Posttraumatic Stress Disorder in Firefighters

Article information

J Korean Med Assoc. 2008;51(12):1103-1110
Publication date (electronic) : 2008 January 10
doi : https://doi.org/10.5124/jkma.2008.51.12.1103
Department of Psychiatry, Ajou University College of Medicine E – mail: ykchung@ajou.ac.kr

Abstract

Abstract

Firefighters are much more likely to be exposed to traumatic events and consequently experience traumatic stress due to the nature of their job. Moreover, firefighters are at an increased risk of repeated exposures to traumatic events. Repeated exposures to traumatic events in firefighters lead to a greater likelihood of suffering from traumatic stress-related mental health problems, including posttraumatic stress disorder (PTSD). Previous studies from several countries have consistently reported higher prevalence rates of PTSD among firefighters. In addition to subjective suffering, PTSD is known to have adverse effects on social, occupational, and familial functionings in patients with PTSD. In the present paper, the authors reviewed the prevalence rates and adverse effects of PTSD on their lives among firefighters. We also present the review on factors affecting the occurrence of PTSD with brief description on how to prevent PTSD in firefighters.

References

1. American Psychiatric Association. Diagnostic and statistical manual of mental disorder 4th ed.th ed. (DSM-IV) American Psychiatric Press; 1994.
2. Regehr C, Bober T. In the line of fire Oxford University Press; 2005.
3. National Emergency Management Agency. Statistics on national fire and emergency management in 2007 Seoul: Samjingihoek; 2007.
4. Kessler RC, Sonnega A, Bromet E, Hughes M, Nelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry 1995;52:1048–1060.
5. Kim SH, Cho SM, Kim JA, Lim KY, Kim KH, Cho JP, Choi HK, Shin YM, Hong CH, Song SH, Kim YJ, Chung YK. A study on posttraumatic stress disorder in Korean firefighters Seoul: National Emergency Management Agency; 2008.
6. Beaton R, Murphy S, Johnson C, Pike K, Corneil W. Exposure to duty-related incident stressors in urban firefighters and paramedics. J Trauma Stress 1998;11:821–828.
7. McFarlane AC. The aetiology of posttraumatic mobidity: predisposing, precipitating and perpetuating factors. Br J Psychiatry 1989;154:221–228.
8. North CS, Tivis L, McMillen JC, Pfefferbaum B, Spitznagel EL, Cox J, Nixon S, Bunch KP, Smith EM. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry 2002;159:857–859.
9. Psarros C, Theleritis CG, Martinaki S, Bergiannaki ID. Traumatic reactions in firefighters after wildfires in Greece. Lancet 2008;371:301.
10. Horowitz M, Wliner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med 1979;41:209–218.
11. Alexander DA, Klein S. Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional wellbeing. Br J Psychiatry 2001;176:76–81.
12. Foa EB. Posttraumatic Stress Diagnostic Scale (PDS) Manual Mineapolis, MN: National Computer System; 1995.
13. Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry 1998;155:1727–1732.
14. Corneil W, Beaton R, Murphy S, Johnson C, Pike Ken. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occ Health Psychology 1999;4:131–141.
15. Mitani S, Fusita M, Nakata K, Shirakawa T. Impact of posttraumatic stress disorder and job-related stress on burnout: a study of fire service workers. J Emerg Med 2006;31:7–11.
16. Chen YS, Chen MC, Chou FHC, Sun FC, Chen PC, Tsai KY, Chao SS. The relationship between quality of life and posttraumatic stress disorder or major depression for firefighters in Kaoshiung, Taiwan. Qual Life Res 2007;16:1289–1297.
17. Eun HJ, Kwon TW, Lee SM, Kim TH, Choi MR, Cho SJ. A study on reliability and Validity of the Korean verson of impact of event scale-revised. J Korean Neuropsychiatr Assoc 2005;44:303–310.
18. Kim SH, Baek EA, Chae KC, Jeong SK. Prevalence of symptoms of posttraumatic stress disorder in Korean firefighters. Recented at the annual meeting of Korean Neuropsychiatric in 2007.
19. Hall RC, Gradner ER, Perl M, Stickney SK, Pfefferbaum B. The professional burnout syndrome. Psychiatr Opinion 1979;16:12–17.
20. Breslau N, Davis GC, Peterson EL, Schultz L. Psychiatric sequelae of posttraumatic stress disorder in women. Arch Gen Psychiatry 1997;54:81–87.
21. Menendez AM, Molloy J, Magaldi MC. Health responses of New York City firefighter spouses and their families post-September 11, 2001 terrorist attacks. Issues Ment Health Nurs 2006;27:905–917.
22. Jordan BK, Marmar CR, Fairbank JA, Schlenger WE, Kulka RA, Hough RL, Weiss DS. Problems in families of male Vietnam veterans with posttraumatic stress disorder. J Consult Clin Psychol 1992;60:916–296.
23. Solomon Z, Waysman M, Levy G, Fried B, Mikulincer M, Ben-benishty R, Florian V, Bleich A. From front line to home front: a study of secondary traumatization. Fam Process 1992;31:289–302.
24. Pfefferbaum B, North CS, Bunch K, Wilson TG, Tucker P, Schorr JK. The impact of the 1995 Oklahoma City bombing on the partners of firefighters. J Urban Health 2002;79:364–372.
25. Boscarino JA. Posttraumatic stress disorder and physical illness: results from clinical and epidemiologic studies. Ann N Y Acad Sci 2004;1032:141–153.
26. Beckham JC, Moore SD, Feldman ME, Hertzberg MA, Kirby AC, Fairbank JA. Health status, somatization, and severity of posttraumatic stress disorder in Vietnam combat veterans with posttraumatic stress disorder. Am J Psychiatry 1998;155:1565–1569.
27. Schnurr PP, Spiro A, Paris AH. Physician-diagnosed medical disorders in relation to PTSD symptoms in older malemilitary veterans. Health Psychol 2000;19:91–97.
28. Dirkzwager AJ, van der Velden PG, Grievink L, Yzermans CJ. Disaster-related posttraumatic stress disorder and physical health. Psychosom Med 2007;69:435–440.
29. McFarlane AC, Atchison M, Rafalowicz E, Papay P. Physical symptoms in posttraumatic stress disorder. J Psycho Res 1994;38:715–726.
30. Orcutt HK, Erickson DJ, Wolfe J. A prospective analysis of trauma exposure: the mediating role of PTSD symptomatology. J Trauma Stress 2002;15:259–266.
31. Mollica RF, McInnes K, Poole C, Tor S. Dose-effect relationships of trauma to symptoms of depression and posttraumatic stress disorder among Cambodian survivors of mass violence. Br J Psychiatry 1998;173:482–488.
32. Bryant RA, Harvey AG. Posttraumatic stress reactions in volunteer firefighters. J Trauma Stress 1996;9:51–62.
33. Bowman ML. Individual differences in posttraumatic distress: problems with the DSM-IV model. Can J Psychiatry 1999;44:21–33.
34. Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol 2000;68:748–766.
35. Marmar CR, McCaslin SE, Metzler TJ, Best S, Weiss DS, Fagan J, Liberman A, Pole N, Otte C, Yehuda R, Mohr D, Neylan T. Predictors of posttraumatic stress in police and other first responders. Ann N Y Acad Sci 2006;1071:1–18.
36. McCarroll JE, Fullerton CS, Ursano RJ, Hermsen JM. Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas. Am J Psychiatry 1996;153:778–782.
37. Pisarski D, Bohle P, Callan V. Extended shifts in ambulance work: influence on health. Stress Health 2002;18:119–126.
38. Fairbank JA, Ebert L, Costello EJ. Epidemiology of traumatic events and posttraumatic disorder. In : Nutt D, Davidson JRT, Zohar J, eds. Post-traumatic stress disorder: Diagnosis, Management and Treatment London: Martin Dunitz Ltd; 2000. p. 19–27.
39. Bryant R, Guthrie RM. Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. J Consult Clin Psychol 2007;75:812–815.
40. Heinrichs M, Wager D, Schoch W, Soravia LM, Hellhammer DH, Ehlert U. Predicting posttraumatic stress symptoms from pretraumatic risk factors: a 2-year prospective follow-up study in firefighters. Am J Psychiatry 2005;162:2276–2286.
41. Beaton R, Murphy S, Johnson C, Pike K, Corneil W. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. J Trauma Stress 1999;12:293–308.
42. Kobasa SC. Stressful life events, personality, and health: an inquiry into hardiness. J Pers Soc Psychol 1979;37:1–11.
43. Farber EW, Schwartz JA, Schaper PE, Moonen DJ, McDaniel JS. Resilience factors associated with adaptation to HIV disease. Psychosomatics 2000;41:140–146.
44. King LA, King DW, Fairbank JA, Keane TM, Adams GA. Resilience-recovery factors in posttraumatic stress disorder among female and male Vietnam veterans: hardiness, postwar social support, and additional stressful life events. J Pers Soc Psychol 1998;74:420–434.
45. Alvarez J, Hunt M. Risk and resilience in canine search and rescue handlers after 9/11. J Trauma Stress 2005;18:497–505.
46. Hagh-Shenas H, Goodarzi MA, Dehbozorgi G, Farashbandi H. Psychological consequences of the Bam Earthquake on professional and nonprofessional helpers. J Trauma Stress 2005;18:477–483.
47. Guo Y, Chen C, Lu M. Posttraumatic stress disorder among professional and nonprofessional rescuers involved in an earthquake in Taiwan. Psychiatry Res 2004;127:35–41.
48. Regehr C, Hill J, Knott T, Sault B. Social support, self-efficacy and trauma in new recruits and experienced firefighters. Stress Health 2003;19:189–193.
49. Mitani S, Fujita M, Sakamoto S, Shirakawa T. Effect of autogenic training on cardiac autonomic nervous activity in high-risk fire service workers for posttraumatic stress disorder. J Psychosom Res 2006;60:439–444.
50. Borman JE, Smith TL, Becker S, Gershwin M, Pada L, Grudzinski AH, Nurmi EA. Efficacy of frequent mantram repetition on stress, quality of life, and spiritual wellbeing in veterans. J Holist Nurs 2005;23:395–414.
51. Kawakami N, Kobayashi Y, Takao S, Tsutsumi A. Effects of web-based supervisor training on supervisor support and psychological distress among workers: a randomized controlled trial. Preventive Med 2005;41:471–478.
52. Shimazu A, Umanodan R, Schaufeli WB. Effects of a brief worksite stress management program on coping skills, psychological distress and physical complaints: a controlled trial. Int Arch Occup Environ Health 2006;80:60–69.

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