Wagner D, Heinrichs M, Ehlert U
Center for Psychobiological and Psychosomatic Research, University of Trier, Germany.
Am J Psychiatry. 1998 Dec;155(12):1727-32. doi: 10.1176/ajp.155.12.1727.
This study investigated the prevalence of posttraumatic stress disorder (PTSD) and comorbid symptoms among professional firefighters in Germany and examined not only primary but also secondary traumatic stress disorder experienced by these firefighters who were exposed to the sufferings of others.
To estimate the prevalence of trauma-related disorders, a representative group of 402 professional firefighters from the State of Rheinland-Pfalz in Germany was surveyed through use of the General Health Questionnaire, a PTSD Symptom Scale, a stress coping questionnaire, and a self-rating scale to assess bodily complaints.
The current prevalence rate of PTSD symptoms among professional firefighters was 18.2%. About 27% of the recruited subjects had a mental disorder according to the General Health Questionnaire. Predictors for the extent of traumatic stress were longer job experience and the number of distressing missions during the last month. Traumatic stress also predicted psychiatric impairment beyond PTSD, such as depressive mood, psychosomatic complaints, social dysfunction, and substance abuse.
The high prevalence of PTSD and other psychiatric impairments in firefighters indicates that they often fail to cope with primary and particularly secondary stress in their daily work. This problem, together with the individual psychological consequences and expenses related to work absenteeism and early retirement, seems to be very specific for the profession of firefighters. The present findings provide a better understanding of the relationship between secondary traumatic stress and PTSD in professional helpers and high-risk populations such as firefighters, emergency workers, and the police.
本研究调查了德国职业消防员中创伤后应激障碍(PTSD)的患病率及共病症状,不仅考察了这些消防员所经历的原发性创伤后应激障碍,还考察了他们因接触他人痛苦而产生的继发性创伤后应激障碍。
为了估计与创伤相关疾病的患病率,通过使用一般健康问卷、PTSD症状量表、压力应对问卷和一份用于评估身体不适的自评量表,对来自德国莱茵兰-普法尔茨州的402名职业消防员的代表性样本进行了调查。
职业消防员中PTSD症状的当前患病率为18.2%。根据一般健康问卷,约27%的受试对象患有精神障碍。创伤性应激程度的预测因素包括更长的工作经验以及过去一个月内令人痛苦的任务数量。创伤性应激还预示着除PTSD之外的精神障碍,如抑郁情绪、身心不适、社会功能障碍和药物滥用。
消防员中PTSD及其他精神障碍的高患病率表明,他们在日常工作中常常难以应对原发性应激,尤其是继发性应激。这个问题,连同与旷工和提前退休相关的个人心理后果及费用,似乎是消防员职业所特有的。目前的研究结果有助于更好地理解在专业救助人员以及消防员、急救人员和警察等高风险人群中继发性创伤性应激与PTSD之间的关系。