Factors Associated with Psychiatric Morbidity, Post-Traumatic Stress Disorder and Post-Traumatic Growth in Paramedic First Responders: The Role of Core Beliefs

Introduction Paramedics are routinely exposed to traumatic events. This study describes the rates of post-traumatic stress disorder (PTSD), psychiatric morbidity and levels of post-traumatic growth (PTG) in New Zealand first responder paramedics, exploring a mix of demographic, professional, crewing status and exposure risk factors associated with these outcomes and their associations with core belief disruptions. Methods A cross-sectional study recruited paramedics (N=579) working in a first responder role. Univariate and multivariate logistic and linear regressions were conducted to identify predictors of PTSD, non-specific psychiatric morbidity and PTG in trauma-exposed participants. Results Two-thirds (66.3%) reported significant psychiatric morbidity, with volunteer paramedics being significantly less at risk when compared with professional paramedics (OR=0.52; 95% CI: 0.31-0.87; p<0.01). Probable PTSD was reported by 14.6% of participants. Older age reduced the odds of this (OR=0.94; 95% CI: 0.92-0.98; p<0.01) while experiencing greater disruptions in core beliefs increased the odds (OR=2.75; 95% CI: 2.00-3.77; p<0.01). Being female (t=4.70; p<0.01) and experiencing greater core belief disruption (t=7.54; p<0.01) (adjusted R 2 =0.27) independently contributed to PTG. Conclusion Although PTSD rates were typical of first responders generally, psychiatric morbidity rates were high and may be more prevalent in professional staff. Contextual and methodological factors may have influenced these outcomes. Core belief disruptions predict both negative and positive emotional states, suggesting their important role in workplace interventions.