSD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Ian H. Stanley
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Melanie A. Hom
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Carol Chu
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Sean P. Dougherty
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | - Austin J. Gallyer
- Department of Psychology, Florida State University, Tallahassee, FL USA
| | | | - Leah Shelef
- Mental Health Unit, Medical Corps, Israel Defense Forces, Haifa, Israel
- Psychology Branch, Israeli Air Force, Haifa, Israel
| | - Eyal Fruchter
- Psychiatry & Mental Health Division, Rambam Health Campus, Haifa, Israel
| | | | - Peter M. Gutierrez
- Department of Psychiatry, University of Colorado School of Medicine, Denver, CO USA
- Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Denver, CO USA
- Denver Veterans Affairs Medical Center, Denver, CO USA
| | | | - Thomas E. Joiner
- Department of Psychology, Florida State University, Tallahassee, FL USA
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Self-Efficacy as a Moderator between Stress and Professional Burnout in Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020183. [PMID: 30634607 PMCID: PMC6352063 DOI: 10.3390/ijerph16020183] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/20/2022]
Abstract
The purpose of the study is to analyze the importance of individual resources in firefighting, one of the highest risk professions. Firefighters from 12 different Polish provinces (N = 580; men; M (mean age) = 35.26 year, SD = 6.74) were analyzed regarding the perceived stress at work, burnout, self-efficacy, and a broad range of sociodemographic variables. The Perceived Stress Scale (PSS), the Link Burnout Questionnaire (LBQ), and the General Self-Efficacy Scale (GSES) were used in the study. To explore the relationships between work-related stress, burnout, and self-efficacy, separate regression models for each burnout dimension were analyzed. The results revealed that self-efficacy is a significant moderator that changes the direction and strength of the relationships between perceived stress and psychophysical exhaustion, sense of professional inefficacy, and disillusion. However, self-efficacy did not moderate the relationship between stress and lack of engagement in relationships (relationship deterioration). The results indicate that self-efficacy in firefighters is a crucial personal resource that buffers the impact of perceived stress on most burnout symptoms. It may be concluded that in high risk professions, special attention should be paid to developing self-efficacy as an important part of burnout prevention programs, pro-health activities, and psychoeducation.
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Turner S, Taillieu T, Carleton RN, Sareen J, Afifi TO. Association between a history of child abuse and suicidal ideation, plans and attempts among Canadian public safety personnel: a cross-sectional survey. CMAJ Open 2018; 6:E463-E470. [PMID: 30337471 PMCID: PMC6201713 DOI: 10.9778/cmajo.20170153] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND A history of child abuse has been identified as a risk factor for suicidal behaviour in general population samples; however, it remains unknown how a history of child abuse and career-related trauma together are related to suicidal behaviour. This cross-sectional survey was designed to 1) estimate the prevalence of a history of child abuse among Canadian public safety personnel, 2) examine the associations between child abuse and suicidal behaviour, 3) examine the associations between career-related trauma and suicidal behaviour and 4) examine the cumulative and interactive effects of child abuse and career-related trauma on suicidal behaviour. METHODS Data were drawn from a Web-based survey collected by the Canadian Institute for Public Safety Research and Treatment Team. Child abuse included physical abuse, sexual abuse and exposure to intimate partner violence in childhood. Suicidal behaviour included lifetime ideation, plans and attempt(s). We used logistic regression models to examine the associations between child abuse and suicidal behaviours, and cumulative and interaction models to test the relations between a history of child abuse and career-related trauma on suicidal behaviours. RESULTS The survey completion rate was 49.3% (n = 4199). A total of 2275/4073 respondents (55.9%) reported experiencing 1 or more types of abuse as a child. All types of child abuse and career-related trauma were significantly associated with suicidal behaviour (adjusted odds ratio 1.57-3.25). No cumulative or interaction effects were noted. INTERPRETATION Both a history of child abuse and career-related trauma were significantly associated with suicidal behaviours; however, stronger relations were seen for the former. This finding may help the development of effective treatment and intervention strategies aimed at reducing suicidal behaviour among public safety personnel.
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Affiliation(s)
- Sarah Turner
- Departments of Community Health Sciences (Turner, Sareen, Afifi), Psychiatry (Turner, Sareen, Afifi) and Psychology (Sareen) and the Applied Health Sciences Program (Taillieu), University of Manitoba, Winnipeg, Man.; Department of Psychology (Carleton), University of Regina, Regina, Sask
| | - Tamara Taillieu
- Departments of Community Health Sciences (Turner, Sareen, Afifi), Psychiatry (Turner, Sareen, Afifi) and Psychology (Sareen) and the Applied Health Sciences Program (Taillieu), University of Manitoba, Winnipeg, Man.; Department of Psychology (Carleton), University of Regina, Regina, Sask
| | - R Nicholas Carleton
- Departments of Community Health Sciences (Turner, Sareen, Afifi), Psychiatry (Turner, Sareen, Afifi) and Psychology (Sareen) and the Applied Health Sciences Program (Taillieu), University of Manitoba, Winnipeg, Man.; Department of Psychology (Carleton), University of Regina, Regina, Sask
| | - Jitender Sareen
- Departments of Community Health Sciences (Turner, Sareen, Afifi), Psychiatry (Turner, Sareen, Afifi) and Psychology (Sareen) and the Applied Health Sciences Program (Taillieu), University of Manitoba, Winnipeg, Man.; Department of Psychology (Carleton), University of Regina, Regina, Sask
| | - Tracie O Afifi
- Departments of Community Health Sciences (Turner, Sareen, Afifi), Psychiatry (Turner, Sareen, Afifi) and Psychology (Sareen) and the Applied Health Sciences Program (Taillieu), University of Manitoba, Winnipeg, Man.; Department of Psychology (Carleton), University of Regina, Regina, Sask.
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Gallyer AJ, Dougherty SP, Gai AR, Stanley IH, Hom MA, Rogers ML, Duffy ME, Buchman-Schmitt JM, Spencer-Thomas S, Joiner TE. Problematic alcohol use and suicidal ideation among firefighters: A multi-study investigation of the explanatory roles of perceived burdensomeness and thwarted belongingness. J Affect Disord 2018; 238:281-288. [PMID: 29898427 DOI: 10.1016/j.jad.2018.05.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 04/18/2018] [Accepted: 05/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Firefighters are at increased risk for both problematic alcohol use and suicidality. Research has found that problematic alcohol use is related to suicidality among this population; however, limited data exist regarding what might account for this association. The present two-study investigation (1) examined the association between suicidality and problematic alcohol use among two large samples of firefighters and (2) tested whether interpersonal theory of suicide constructs-perceived burdensomeness (PB) and thwarted belongingness (TB)-serve as indirect indicators of this relationship. METHODS Participants in Study 1 were 944 U.S. firefighters (12.5% female); participants in Study 2 were 241 U.S. women firefighters. Participants completed the Interpersonal Needs Questionnaire, Alcohol Use Disorders Identification Test, and the Depressive Symptom Inventory-Suicidality Subscale (Study 1) or the Self-Injurious Thoughts and Behaviors Interview-Short Form (Study 2). Bias-corrected bootstrap indirect effects path analyses were utilized. RESULTS In Study 1, more problematic alcohol use was significantly associated with more severe career suicidal ideation via PB but not TB. In Study 2, problematic alcohol use was associated with career suicidal ideation via both PB and TB. PB seems to account for the relationship between problematic alcohol use and career suicidal ideation among male and female firefighters. LIMITATIONS Limitations include use of a cross-sectional design, use of retrospective measures of suicidal ideation, and our findings derived from subsamples of two existing datasets. CONCLUSIONS Findings suggest that PB and TB may explain the relationship between problematic alcohol use and suicidal ideation, but that this effect is discrepant based on gender.
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Affiliation(s)
- Austin J Gallyer
- Department of Psychology, Florida State University, Tallahassee, FL, United States.
| | - Sean P Dougherty
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Anna R Gai
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Ian H Stanley
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Megan L Rogers
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Mary E Duffy
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | | | | | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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Wildland firefighters and suicide risk: Examining the role of social disconnectedness. Psychiatry Res 2018; 266:269-274. [PMID: 29573853 DOI: 10.1016/j.psychres.2018.03.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/02/2018] [Accepted: 03/05/2018] [Indexed: 11/22/2022]
Abstract
Recent research has indicated that firefighters are at elevated suicide risk. Fire service organizations have called for research to examine fire service subgroups that might be at relatively increased suicide risk. Although anecdotal reports suggest that wildland firefighters represent one such group, to our knowledge, no study has empirically examined this conjecture. Thus, the present investigation examined if wildland firefighters report greater levels of suicide risk than non-wildland firefighters. Moreover, we sought to determine if two constructs proposed by the interpersonal theory of suicide to comprise suicidal desire-thwarted belongingness and perceived burdensomeness-statistically explain the link between wildland firefighter status and suicide risk. Merged data from two nationwide investigations of firefighter mental health were utilized (N = 1,131; 68.2% male, 89.4% White). A total of 1.8% (n = 20) of the sample identified as wildland firefighters. Compared to non-wildland firefighters, wildland firefighters reported greater levels of suicide risk. Thwarted belongingness, but not perceived burdensomeness, statistically explained this link. Findings suggest that programs enhancing social connectedness within the fire service, particularly among wildland firefighters, might be one avenue for suicide prevention among firefighters. Results of this novel investigation should be interpreted in light of the relatively small subgroup of wildland firefighters.
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Stanley IH, Boffa JW, Smith LJ, Tran JK, Schmidt NB, Joiner TE, Vujanovic AA. Occupational stress and suicidality among firefighters: Examining the buffering role of distress tolerance. Psychiatry Res 2018; 266:90-96. [PMID: 29857292 PMCID: PMC6397653 DOI: 10.1016/j.psychres.2018.05.058] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 04/29/2018] [Accepted: 05/23/2018] [Indexed: 11/24/2022]
Abstract
Past research indicates that firefighters are at increased risk for suicide. Firefighter-specific occupational stress may contribute to elevated suicidality. Among a large sample of firefighters, this study examined if occupational stress is associated with multiple indicators of suicide risk, and whether distress tolerance, the perceived and/or actual ability to endure negative emotional or physical states, attenuates these associations. A total of 831 firefighters participated (mean [SD] age = 38.37y[8.53y]; 94.5% male; 75.2% White). The Sources of Occupational Stress-14 (SOOS-14), Distress Tolerance Scale (DTS), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to examine firefighter-specific occupational stress, distress tolerance, and suicidality, respectively. Consistent with predictions, occupational stress interacted with distress tolerance, such that the effects of occupational stress on suicide risk, broadly, as well as lifetime suicide threats and current suicidal intent, specifically, were attenuated at high levels of distress tolerance. Distress tolerance may buffer the effects of occupational stress on suicidality among firefighters. Pending replication, findings suggest that distress tolerance may be a viable target for suicide prevention initiatives within the fire service.
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Affiliation(s)
- Ian H. Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Joseph W. Boffa
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Lia J. Smith
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA
| | - Jana K. Tran
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, TX 77002, USA
| | - N. Brad Schmidt
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA,Corresponding author. (A.A. Vujanovic)
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Hom MA, Stanley IH, Spencer-Thomas S, Joiner TE. Exposure to suicide and suicide bereavement among women firefighters: Associated suicidality and psychiatric symptoms. J Clin Psychol 2018; 74:2219-2237. [PMID: 30022494 DOI: 10.1002/jclp.22674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/18/2018] [Accepted: 06/21/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine experiences with suicide exposure and bereavement among women firefighters. METHODS Women firefighters (N = 266, Mage = 37.64y) completed self-report measures assessing their experiences with suicide exposure, history of suicidality, current psychiatric symptoms, and suicide risk. RESULTS Three-fourths (74.4%) of participants reported knowing someone who had died by suicide; of these participants, 31.3% reported losing a fellow firefighter to suicide. Exposure to suicide during one's firefighting career was associated with more severe psychiatric symptoms and suicide risk. Greater impact of a suicide death was significantly associated with more severe current suicide risk, even after controlling for prior suicidality and other psychiatric symptoms. CONCLUSIONS Women firefighters exposed to suicide during their careers may experience more severe psychiatric symptoms and increased suicide risk as compared to their counterparts without this exposure. In particular, women firefighters who are more severely impacted by a suicide loss may be at increased suicide risk.
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Affiliation(s)
- Melanie A Hom
- Department of Psychology, Florida State University, Tallahassee, Florida
| | - Ian H Stanley
- Department of Psychology, Florida State University, Tallahassee, Florida
| | | | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida
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Stanley IH, Smith LJ, Boffa JW, Tran JK, Schmidt NB, Joiner TE, Vujanovic AA. Anxiety sensitivity and suicide risk among firefighters: A test of the depression-distress amplification model. Compr Psychiatry 2018; 84:39-46. [PMID: 29684659 PMCID: PMC6402324 DOI: 10.1016/j.comppsych.2018.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 02/18/2018] [Accepted: 03/28/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Firefighters represent an occupational group at increased suicide risk. How suicidality develops among firefighters is poorly understood. The depression-distress amplification model posits that the effects of depression symptoms on suicide risk will be intensified in the context of anxiety sensitivity (AS) cognitive concerns. The current study tested this model among firefighters. METHODS Overall, 831 firefighters participated (mean [SD] age = 38.37 y [8.53 y]; 94.5% male; 75.2% White). The Center for Epidemiologic Studies Depression Scale (CES-D), Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess for depression symptoms, AS concerns (cognitive, physical, social), and suicide risk, respectively. Linear regression interaction models were tested. RESULTS The effects of elevated depression symptoms on increased suicide risk were augmented when AS cognitive concerns were also elevated. Unexpectedly, depression symptoms also interacted with AS social concerns; however, consistent with expectations, depression symptoms did not interact with AS physical concerns in the prediction of suicide risk. CONCLUSIONS In the context of elevated depression symptoms, suicide risk is potentiated among firefighters reporting elevated AS cognitive and AS social concerns. Findings support and extend the depression-distress amplification model of suicide risk within a sample of firefighters. Interventions that successfully impact AS concerns may, in turn, mitigate suicide risk among this at-risk population.
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Affiliation(s)
- Ian H. Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Lia J. Smith
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA
| | - Joseph W. Boffa
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Jana K. Tran
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, TX 77002, USA
| | - N. Brad Schmidt
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Thomas E. Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, Houston, TX 77204, USA, Corresponding author at: Trauma and Stress Studies Center, University of Houston, Department of Psychology, 3695 Cullen Boulevard, 126 Heyne Building, Houston, TX 77204, USA. (A.A. Vujanovic)
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Boffa JW, Stanley IH, Smith LJ, Mathes BM, Tran JK, Buser SJ, Schmidt NB, Vujanovic AA. Posttraumatic Stress Disorder Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity. J Nerv Ment Dis 2018; 206:179-186. [PMID: 29309295 PMCID: PMC5825264 DOI: 10.1097/nmd.0000000000000779] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Posttraumatic stress disorder (PTSD) symptoms are positively related to suicide risk among firefighters. One mechanism that may account for this relationship is anxiety sensitivity (AS) cognitive concerns-the fear that cognitive symptoms of anxiety will have catastrophic consequences. We sought to replicate the mediating effect of AS cognitive concerns on the relationship between PTSD symptoms and suicide risk among 214 trauma-exposed male firefighters with non-zero suicide risk. Bootstrap mediation analyses tested AS cognitive concerns as a statistical mediator of PTSD symptoms (total and symptoms clusters scores) and suicide risk, controlling for depression symptoms and relevant demographic variables. AS cognitive concerns statistically mediated the relationship between PTSD symptoms (total score, as well as intrusion, avoidance, and arousal-reactivity symptoms clusters) and suicide risk; however, the reverse was also true. AS cognitive concerns may confer risk for suicide among trauma-exposed firefighters. Firefighters may benefit from AS-specific interventions, which are shown to reduce PTSD symptoms and suicidality.
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Affiliation(s)
- Joseph W. Boffa
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Ian H. Stanley
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Lia J. Smith
- Department of Psychology, University of Houston, 126 Heyne Building, 3695 Cullen Boulevard, Houston, Texas, USA
| | - Brittany M. Mathes
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Jana K. Tran
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, Texas, USA
| | - Sam J. Buser
- Houston Fire Department, 1801 Smith Street, Suite 626, Houston, Texas, USA
| | - Norman B. Schmidt
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, Florida, USA
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, 126 Heyne Building, 3695 Cullen Boulevard, Houston, Texas, USA
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Abstract
This cross-sectional study investigated the association between harassment, career suicidality, and psychiatric symptoms among women firefighters. Women firefighters (n = 290) completed self-report measures of experiences with harassment on the job, career suicidality, and various psychiatric symptoms. Logistic regression analyses and one-way analyses of variance were used to address study aims. Of the sample, 21.7% reported having experienced sexual harassment and 20.3% reported having been threatened or harassed in another way on their firefighting job. Sexual harassment and other threats/harassment on the job were both significantly associated with a greater likelihood of reporting career suicidal ideation, as well as reporting more severe psychiatric symptoms. Harassment and threats experienced on the job may be associated with increased suicide risk and more severe psychiatric symptoms among women firefighters. Efforts are needed to reduce the occurrence of harassment and threats within the fire service and provide support for women firefighters who have been harassed or threatened.
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Stanley IH, Hom MA, Spencer-Thomas S, Joiner TE. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters. J Anxiety Disord 2017. [PMID: 28645017 DOI: 10.1016/j.janxdis.2017.06.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. METHOD A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). RESULTS Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. CONCLUSIONS Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors.
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Affiliation(s)
- Ian H Stanley
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA.
| | - Melanie A Hom
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
| | | | - Thomas E Joiner
- Department of Psychology, Florida State University, 1107 West Call Street, Tallahassee, FL 32306, USA
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