Peer Delivered, Emotion Regulation-Focused Mental Health Prevention Training for Fire Fighter Trainees

大约110万名消防员(FF；350,000名专业消防员或受薪消防员，750,000名志愿者)保护 美国人，他们的家庭，企业，高速公路和荒野，执行紧急情况 尽管他们自己的健康和福祉面临重大风险，但他们仍然做出了反应。即使FFS是 在进入这一职业后接受心理健康风险筛查，相当一部分人出现了 火灾职业生涯中的心理健康问题，包括创伤后应激障碍(PTSD)， 有问题的酗酒、抑郁和焦虑。正如预期的那样，利率上升 在精神健康状况方面，自杀风险是FF的主要担忧。总而言之，职业 消防服务压力是导致早死2年的消防人员早期死亡的原因 美国男性。FF必须配备更有效的情绪调节 在进入该行业时掌握的技能，以缓冲他们将面临的各种压力源。 等待心理健康挑战出现是一种有缺陷的方法。心理健康的障碍 为FFS寻求治疗的人很多；FFS将从情绪训练中受益最大 由可信的同行在进入和社会化该职业时传授的监管技能。 这可能会防止下游出现实质性的负面后果，同时提高韧性 和健康。预防创伤后应激障碍、酗酒和其他常见疾病的培训 共同出现的心理健康挑战应该是跨诊断的，重点放在潜在的 情绪调节机制。拟议的项目是我们的系列中合乎逻辑的下一步 其长期目标是将重大科学发现转化为预防 残障儿童心理健康挑战的发展。我们的中心假设是同龄人- 提供情绪障碍跨诊断治疗(BUP)的简要统一方案， 在消防学院期间提供，将防止创伤后应激障碍和相关精神疾病的发展 健康结果。我们将进行一项整群随机对照试验(RCT)，以比较同伴和 将BUP提供给同伴提供的关于心理健康的心理教育(PSYED)给Small 消防学院期间为预防创伤后应激障碍、酒精等症状而培训的学员小组 随着时间的推移，新的FF会出现滥用、抑郁、焦虑和功能障碍。我们将测试 神经质和情绪调节的改变是否介导了BUP对 结果。这将是第一次对FF新兵进行心理健康预防干预的随机对照试验， 一个重要但未被充分研究的群体，经常暴露在创伤中，第一个由 同伴们。如果成功，这种方法将提供一种文化上有能力的、可扩展的方法来 提高复原力，从而预防与工作有关的心理伤害。

About 1.1 million firefighters (FFs; 350,000 professional or paid, 750,000 volunteers) protect Americans, their households, businesses, highways, and wildlands, performing emergency response despite significant risk to their own health and well-being. Even though FFs are screened for mental health risk upon entry into the profession, a substantial minority develop mental health problems during fire careers including posttraumatic stress disorder (PTSD), problematic alcohol use, depression, and anxiety. As might be expected with elevated rates of mental health conditions, suicide risk is a major concern among FFs. In sum, the occupational stress of fire service contributes to the early mortality of FFs who die 2 years earlier than other American males. It is imperative that FFs are equipped with more effective emotion regulation skills upon entry into the profession to buffer against the varied stressors that they will face. Waiting until mental health challenges emerge is a flawed approach. Barriers to mental health treatment seeking for FFs are numerous; FFs would benefit most from training in emotion regulation skills delivered by credible peers upon entry and socialization into the profession. This would likely prevent substantial negative outcomes downstream while promoting resilience and wellness. Training to prevent development of PTSD, alcohol misuse, and other commonly co-occurring mental health challenges should be transdiagnostic, focusing on the underlying mechanism of emotion regulation. The proposed project is the next logical step in our line of research whose long-range goal is to translate significant scientific findings to prevent the development of disabling mental health challenges in FFs. Our central hypothesis is that peer- delivered Brief Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (BUP), delivered during the fire academy, will prevent the development of PTSD and related mental health outcomes. We will conduct a cluster randomized controlled trial (RCT) to compare peer- delivered BUP to peer-delivered psychoeducation regarding mental health (PSYED) to small groups of FF trainees during the fire academy for preventing symptoms of PTSD, alcohol misuse, depression, anxiety, and functional impairment over time in new FFs. We will test whether changes in neuroticism and emotion regulation mediate the effect of BUP on the outcomes. This would be the first RCT of a mental health prevention intervention in FF recruits, an important but understudied group with frequent trauma exposure and the first delivered by peers. If successful, this approach would provide a culturally competent, scalable approach to promoting resilience, thereby preventing work-related psychological injuries.