Research Article
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İtfaiyecilerde travmatik stres belirtilerinin belirleyicileri

Year 2022, Volume: 6 Issue: 2, 182 - 196, 25.08.2022
https://doi.org/10.5455/kpd.26024438m000067

Abstract

İtfaiyeciler acil durumlarda ilk müdahalede bulunan diğer meslek grupları gibi ruhsal bozukluklar deneyimleme riski yüksek bir gruptur. Yapılan bu çalışmada Türkiye’de çalışan itfaiyecilerde travmatik stres belirtileri ve depresyon riskini araştırmak; ayrıca travmatik stres belirtilerini yordayan olay öncesi ve sırasındaki değişkenleri incelemek amaçlanmıştır. Davranış, Güvenlik ve Kültür-Acil Durum Müdahale Ekibi Formu, Hasta Sağlık Anketi-2 ve Olayların Etkisi Ölçeği kullanılarak araştırmaya katılmayı kabul eden 35 ilin itfaiye şefliğinde çalışan toplam 468 itfaiyeciden veri toplanmıştır. Yapılan çalışma sonucunda itfaiyecilerin yaklaşık yarısının olası travma sonrası stres bozukluğu tanısını karşıladığı, yaklaşık beşte birinin ise depresyon riskine sahip olduğu görülmüştür. Olay sırasında deneyimlenen sıkıntı düzeyinin travmatik stres belirti düzeyindeki varyansı en fazla açıklayan değişken olduğu görülmüştür. Elde edilen bulgular, itfaiyecilerin psikolojik destek sistemine erişiminin sağlanması gerektiğine işaret etmektedir. Böylece hem ruhsal sorunların sürmesi hem de yaşam kalitesinin azalmasını önlemek mümkün olabilir.

References

  • Alden, L. E., Matthews, L. R., Wagner, S., Fyfe, T., Randall, C., Regehr, C., White, M., Buys, N., Carey, M. G., Corneil, W., White, N., Fraess-Phillips, A. ve Krutop, E. (2021). Systematic literature review of psychological interventions for first responders. Work & Stress, 35(2), 193-215.
  • Amat, J., Paul, E., Watkins, L. R. ve Maier, S. F. (2008). Activation of the ventral medial prefrontal cortex during an uncontrollable stressor reproduces both the immediate and long-term protective effects of behavioral control. Neuroscience, 154, 1178-1186.
  • Antonovsky, A. (1979). Health, stress, and coping. Jossey-Bass.
  • Ayranci, U. (2005). Violence toward health care workers in emergency departments in west Turkey. The Journal of emergency medicine, 28(3), 361-365.
  • Banes, C. J. (2014). Firefighters’ cardiovascular risk behaviors effective interventions and cultural congruence. Work Place Health & Safety, 62(1), 27-34.
  • Beaton, R., Murphy, S., Johnson, C., Pike, K. ve Corneil, W. (1998). Exposure to duty‐related incident stressors in urban firefighters and paramedics. Journal of Traumatic Stress, 11(4), 821-828.
  • Beck, A. T., Rush, A. J., Shaw, B. F. ve Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
  • Bing-Canar, H., Ranney, R. M., McNett, S., Tran, J. K., Berenz, E. C. ve Vujanovic, A. A. (2019). Alcohol use problems, posttraumatic stress disorder, and suicide risk among trauma-exposed firefighters. The Journal of Nervous and Mental Disease, 207(3), 192-198.
  • Boffa, J. W., Stanley, I.H., Hom, M. A., Norr, A. M., Joiner, T. E. ve Schmidt, N. B. (2017). PTSD symptoms and suicidal thoughts and behaviors among firefighters. Journal of Psychiatric Research, 84, 277-283.
  • Bryant, R. A. ve Guthrie, R. M. (2007). Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 75, 812-815.
  • Bryant, R. A. ve Harvey, A. G. (1996). Posttraumatic stress reactions in volunteer firefighters. Journal of Traumatic Stress, 9(1), 51-62.
  • Cankardaş, S. ve Sofuoğlu, Z. (2019). Deprem ya da yangın deneyimlemiş kişilerde travma sonrası stres bozukluğu belirtileri ve belirtilerin yordayıcıları. Türk Psikiyatri Dergisi, 30(3), 151-156.
  • Carey, M. G., Al-Zaiti, S. S., Dean, G. E., Sessann, L. ve Finnell, D. S. (2011). Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. Journal of Occupational and Environmental Medicine/American College of Occupational and Environmental Medicine, 53(8), 928-933.
  • Creamer, M., Bell, R. ve Failla, S. (2003). Psychometric properties of the Impact of Event Scale-Revised. Behaviour Research and Therapy, 41, 1489-1496.
  • Çorapçıoğlu, A., Yargıç, İ., Geyran, P. ve Kocabaşolu, N. (2006). Olayların Etkisi Ölçeği (IES-R) Türkçe versiyonunun geçerlilik ve güvenilirliği. New/Yeni Symposium: Psikiyatri, Nöroloji ve Davranış Bilimleri Dergisi, 44(1), 14-22.
  • Desmond, M. (2011). Making firefighters deployable. Qualitative Sociology, 34(1), 59-77.
  • Dudek, B. ve Koniarek, J. (2000). Relationship between sense of coherence and post-traumatic stress disorder symptoms among firefighters. International Journal of Occupational Medicine and Environmental Health, 13(4), 299-305.
  • Ferreira, R., Pires De Lima, C., Correia-Santos, P., Dias, L., Moreira, M., Oliveira, A., Pereira, D., Reis, A., Silva, S. ve Teles, R. (2019). Sleep problems within PTSD in firefighters: A screening program from the portuguese red cross. European Pscyhiatry, 56, 463- 464.
  • Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F. ve Orsillo, S. M. (1999). The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychological Assessment, 11, 303-314.
  • Hart, G. (1982). Hierarchy career and community: An occupational study of the fire service (Yayınlanmamış doktora tezi). Department of Sociology, The University of Kent, Canterbury.
  • Harvey, S. B., Milligan-Saville, J. S., Paterson, H. M., Harkness, E. L., Marsh, A. M., Dobson, M., Kemp, R. ve Bryant, R. A. (2016). The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. Australian & New Zealand Journal of Psychiatry, 50(7), 649-658.
  • Haslam, C. ve Mallon, K. (2003). A preliminary investigation of posttraumatic stress symptoms among firefighters. Work and Stress, 17(3), 277-285.
  • Jacobsson, A., Backteman-Erlanson, S., Brulin, C. ve Hörnsten, Å. (2015). Experiences of critical incidents among female and male firefighters. International Emergency Nursing, 23(2), 100-104.
  • Kehl, D., Knuth, D., Galea, E., Hulse, L., Sans, J., Valles, L., Seidler, F., Diebe, E., Kecklund, L., Petterson, S., Wolanin, J., Beltowski, G., Preiss, M., Holubova, M., Sofuoglu, T., Baskaya-Sofuoglu, Z., Pietrantoni, L.,
  • Saccinto, E. ve Schmidt, S. (2014a). Advancing disaster relief: Development of a self-report questionnaire for firefighters. International Perspectives in Psychology: Research, Practice, Consultation, 3(3), 167-183.
  • Kehl, D., Knuth, D., Hulse, L. ve Schmidt, S. (2014b). Posttraumatic reactions among firefighters after critical incidents: Cross-national data. Journal of Aggression, Maltreatment & Trauma, 23(8), 842-853.
  • Kroenke, K., Spitzer, R. L. ve Williams, J. B. W. (2003). The Patient Health Questionnaire-2. Medical Care, 41(11), 1284-1292.
  • La Bash, H. ve Papa, A. (2014). Shame and PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 6(2), 159-166.
  • Lilly, M.M. ve Pierce, H. (2013). PTSD and depressive symptoms in 911 telecommunicators: The role of peritraumatic distress and world assumptions in predicting risk. Psychological Trauma: Theory, Research, Practice, and Policy, 5(2), 135-141.
  • Maguire, B. J., O'Meara, P., O'Neill, B. J. ve Brightwell, R. (2018). Violence against emergency medical services personnel: A systematic review of the literature. American Journal of Industrial Medicine, 61(2), 167-180.
  • Maia, D. B., Marmar, C. R., Henn-Haase, C., Nobrega, A., Fiszman, A., Marques-Portella, C., Mendlowicz, M. V., Coutinho, E. S. F. ve Figueira, I. (2011). Predictors of PTSD symptoms in Brazilian police officers: The synergy of negative affect and peritraumatic dissociation. Brazilian Journal of Psychiatry, 33(4), 362-366.
  • Maier, S. F. ve Seligman, M. E. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105, 3-46.
  • Pinto, R. J., Henriques, S. P., Jongenelen, I., Carvalho, C. ve Maia, A. C. (2015). The strongest correlates of PTSD for firefighters: Number, recency, frequency, or perceived threat of traumatic events? Journal of Traumatic Stress, 28(5), 434-440.
  • Veronese, G., Fiore, F., Castiglioni, M., el Kawaja, H. ve Said, M. (2013). Can sense of coherence moderate traumatic reactions? A cross-sectional study of Palestinian helpers operating in war contexts. British Journal of Social Work, 43(4), 651-666.
  • Veronese, G. ve Pepe, A. (2014). Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers. American Journal of Orthopsychiatry, 84(5), 597-606.
  • Weiss, D. ve Marmar, C. (1996). The impact of Event Scale-Revised. J. Wilson ve T. Keane (Ed.), Assessing psychological trauma and PTSD içinde (s. 399-411). Guilford.
  • Wild, J., Greenberg, N., Moulds, M. L., Sharp, M. L., Fear, N., Harvey, S., Wessely, S. ve Bryant, R. A. (2020). Pre-incident training to build resilience in first responders: Recommendations on what to and what not to do. Psychiatry, 83(2), 128-142.
  • Williamson, V., Stevelink, S. A. ve Greenberg, N. (2018). Occupational moral injury and mental health: Systematic review and meta-analysis. The British Journal of Psychiatry, 212(6), 339-346.
  • Wood, K. H., Wheelock, M. D., Shumen, J. R. ve Bowen, K. H. (2015). Controllability modulates the neural response to predictable but not unpredictable threat in humans. Neuroimage, 119, 371-381.

Determinants of traumatic stress symptoms in firefighters

Year 2022, Volume: 6 Issue: 2, 182 - 196, 25.08.2022
https://doi.org/10.5455/kpd.26024438m000067

Abstract

Firefighters are at high risk of experiencing mental disorders like other first responders. Although the studies on the prevalence of mental health problems in firefighters are common in the literature, it is seen that there are limited studies on the causes of these problems. This study aimed to investigate the risk of depression and traumatic stress symptoms among firefighters working in Turkey. In addition, it was aimed to investigate the variables before and during the event that predicted the traumatic stress symptoms. For this purpose, data were collected from the 468 firefighters working in the fire department of 35 provinces that agreed to participate in the study by using the Behavior, Safety, and Culture-First Responders, Patient Health Questionnaire-2, and Impact of Events Scale. It was seen that approximately half of the firefighters met the diagnosis of possible post-traumatic stress disorder, and approximately one fifth had a risk of depression. It was observed that the level of distress experienced during the event was the variable that explained the higher variance in the level of traumatic stress symptoms. Findings indicate that firefighters should have access to the psychological support system. Thus, it may be possible to prevent the continuation of mental problems and decrease in the quality of life.

References

  • Alden, L. E., Matthews, L. R., Wagner, S., Fyfe, T., Randall, C., Regehr, C., White, M., Buys, N., Carey, M. G., Corneil, W., White, N., Fraess-Phillips, A. ve Krutop, E. (2021). Systematic literature review of psychological interventions for first responders. Work & Stress, 35(2), 193-215.
  • Amat, J., Paul, E., Watkins, L. R. ve Maier, S. F. (2008). Activation of the ventral medial prefrontal cortex during an uncontrollable stressor reproduces both the immediate and long-term protective effects of behavioral control. Neuroscience, 154, 1178-1186.
  • Antonovsky, A. (1979). Health, stress, and coping. Jossey-Bass.
  • Ayranci, U. (2005). Violence toward health care workers in emergency departments in west Turkey. The Journal of emergency medicine, 28(3), 361-365.
  • Banes, C. J. (2014). Firefighters’ cardiovascular risk behaviors effective interventions and cultural congruence. Work Place Health & Safety, 62(1), 27-34.
  • Beaton, R., Murphy, S., Johnson, C., Pike, K. ve Corneil, W. (1998). Exposure to duty‐related incident stressors in urban firefighters and paramedics. Journal of Traumatic Stress, 11(4), 821-828.
  • Beck, A. T., Rush, A. J., Shaw, B. F. ve Emery, G. (1979). Cognitive therapy of depression. Guilford Press.
  • Bing-Canar, H., Ranney, R. M., McNett, S., Tran, J. K., Berenz, E. C. ve Vujanovic, A. A. (2019). Alcohol use problems, posttraumatic stress disorder, and suicide risk among trauma-exposed firefighters. The Journal of Nervous and Mental Disease, 207(3), 192-198.
  • Boffa, J. W., Stanley, I.H., Hom, M. A., Norr, A. M., Joiner, T. E. ve Schmidt, N. B. (2017). PTSD symptoms and suicidal thoughts and behaviors among firefighters. Journal of Psychiatric Research, 84, 277-283.
  • Bryant, R. A. ve Guthrie, R. M. (2007). Maladaptive self-appraisals before trauma exposure predict posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 75, 812-815.
  • Bryant, R. A. ve Harvey, A. G. (1996). Posttraumatic stress reactions in volunteer firefighters. Journal of Traumatic Stress, 9(1), 51-62.
  • Cankardaş, S. ve Sofuoğlu, Z. (2019). Deprem ya da yangın deneyimlemiş kişilerde travma sonrası stres bozukluğu belirtileri ve belirtilerin yordayıcıları. Türk Psikiyatri Dergisi, 30(3), 151-156.
  • Carey, M. G., Al-Zaiti, S. S., Dean, G. E., Sessann, L. ve Finnell, D. S. (2011). Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters. Journal of Occupational and Environmental Medicine/American College of Occupational and Environmental Medicine, 53(8), 928-933.
  • Creamer, M., Bell, R. ve Failla, S. (2003). Psychometric properties of the Impact of Event Scale-Revised. Behaviour Research and Therapy, 41, 1489-1496.
  • Çorapçıoğlu, A., Yargıç, İ., Geyran, P. ve Kocabaşolu, N. (2006). Olayların Etkisi Ölçeği (IES-R) Türkçe versiyonunun geçerlilik ve güvenilirliği. New/Yeni Symposium: Psikiyatri, Nöroloji ve Davranış Bilimleri Dergisi, 44(1), 14-22.
  • Desmond, M. (2011). Making firefighters deployable. Qualitative Sociology, 34(1), 59-77.
  • Dudek, B. ve Koniarek, J. (2000). Relationship between sense of coherence and post-traumatic stress disorder symptoms among firefighters. International Journal of Occupational Medicine and Environmental Health, 13(4), 299-305.
  • Ferreira, R., Pires De Lima, C., Correia-Santos, P., Dias, L., Moreira, M., Oliveira, A., Pereira, D., Reis, A., Silva, S. ve Teles, R. (2019). Sleep problems within PTSD in firefighters: A screening program from the portuguese red cross. European Pscyhiatry, 56, 463- 464.
  • Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F. ve Orsillo, S. M. (1999). The Posttraumatic Cognitions Inventory (PTCI): Development and validation. Psychological Assessment, 11, 303-314.
  • Hart, G. (1982). Hierarchy career and community: An occupational study of the fire service (Yayınlanmamış doktora tezi). Department of Sociology, The University of Kent, Canterbury.
  • Harvey, S. B., Milligan-Saville, J. S., Paterson, H. M., Harkness, E. L., Marsh, A. M., Dobson, M., Kemp, R. ve Bryant, R. A. (2016). The mental health of fire-fighters: An examination of the impact of repeated trauma exposure. Australian & New Zealand Journal of Psychiatry, 50(7), 649-658.
  • Haslam, C. ve Mallon, K. (2003). A preliminary investigation of posttraumatic stress symptoms among firefighters. Work and Stress, 17(3), 277-285.
  • Jacobsson, A., Backteman-Erlanson, S., Brulin, C. ve Hörnsten, Å. (2015). Experiences of critical incidents among female and male firefighters. International Emergency Nursing, 23(2), 100-104.
  • Kehl, D., Knuth, D., Galea, E., Hulse, L., Sans, J., Valles, L., Seidler, F., Diebe, E., Kecklund, L., Petterson, S., Wolanin, J., Beltowski, G., Preiss, M., Holubova, M., Sofuoglu, T., Baskaya-Sofuoglu, Z., Pietrantoni, L.,
  • Saccinto, E. ve Schmidt, S. (2014a). Advancing disaster relief: Development of a self-report questionnaire for firefighters. International Perspectives in Psychology: Research, Practice, Consultation, 3(3), 167-183.
  • Kehl, D., Knuth, D., Hulse, L. ve Schmidt, S. (2014b). Posttraumatic reactions among firefighters after critical incidents: Cross-national data. Journal of Aggression, Maltreatment & Trauma, 23(8), 842-853.
  • Kroenke, K., Spitzer, R. L. ve Williams, J. B. W. (2003). The Patient Health Questionnaire-2. Medical Care, 41(11), 1284-1292.
  • La Bash, H. ve Papa, A. (2014). Shame and PTSD symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 6(2), 159-166.
  • Lilly, M.M. ve Pierce, H. (2013). PTSD and depressive symptoms in 911 telecommunicators: The role of peritraumatic distress and world assumptions in predicting risk. Psychological Trauma: Theory, Research, Practice, and Policy, 5(2), 135-141.
  • Maguire, B. J., O'Meara, P., O'Neill, B. J. ve Brightwell, R. (2018). Violence against emergency medical services personnel: A systematic review of the literature. American Journal of Industrial Medicine, 61(2), 167-180.
  • Maia, D. B., Marmar, C. R., Henn-Haase, C., Nobrega, A., Fiszman, A., Marques-Portella, C., Mendlowicz, M. V., Coutinho, E. S. F. ve Figueira, I. (2011). Predictors of PTSD symptoms in Brazilian police officers: The synergy of negative affect and peritraumatic dissociation. Brazilian Journal of Psychiatry, 33(4), 362-366.
  • Maier, S. F. ve Seligman, M. E. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology: General, 105, 3-46.
  • Pinto, R. J., Henriques, S. P., Jongenelen, I., Carvalho, C. ve Maia, A. C. (2015). The strongest correlates of PTSD for firefighters: Number, recency, frequency, or perceived threat of traumatic events? Journal of Traumatic Stress, 28(5), 434-440.
  • Veronese, G., Fiore, F., Castiglioni, M., el Kawaja, H. ve Said, M. (2013). Can sense of coherence moderate traumatic reactions? A cross-sectional study of Palestinian helpers operating in war contexts. British Journal of Social Work, 43(4), 651-666.
  • Veronese, G. ve Pepe, A. (2014). Sense of coherence mediates the effect of trauma on the social and emotional functioning of Palestinian health providers. American Journal of Orthopsychiatry, 84(5), 597-606.
  • Weiss, D. ve Marmar, C. (1996). The impact of Event Scale-Revised. J. Wilson ve T. Keane (Ed.), Assessing psychological trauma and PTSD içinde (s. 399-411). Guilford.
  • Wild, J., Greenberg, N., Moulds, M. L., Sharp, M. L., Fear, N., Harvey, S., Wessely, S. ve Bryant, R. A. (2020). Pre-incident training to build resilience in first responders: Recommendations on what to and what not to do. Psychiatry, 83(2), 128-142.
  • Williamson, V., Stevelink, S. A. ve Greenberg, N. (2018). Occupational moral injury and mental health: Systematic review and meta-analysis. The British Journal of Psychiatry, 212(6), 339-346.
  • Wood, K. H., Wheelock, M. D., Shumen, J. R. ve Bowen, K. H. (2015). Controllability modulates the neural response to predictable but not unpredictable threat in humans. Neuroimage, 119, 371-381.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Clinical Psychology
Journal Section Research Articles
Authors

Zeynep Sofuoğlu This is me 0000-0003-4136-9739

Sinem Cankardaş This is me 0000-0003-4140-2068

Publication Date August 25, 2022
Submission Date March 19, 2021
Published in Issue Year 2022 Volume: 6 Issue: 2

Cite

APA Sofuoğlu, Z., & Cankardaş, S. (2022). İtfaiyecilerde travmatik stres belirtilerinin belirleyicileri. Journal of Clinical Psychology Research, 6(2), 182-196. https://doi.org/10.5455/kpd.26024438m000067