No CrossRef data available.
Article contents
Coping Strategies Related to Posttraumatic Stress Disorder in First Responders
Published online by Cambridge University Press: 03 November 2025
Abstract
Introduction:
Through a range of coping strategies, individuals seek to manage the stressors to which they are exposed, employing cognitive and behavioral responses that shape their emotional regulation of such events. Emergency first responders are routinely subjected to high-stress situations due to the nature of their duties and the continuous care of critically ill patients. This sustained exposure significantly increases their vulnerability to the development of mental health disorders, notably posttraumatic stress disorder (PTSD).
Objective:
The aim of this study was to determine the coping strategies used by first responders when facing critical incidents and their association with PTSD.
Methods:
A cross-sectional analytical study was conducted in 2022. All first responders from a volunteer fire department in a major Colombian city who voluntarily agreed to participate were included in the study. The participants were 28 ambulance crew members and 187 firefighters. Descriptive statistics were used for data analysis, and logistic regression models were applied to assess associations with PTSD. Principal components analysis was used to compute total scores, while the Lasso Method identified significant predictors.
Results:
The first responders most often employed avoidance and denial as coping strategies in response to the demands of their work in the prehospital field. After witnessing devastating events, many of them turned to religion for stress relief.
Conclusions:
The study identified the use of maladaptive strategies associated with PTSD among staff, making it critical to develop training programs that help first responders cope with critical incidents by developing adaptive coping skills.
Information
- Type
- Innovation Report
- Information
- Copyright
- © The Author(s), 2025. Published by Cambridge University Press on behalf of World Association for Disaster and Emergency Medicine
References
Lazarus, R, Folkman, S. Stress, Appraisal, and Coping. New York USA: Springer Publishing Company, Inc.; 1984:p445.Google Scholar
Stępka-Tykwińska, E, Basińska, MA, Sołtys, M, Piórowska, A. Selected personality traits as predictors of coping flexibility in a group of officers of the state fire service. Med Pr. 2019;70(5):555–565.Google Scholar
Dautovich, ND, Katjijova, M, Cyrus, JW, Kliewer, W. Duty-related stressors, adjustment, and the role of coping processes in first responders: a systematic review. Psychol Trauma. 2023;15(Suppl 2):s286–S296.CrossRefGoogle ScholarPubMed
Echeburúa, E, Amor, PJ. Traumatic memories: adaptive and maladaptive coping strategies. Psychological Therapy. 2019;37(1):71–80.Google Scholar
Borzyszkowska, A, Basińska, MA. Two types of flexibility: in coping and cognitive, and their relationship with stress among firefighters. Med Pr. 2020;71(4):441–450.Google ScholarPubMed
Loef, J, Vloet, LCM, Vierhoven, PH, et al. Starting ambulance care professionals and critical incidents: a qualitative study on experiences, consequences and coping strategies. BMC Emerg Med. 2021;21(1):110.CrossRefGoogle ScholarPubMed
Barquín-Cuervo, R, Begoña Medina-Gómez, M, Gloria Pérez de Albéniz-Garrote Y. Coping strategies among people with intellectual disability. Psychosocial Intervention. 2018;27(2):89–94.CrossRefGoogle Scholar
Fonseca, SM, Cunha, S, Faria, S, Campos, R, Queirós, C. Why are emergency medical technicians’ coping strategies dysfunctional? Direct and indirect effects of resilience and perceived stress. Int Emerg Nurs. 2021;56:100995.CrossRefGoogle ScholarPubMed
Bilsker, D, Gilbert, M, Alden, L, Sochting, I, Khalis, A. Basic dimensions of resilient coping in paramedics and dispatchers. Australasian Journal of Paramedicine. 2019;16:1–8.CrossRefGoogle Scholar
Boland, LL, Mink, PJ, Kamrud, JW, Jeruzal, JN, Stevens, AC. Social support outside the workplace, coping styles, and burnout in a cohort of EMS providers from Minnesota. Workplace Health Saf. 2019;67(8):414–422.CrossRefGoogle Scholar
Theleritis, C, Psarros, C, Mantonakis, L, et al. Coping and its relation to PTSD in Greek firefighters. J Nerv Ment Dis. 2020;208(3):252–259.CrossRefGoogle ScholarPubMed
Piñar-Navarro, E, Fuente, GACDL, González-Jiménez, E, Hueso-Montoro, C. Anxiety and strategies for coping with stress used by first responders and out-of-hospital emergency health care staff before the COVID-19 pandemic. Emergencias. 2020;32(5):371–373.Google ScholarPubMed
Velásquez, MV, Castillo, C, Mancilla, I, López, I, Arenales, R. [Prevalence of depression and post-traumatic stress in volunteer firefighters.] Medical Journal (College of Physicians and Surgeons of Guatemala). 2019;158(1):30–32.Google Scholar
Brooks, D, Brooks, R. A systematic review: what factors predict post-traumatic stress symptoms in ambulance personnel? Br Paramed J. 2021;5(4):18–24.CrossRefGoogle ScholarPubMed
Lewis-Schroeder, NF, Kieran, K, Murphy, BL, et al. Conceptualization, assessment, and treatment of traumatic stress in first responders: a review of critical issues. Harv Rev Psychiatry. 2018;26(4):216–227.CrossRefGoogle ScholarPubMed
Park, H, Kim, JI, Oh, S, Kim, JH. The impact of emotional labor on the severity of PTSD symptoms in firefighters. Compr Psychiatry. 2018;83:53–58.CrossRefGoogle ScholarPubMed
Igboanugo, S, Bigelow, PL, Mielke, JG. Health outcomes of psychosocial stress within firefighters: a systematic review of the research landscape. J Occup Health. 2021;63(1):e12219.CrossRefGoogle ScholarPubMed
Soravia, LM, Schwab, S, Walther, S, Müller, T. Rescuers at risk: post-traumatic stress symptoms among police officers, fire fighters, ambulance personnel, and emergency and psychiatric nurses. Front Psychiatry. 2021;11:602064.CrossRefGoogle Scholar
Huang, J, Li, X, An, Y. The mediating role of coping in the relationship of post-traumatic stress disorder symptoms (PTSS) and job burnout among Chinese firefighters. Int Arch Occup Environ Health. 2021;94(2):243–250.CrossRefGoogle ScholarPubMed
Aguas Escobar, AF, Flores Hernández, VF. [Post-traumatic stress and its relationship with anxiety in operational firefighters]. LATAM Latin American Journal of Social Sciences and Humanities. 2023;4(1):1036–1050.Google Scholar
Londoño, NH, Henao López, GC, Puerta, IC, Posada, S, Arango, D, Aguirre Acevedo, D. [Psychometric properties and validation of the modified coping strategies scale (EEC-M) in a Colombian sample]. Universitas Psychologica. 2006;5(2):327–350.Google Scholar
Martínez-Levy, GA, Bermúdez-Gómez, J, Merlín-García, I, et al. After a disaster: validation of PTSD checklist for DSM-5 and the four- and eight-item abbreviated versions in mental health service users. Psychiatry Res. 2021;305:114197.CrossRefGoogle ScholarPubMed
Witczak-Błoszyk, K, Krysińska, K, Andriessen, K, Stańdo, J, Czabański, A. Work-related suicide exposure, occupational burnout, and coping in Emergency Medical Services personnel in Poland. Int J Environ Res Public Health. 2022;19(3):1156.CrossRefGoogle ScholarPubMed
An, Y, Wang, M, Ye, Y, Chen, Y. The symptom network structure of post-traumatic stress disorder among Chinese firefighters. J Clin Psychol. 2022;78(7):1436–1450.CrossRefGoogle ScholarPubMed
Zwetzig, SE, Koch, LM, Blount, TH, Graham, MM, Peterson, AL. Massed prolonged exposure for PTSD in two firefighters: preliminary case study findings. Behav Modif. 2022;46(3):427–452.CrossRefGoogle ScholarPubMed
Almutairi, MN, Azza, AA. Burnout and coping methods among emergency medical services professionals. J Multidiscip Healthc. 2020;13:271–279.CrossRefGoogle ScholarPubMed
Donovan, N. Peer support facilitates post-traumatic growth in first responders: a literature review. Trauma (United Kingdom). 2022;24(4):277–285.Google Scholar
Lobza, O, Korotkova, V, Bunakova, T. Personal determinants of stress-coping behavior demonstrated by employees of The Ministry of the Russian Federation for Civil Defense, Emergencies, and Elimination of Consequences of Natural Disasters. Advances in Social Science, Education, and Humanities Research. 2019;321:127–129.Google Scholar
Lee, SS, Jeong, S, Choi, YS. The factors influencing on stress coping and resilience of firefighters. International Journal of IT-based Social Welfare Promotion and Management. 2019;6(1):13–18.Google Scholar
Henson, C, Truchot, D, Canevello, A. PTSD and PTG in French and American firefighters: a comparative study. Int J Environ Res Public Health. 2022;19(19):11973.CrossRefGoogle ScholarPubMed
Torres, VA, Gulliver, SB. Firefighters: an occupational case study of resilience. Positive Psychological Approaches to Disaster: Meaning, Resilience, and Post-traumatic Growth. 2020;99–114.CrossRefGoogle Scholar
Hoell, A, Kourmpeli, E, Dressing, H. Work-related post-traumatic stress disorder in paramedics in comparison to data from the general population of working age. A systematic review and meta-analysis. Front Public Health. 2023;11:1151248.CrossRefGoogle Scholar
Jitnarin, N, Jahnke, SA, Poston, WSC, Haddock, CK, Kaipust, CM. Post-traumatic stress disorder (PTSD) and mental health comorbidity in firefighters. J Workplace Behav Health. 2022;37(3):147–168.CrossRefGoogle Scholar
Klimley, KE, Van Hasselt, VB, Stripling, AM. Post-traumatic stress disorder in police, firefighters, and emergency dispatchers. Aggress Violent Behav. 2018;43:33–44.CrossRefGoogle Scholar
Muhammad, N, Ismail, H, Hanizah, Y. Prevalence and predictors for post-traumatic stress disorder (PTSD) among firefighters: a systematic review. Int J Public Health Res. 2020;10(1):1183–1194.Google Scholar
Obuobi-Donkor, G, Oluwasina, F, Nkire, N, Agyapong, VIO. A scoping review on the prevalence and determinants of post-traumatic stress disorder among military personnel and firefighters: implications for public policy and practice. Int J Environ Res Public Health. 2022;19(3):1–19.CrossRefGoogle ScholarPubMed
Díaz-Tamayo et al. supplementary material
Díaz-Tamayo et al. supplementary material
File
19.2 KB