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The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters

Published online by Cambridge University Press:  10 December 2017

Michelle L. Pennington
Affiliation:
Baylor Scott and White Health, Warriors Research Institute, Waco, Texas USA
Thomas P. Carpenter
Affiliation:
Seattle Pacific University, School of Psychology, Family, and Community, Seattle, Washington USA
Samantha J. Synett
Affiliation:
Baylor Scott and White Health, Warriors Research Institute, Waco, Texas USA
Victoria A. Torres
Affiliation:
Baylor Scott and White Health, Warriors Research Institute, Waco, Texas USA
Jennifer Teague
Affiliation:
Baylor University College of Arts and Sciences, Department of Biology, Waco, Texas USA
Sandra B. Morissette
Affiliation:
The University of Texas at San Antonio, Department of Psychology, San Antonio, Texas USA
Jeffrey Knight
Affiliation:
Veterans Affairs Boston Healthcare System, Boston, Massachusetts USA Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts USA
Barbara W. Kamholz
Affiliation:
Veterans Affairs Boston Healthcare System, Boston, Massachusetts USA Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts USA
Terence M. Keane
Affiliation:
Veterans Affairs Boston Healthcare System, Boston, Massachusetts USA Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts USA
Rose T. Zimering
Affiliation:
Veterans Affairs Boston Healthcare System, Boston, Massachusetts USA Boston University School of Medicine, Department of Psychiatry, Boston, Massachusetts USA
Suzy B. Gulliver*
Affiliation:
Baylor Scott and White Health, Warriors Research Institute, Waco, Texas USA Texas A&M University Health Science Center, Department of Psychiatry and Behavioral Science, Temple, Texas USA
*
Correspondence: Suzy B. Gulliver, PhD Baylor Scott & White Health Warriors Research Institute 2201 MacArthur Drive, Suite 2200 Waco, Texas 76708 USA E-mail: suzybird@aol.com

Abstract

Introduction

Firefighters represent an important population for understanding the consequences of exposure to potentially traumatic stressors.

Hypothesis/Problem

The researchers were interested in the effects of pre-employment disaster exposure on firefighter recruits’ depression and posttraumatic stress disorder (PTSD) symptoms during the first three years of fire service and hypothesized that: (1) disaster-exposed firefighters would have greater depression and PTSD symptoms than non-exposed overall; and (2) depression and PTSD symptoms would worsen over years in fire service in exposed firefighters, but not in their unexposed counterparts.

Methods

In a baseline interview, 35 male firefighter recruits from seven US cities reported lifetime exposure to natural disaster. These disaster-exposed male firefighter recruits were matched on age, city, and education with non-exposed recruits.

Results

A generalized linear mixed model revealed a significant exposure×time interaction (e coef =1.04; P<.001), such that depression symptoms increased with time for those with pre-employment disaster exposure only. This pattern persisted after controlling for social support from colleagues (e coefficient=1.05; P<.001), social support from families (e coefficient=1.04; P=.001), and on-the-job trauma exposure (coefficient=0.06; e coefficient=1.11; P<.001). Posttraumatic stress disorder symptoms did not vary significantly between exposure groups at baseline (P=.61).

Conclusion

Depression symptoms increased with time for those with pre-employment disaster exposure only, even after controlling for social support. Posttraumatic stress disorder symptoms did not vary between exposure groups.

Pennington ML , Carpenter TP , Synett SJ , Torres VA , Teague J , Morissette SB , Knight J , Kamholz BW , Keane TM , Zimering RT , Gulliver SB . The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters. Prehosp Disaster Med. 2018;33(1):102–108.

Type
Brief Report
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/funding/disclaimer: This research was supported by a research grant from National Institute of Mental Health (NIMH; Bethesda, Maryland USA; R01-MH-73808) to Suzy B. Gulliver entitled “Pathways of Risk and Resilience in Firefighter Recruits.” The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of NIMH, Veterans Affairs, or the United States government. The authors have no conflicts of interest to declare.

References

1. Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiat. 1995;52(12):1048-1060.Google Scholar
2. Fullerton, CS, Ursano, RJ, Wang, L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiat. 2004;161(8):1370-1376.CrossRefGoogle ScholarPubMed
3. Berger, W, Coutinho, ESF, Figueira, I, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Soc Psychiatry Psychiatr Epidemiol. 2012;47(6):1001-1011.CrossRefGoogle Scholar
4. Neria, Y, Nandi, A, Galea, S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. 2008;38(4):467-480.Google Scholar
5. Acierno, R, Ruggiero, KJ, Galea, S, et al. Psychological sequelae resulting from the 2004 Florida hurricanes: implications for post-disaster intervention. Am J Public Health. 2007;97(Suppl 1):S103-S108.Google Scholar
6. Bei, B, Bryant, C, Gilson, K, et al. A prospective study of the impact of floods on the mental and physical health of older adults. Aging Ment Health. 2013;17(8):992-1002.Google Scholar
7. Canino, G, Bravo, M, Rubio-Stipec, M, Woodbury, M. The impact of disaster on mental health: prospective and retrospective analyses. Int J Ment Health. 1990;19(1):51-69.CrossRefGoogle Scholar
8. Gadermann, AM, Alonso, J, Vilagut, G, Zaslavsky, AM, Kessler, RC. Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R). Depress Anxiety. 2012;29(9):797-806.Google Scholar
9. Ginexi, EM, Weihs, K, Simmens, SJ, Hoyt, DR. Natural disaster and depression: a prospective investigation of reactions to the 1993 Midwest floods. Am J Commun Psychol. 2000;28(4):495-518.Google Scholar
10. Kohn, R, Levav, I, Garcia, ID, Machuca, ME, Tamashiro, R. Prevalence, risk factors, and aging vulnerability for psychopathology following a natural disaster in a developing country. Int J Geriatr Psychiatry. 2005;20(9):835-841.Google Scholar
11. Pietrzak, RH, Southwick, SM, Tracy, M, Galea, S, Norris, FH. Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike. J Affect Disord. 2012;138(1-2):96-103.Google Scholar
12. Rhodes, J, Chan, C, Paxson, C, Rouse, CE, Waters, M, Fussel, E. The impact of Hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry. 2010;80(2):237-247.CrossRefGoogle ScholarPubMed
13. Shore, JH, Tatum, EL, Vollmer, WM. Psychiatric reactions to disaster: the Mount St. Helens experience. Am J Psychiatry. 1986;143(5):590-595.Google Scholar
14. Toukmanian, SG, Jadaa, D, Lawless, D. A cross-cultural study of depression in the aftermath of a natural disaster. Anxiety Stress Coping. 2000;13(3):289-307.CrossRefGoogle Scholar
15. Tracy, M, Norris, FH, Galea, S. Differences in the determinants of posttraumatic stress disorder and depression after a mass traumatic event. Depress Anxiety.. 2011;28(8):666-675.CrossRefGoogle ScholarPubMed
16. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC USA: American Psychiatric Association; 2013.Google Scholar
17. Centers for Disease Control and Prevention (2006). Health hazard evaluation of police officers and firefighters after Hurricane Katrina--New Orleans, Louisiana, October 17-28 and November 30-December 5, 2005. MMWR Morb Mortal Wkly Rep. 2006;55(16):456-458.Google Scholar
18. Tak, S, Driscoll, R, Bernard, B, West, C. Depressive symptoms among firefighters and related factors after the response to Hurricane Katrina. J Urban Health. 2007;84(2):153-161.CrossRefGoogle ScholarPubMed
19. Armagan, E, Engindeniz, Z, Devay, AO, Erdur, B, Ozcakir, A. Frequency of post-traumatic stress disorder among relief force workers after the tsunami in Asia: do rescuers become victims? Prehosp Disaster Med. 2006;21(3):168-172.CrossRefGoogle ScholarPubMed
20. Ozen, S, Sir, A. Frequency of PTSD in a group of search and rescue workers two months after 2003 Bingol (Turkey) earthquake. J Nerv Ment Dis. 2004;192(8):573-575.Google Scholar
21. McFarlane, AC, Papay, P. Multiple diagnoses in posttraumatic stress disorder in the victims of a natural disaster. J Nerv Ment Dis. 1992;180(8):498-504.Google Scholar
22. Sheehan, DV, Lecrubier, Y, Harnett-Sheehan, K, et al. The MINI International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview. J Clin Psychiatry. 1998;59(Suppl 20):22-33.Google Scholar
23. Blake, DD, Weathers, FW, Nagy, LM, et al. The development of a clinician-administered PTSD scale. J Trauma Stress. 1995;8(1):75-90.Google Scholar
24. Weathers, FW, Litz, BT. Psychometric properties of the clinician-administered PTSD scale, CAPS-1. PTSD Research Quarterly. 1994;5:2-6.Google Scholar
25. Spitzer, RL, Williams, JB, Gibbon, M, First, MB. The structured clinical interview for DSM-III-R (SCID) I: history, rationale, and description. Arch Gen Psychiatry. 1992;49(8):624.Google Scholar
26. Green, BL. Trauma history questionnaire. Measurement of Stress, Trauma, and Adaptation. 1996;1:366-369.Google Scholar
27. Beck, AT, Guth, D, Steer, RA, Ball, R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35(8):785-791.CrossRefGoogle ScholarPubMed
28. Weathers, FW, Litz, BT, Herman, DS, Huska, JA, Keane, TM. The PTSD Checklist (PCL): Reliability, Validity, and Diagnostic Utility. Paper presented at: Annual Meeting of the International Society for Traumatic Stress Studies; San Antonio, Texas USA: October 1993.Google Scholar
29. Ruggiero, KJ, Ben, KD, Scotti, JR, Rabalais, AE. Psychometric properties of the PTSD Checklist – Civilian version. J Trauma Stress. 2003;16(5):495-502.Google Scholar
30. King, DW, King, LA, Vogt, DS. Manual for the Deployment Risk and Resilience Inventory (DRRI): A Collection of Scales for Studying Deployment-Related Experiences in Military Veterans. Boston, Massachusetts USA: National Center for PTSD; 2003.Google Scholar
31. Hox, J, et al. (eds). Multilevel Analysis: Techniques and Applications. 2nd ed. New York, New York USA: Routledge; 2010.Google Scholar
32. Raudenbush, SW, Bryk, AS, et al. (eds). Hierarchical Linear Models: Applications and Data Analysis Methods. 2nd ed. Thousand Oaks, California USA: Sage; 2002.Google Scholar
33. Bates, D, Mächler, M, Bolker, BM, Walker, SC. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1):1-48.Google Scholar
34. lmerTest: Tests for random and fixed effects for linear mixed effect models (lmer objects of lme4 package): R package version 2.0-6. http://cran.r-project.org/package=lmerTest. Accessed July 12, 2014.Google Scholar
35. Atkins, DC, Baldwin, SA, Zheng, C, Gallop, RJ, Neighbors, C. A tutorial on count regression and zero-altered count models for longitudinal substance use data. Psychol Addict Behav. 2013;27(1):166-177.Google Scholar