Bakirci Ahmet Erhan, Sar Vedat, Cetin Ali
Department of Civil Defense and Firefighting, Vocational School of Technical Science, Istanbul University-Cerrahpasa, 34320 Istanbul, Turkey.
Department of Psychiatry, Faculty of Medicine, Koc University, 34450 Istanbul, Turkey.
Eur J Investig Health Psychol Educ. 2025 May 9;15(5):75. doi: 10.3390/ejihpe15050075.
The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological variables on both the presence and severity of PTSD symptomatology in this high-risk occupational cohort.
A cross-sectional investigation was performed to assess psychological conditions among 760 metropolitan male firefighters, employing conditional process analysis with multiple mediation modeling (PROCESS macro Model 6). The investigative protocol employed validated psychometric instruments including the PTSD Checklist (PCL-5); the Childhood Trauma Questionnaire (CTQ-33); the Dissociative Experiences Scale (DES); the Suicidal Behaviors Questionnaire (SBQ-4); and the Patient Health Questionnaire (PHQ-9). Bootstrap resampling ( = 5000) generated bias-corrected 95% confidence intervals, enabling interrogation of complex trauma response mechanisms.
Conditional process analysis demonstrated that childhood trauma functions as a significant mediator (indirect effect = 0.142, 95% CI [0.086, 0.198]), with emotional abuse pathways revealing significant mediational effects (β = 0.285, < 0.001). Stratifying participants using a PCL-5 ≥ 33 threshold (non-PTSD: = 543, 71.5%, median PCL-5: 22; PTSD: = 217, 28.5%, median PCL-5: 39), the investigation elucidated serial mediation mechanisms, particularly through childhood trauma to dissociative experiences (serial indirect effect = 0.168, 95% CI [0.092, 0.244]), collectively explaining nearly half of PTSD variance through complex psychological interaction pathways.
Conditional process analysis revealed childhood trauma as a pivotal mediator, with emotional abuse pathways demonstrating significant mediational effects, while dissociative experiences emerged as a significant secondary mechanism, collectively explaining a substantial portion of PTSD variance through interactions between occupational trauma exposure and intrinsic psychological vulnerabilities.
本研究旨在探讨患有创伤后应激障碍（PTSD）的都市消防员早年不良经历、解离症状、自杀意念和抑郁表现之间的相互关系，并阐明这些心理变量对该高危职业群体中PTSD症状的存在和严重程度的潜在中介作用。
进行了一项横断面调查，以评估760名都市男性消防员的心理状况，采用多重中介模型的条件过程分析（PROCESS宏模型6）。调查方案采用了经过验证的心理测量工具，包括PTSD检查表（PCL-5）；儿童创伤问卷（CTQ-33）；解离体验量表（DES）；自杀行为问卷（SBQ-4）；以及患者健康问卷（PHQ-9）。自抽样重抽样（=5000）生成偏差校正的95%置信区间，从而能够探究复杂的创伤反应机制。
条件过程分析表明，童年创伤起着重要的中介作用（间接效应=0.142，95%CI[0.086，0.198]），其中情感虐待途径显示出显著的中介效应（β=0.285，<0.001）。使用PCL-5≥33阈值对参与者进行分层（非PTSD：=543，71.5%，PCL-5中位数：22；PTSD：=217，28.5%，PCL-5中位数：39），该研究阐明了系列中介机制，特别是通过童年创伤到解离体验（系列间接效应=0.168，95%CI[0.092，0.244]），通过复杂的心理交互途径共同解释了近一半的PTSD方差。
条件过程分析表明童年创伤是一个关键中介，情感虐待途径显示出显著的中介效应，而解离体验是一个重要的次要机制，通过职业创伤暴露与内在心理脆弱性之间的相互作用共同解释了很大一部分PTSD方差。
