Prevalence of posttraumatic stress disorder symptoms in firefighters

Symptoms of posttraumatic stress disorder (PTSD) have been extensively studied in victim populations (e.g., survivors of sexual assault), but not nearly as thoroughly in the responders who come to the aid of those victims, particularly firefighters. The prevalence rates for PTSD (as defined by previous authors) in firefighters vary widely, from 6.5% to 37%, using various cutoff scores on a variety of measures (primarily self-report) with rather dissimilar samples and events. This study utilized the Posttraumatic Stress Disorder Checklist (PCL), a measure consistent with current DSM-IV criteria, to evaluate the prevalence of PTSD symptoms in 131 firefighters from two US states. Using a standard cutoff score on the PCL, a prevalence rate of 8% was found. When measures of fear, helplessness, or horror (DSM-IV Criterion A2) and functional impairment (Criterion F) were included, a lower prevalence rate of 5% was obtained, a rate lower than typically is found in previously published reports. Previous psychological treatment, age at which the firefighters started working, Miscellaneous Calls, and the response of horror following the firefighter's Single Worst Event predicted PTSD symptoms. The present findings highlight the importance of using a symptom measure consistent with the full DSM-IV criteria to more fully assess firefighters' responses of fear, helplessness, and horror.