School of Psychology, Curtin University, Perth, Western Australia.
Wellbeing and Support Services, St John Ambulance, Perth, Western Australia.
J Affect Disord. 2021 Feb 15;281:517-532. doi: 10.1016/j.jad.2020.12.021. Epub 2020 Dec 14.
Emergency services personnel have an elevated risk of developing mental health conditions. Most research in this area is cross-sectional, which precludes inferences about temporal and potentially causal relationships between risk and protective factors and mental health outcomes. The current study systematically reviewed prospective studies of risk and protective factors for mental health outcomes in civilian emergency services personnel (firefighters, paramedics, police) assessed at pre-operational and operational stages. Out of 66 eligible prospective studies identified, several core groups of risk and protective factors emerged: (1) cognitive abilities; (2) coping tendencies; (3) personality factors; (4) peritraumatic reactions and post-trauma symptoms; (5) workplace factors; (6) interpersonal factors; (7) events away from work. Although there was insufficient evidence for many associations, social support was consistently found to protect against the development of mental health conditions, and peritraumatic dissociation, prior mental health issues, and prior trauma exposure were risk factors for future mental health conditions. Among operational studies, neuroticism was significantly associated with future PTSD symptoms, burnout, and general poor mental health, and avoidance and intrusion symptoms of PTSD were associated with future PTSD and depression symptoms. The current review results provide important targets for future research and interventions designed to improve the mental health of emergency services personnel.
紧急服务人员患心理健康问题的风险较高。该领域的大多数研究都是横断面研究，这使得无法对风险和保护因素与心理健康结果之间的时间和潜在因果关系进行推断。本研究系统地回顾了针对平民紧急服务人员（消防员、护理人员、警察）在操作前和操作阶段进行的心理健康结果的风险和保护因素的前瞻性研究。在 66 项符合条件的前瞻性研究中，出现了几个核心的风险和保护因素组：（1）认知能力；（2）应对倾向；（3）人格因素；（4）创伤前反应和创伤后症状；（5）工作场所因素；（6）人际因素；（7）工作以外的事件。尽管许多关联的证据不足，但社会支持始终被发现可预防心理健康问题的发展，而创伤前解离、先前的心理健康问题和先前的创伤暴露是未来心理健康问题的风险因素。在操作研究中，神经质与未来 PTSD 症状、倦怠和一般较差的心理健康显著相关，而 PTSD 的回避和闯入症状与未来 PTSD 和抑郁症状相关。本综述结果为旨在改善紧急服务人员心理健康的未来研究和干预措施提供了重要目标。
