Associations between organizational and incident factors and emotional distress in emergency ambulance personnel.

OBJECTIVES This study examined the prevalence and correlates of post-traumatic stress disorder (PTSD), anxiety and depression among emergency ambulance personnel. DESIGN AND METHOD A questionnaire and reminder were sent anonymously to 1029 emergency ambulance personnel in a large ambulance service. RESULTS Among the 617 respondents, levels of PTSD symptoms did not differ according to grade, but men had a higher prevalence rate than women. Key predictors of the severity of symptoms were organizational stress, the frequency of experiencing potentially traumatic incidents, length of service, and dissociation in response to an index incident. The degree of organizational, but not incident-related, stress discriminated between 'cases' and 'non-cases'. Nine and 23% of recorded scores indicated clinical levels of depression and anxiety respectively. Several work factors were associated with these emotions, explaining 38% of anxiety and 31% of depression scores. CONCLUSION Both organizational and individually based interventions may be necessary to minimize PTSD and other emotional disorders among ambulance personnel.

[1]  C. Tennant.  Work-related stress and depressive disorders. , 2001, Journal of psychosomatic research.

[2]  P. Rosch.  Reminiscences of Hans Selye, and the birth of "stress". , 1999, International journal of emergency mental health.

[3]  A. Taylor,et al.  The impact of severity of physical injury and perception of life threat in the development of post-traumatic stress disorder in motor vehicle accident victims. , 1995, Behaviour research and therapy.

[4]  U. Ehlert,et al.  Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. , 1998, The American journal of psychiatry.

[5]  K. Brady,et al.  Screening for PTSD in a Substance Abuse Sample: Psychometric Properties of a Modified Version of the PTSD Symptom Scale Self-Report , 1998, Journal of traumatic stress.

[6]  P. Bennett,et al.  Stress in nurses: Coping, managerial support and work demand. , 2001 .

[7]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[8]  A. Ehlers,et al.  PTSD symptoms, response to intrusive memories and coping in ambulance service workers. , 1999, The British journal of clinical psychology.

[9]  D. Clark,et al.  Cognitive factors involved in the onset and maintenance of posttraumatic stress disorder (PTSD) after physical or sexual assault. , 1999, Behaviour research and therapy.

[10]  J M Violanti,et al.  Sources of Police Stressors, Job Attitudes, and Psychological Distress , 1993, Psychological reports.

[11]  H. Wittchen,et al.  Traumatic events and post‐traumatic stress disorder in the community: prevalence,risk factors and comorbidity , 2000, Acta psychiatrica Scandinavica.

[12]  J. Pennebaker.  The effects of traumatic disclosure on physical and mental health: the values of writing and talking about upsetting events. , 1999, International journal of emergency mental health.

[13]  S Rose,et al.  Psychological debriefing for preventing post traumatic stress disorder (PTSD). , 2002, The Cochrane database of systematic reviews.

[14]  R. Kessler,et al.  Previous exposure to trauma and PTSD effects of subsequent trauma: results from the Detroit Area Survey of Trauma. , 1999, The American journal of psychiatry.

[15]  R. Snaith,et al.  The Hospital Anxiety and Depression Scale , 1983 .

[16]  A. Baum,et al.  Similarity of prior trauma exposure as a determinant of chronic stress responding to an airline disaster. , 2000, Journal of consulting and clinical psychology.

[17]  R. Kessler,et al.  Posttraumatic stress disorder in the National Comorbidity Survey. , 1995, Archives of general psychiatry.

[18]  A. Tattersall,et al.  Stress and coping in hospital doctors , 1999 .

[19]  A. Ehlers,et al.  Early psychological interventions for adult survivors of trauma: a review , 2003, Biological Psychiatry.

[20]  M. Creamer,et al.  Risk Factors for Posttrauma Reactions in Police Officers: A Longitudinal Study , 2001, The Journal of nervous and mental disease.

[21]  D. Alexander,et al.  Ambulance personnel and critical incidents , 2001, British Journal of Psychiatry.

[22]  P. Bennett,et al.  Predicting post-traumatic symptoms in cardiac patients. , 2001, Heart & lung : the journal of critical care.

[23]  C. Slovis,et al.  Anxiety levels in EMS providers: effects of violence and shifts schedules. , 1999, The American journal of emergency medicine.

[24]  D. Weiss,et al.  Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. , 1999, The Journal of nervous and mental disease.

[25]  F. Grevin,et al.  Posttraumatic Stress Disorder, Ego Defense Mechanisms, and Empathy among Urban Paramedics , 1996, Psychological reports.

[26]  Chris R Brewin,et al.  Psychological theories of posttraumatic stress disorder. , 2003, Clinical psychology review.