Posttraumatic Stress Symptomatology in Fire Fighters

Introduction

A cross-sectional survey for exposure to traumatic incidents and the prevalence of posttraumatic stress symptomatology was carried out by Cornell, Beaton, Murphy, Johnson, and Pike (1999) among the urban firefighters in United States and Canada. This study was undertaken with a sample 203 firefighters from U.S. and 625 firefighters from Canada. These samples composed mostly men with an average age of 39 years. The women who were involved in this sample comprised 9 percent in the U.S. sample with no female respondents in the Canadian sample (Cornell et al., 1999). In the U.S. sample the percentage of paramedics was 13% versus the Canadian sample which did not include paramedics due to different ambulance medic service. Both U.S. and Canadian samples had almost the same average mean with U.S mean being 38.85 years versus that of Canada which was 38.90 years.

The other aspects that were compared between the two samples was the average years that each sample had been employed in the fire service where the U.S sample was 12.25 years versus that of Canadian sample which stood at 10.86 years. The other difference between the two samples was the individual behavior between the two samples where the U.S sample showed a higher rate of likelihood to smoke and had a possession of a second job compared to that of Canadian sample. In addition, the U.S sample had a higher rate of on-the-job injury which was 42.4 versus that of Canadian which was 25.4. The similarities that were noted between the two samples were mostly in background, biodemographic indexes like the percentage number of individuals who were married at the time and those who had been in the firefighter service for not less than 15 years. Both samples showed similarities on comparison with other urban fighters from other countries in terms of their structures in the paramilitary organization, stress and risk in their duties and even recurrent exposures to sufferings the population they deal with go through which include death. The survey also identified that in both samples, the exposure to traumatic incidents among the respondents was similar to that of nonparticipants (Cornell et al., 1999).

Methodology and results of the study

The method that was used for this study was naturalistic observation where the instrument used to evaluate the presence and frequency of posttraumatic stress symptomatology was the Impact of Events Scale (IES). The scale which is 15-item measure of these events resulting to a total score and subscale score in both Intrusive and Avoidance IES. Its possession of effective internal reliability makes the evaluation of these events in various populations that are exposed to trauma possible. This includes the volunteer firefighters who are often exposed to several fatalities due to different incidences like apartment and fatal bush fires. The scale is also used to assess victims of war like it did during the Gulf war. The other strength that IES scale exhibits is the ability to have good sensitivity and being specific. This is due to possession of effective test and retest in both Intrusive and Avoidance IES subscales.

During the survey, the respondents were directed on how they would indicate the frequency that would show how they experienced a certain symptom within the previous week. Using the weightings of the respondents’ frequency which were as follows: 0 represented those who did not experience the symptoms at all, 1 represented those who experienced the symptoms rarely, 3 represented those who experienced the symptoms sometimes while 5 represented those who experienced the symptoms often in the previous week; the total and subscale IES scale were derived from them. The total IES score was used to establish the case of a posttraumatic stress symptomatology among the respondents (Cornell et al., 1999).

The other instrument that was used in the survey is the Sources of Occupational Stress (SOOS). This method had a clear record of reliability and validity in its previous research thus, it was effective for this survey. It was therefore used to come up with work-related strain among the U.S. firefighter sample. Using this instrument, the evaluation of the types and levels of psychological stressors among the firefighters and the paramedics was made possible. This was achieved through the indication of the respondents whether they had experienced any stressor that was related to their occupation during the previous 10 work shifts. They were also expected to indicate the bother that the stressor had caused on their lives using a visual analog scale that rated from 0-100. The weightings of this scale were as follows: 100 represented those who were extremely bothered, 50 represented the respondents who were bothered in a way while 0 represented the respondents who were not bothered at all. Among the Canadian urban firefighter sample, Work Environment Scale (WES) was used to evaluate their work strain (Cornell et al.,

1999). This scale is also reliable and valid in determining the strain in various dimensions of social climate.

After the survey was undertaken, the results showed that the posttraumatic stress sysmptomatology among the Canadian firefighters had almost similar frequencies of avoidance and intrusive rates with that of U.S. firefighters. This is because the rate of PSTD based on the caseness criterion that was employed showed that the U.S firefighter sample was 22% which was not significantly greater than that of the Canadian firefighter sample which was rated at 17 % on the same caseness criterion (Cornell et al., 1999).

Conclusion

The results of the survey indicated that the PTSD which was based on self-reports of post trauma sysmptomatology on the IES led to a result that indicated that the U.S. sample firefighters compared to that of their Canadian counterpart was not significantly different. This sharply contrasted the records that had been indicated by the documental records in the U.S. fire service respondents. The sample data for this survey illustrated that in both U.S. and Canadian samples, the risk factors for post trauma results in urban firefighters are multifaceted. The contrast in this survey was as a result of using the same self-report measure in the various cases. The other factor that led to this contrast was the use of naturalistic observation which made it impossible to control the type of traumatic incident exposures. This is unlike the previous documented records where an operational criterion was used to categorize these traumatic exposures. The use of shorter timeframe in recording the experiences of the respondents is another factor that determined the reliability of the study. This is because unlike in the previous practices where the experiences of the respondents would be recorded for a period of one year, this study recorded the experiences of the respondents within a shorter period like a week. This is bound to produce more reliable results as the respondents can easily recall how the experiences they underwent affected their lives unlike an occurrence that took place a year ago since they may forget.

The study also indicated that there are other factors that contribute to posttraumatic stress disorders among the firefighters besides exposure to traumatic events. These are aspects that involve their social support when not in the work activities like in their families and also the nature of their working conditions. According to Cornell et al. (1999) the improvement of the firefighters' conditions of work especially in their organizational and even administrative factors is an important factor in reducing this stress. The findings that this study has established have great implications on future research especially due to issues of vulnerability-resilience factors.

This is because the study has established that the a good working condition that involve protection of the firefighters and effective social support on these individuals is bound to reduce the work- related strain and also improving the health of the firefighters in general. The study has also indicated the work-related traumatic incidents are not the main reasons for PSTD as it was earlier thought. This was confirmed by the U.S. firefighter sample.

The findings of this study are likely to affect the lives of the firefighters, their organizations and even their families in a number of ways. This is because the way an organization trains its workers to deal with emergency situation was noted as an important factor in determining how well they are equipped.

Some of the limitations that this study indicated include use of cross-sectional methodology and self-report assessment alone. This therefore limited the determination of trauma that individuals may have experienced before the period that was recorded. The individual past psychological issues was also highlighted as a factor that may influence the ability of the firefighters to deal with trauma that is developed by various experiences during their duties. The other limitations in this study involved the use of different sample sizes between the two countries and also lack of inclusion of a measure of the Diagnostic and Statistical Manual of Mental Disorders which was significant in authenticating the self-report PSTD caseness method that was employed.