Pathways of Risk and Resilience in Firefighter Recruits

消防员新兵的风险和复原力途径

• 批准号: 7904220
• 负责人: SUZY B GULLIVER
• 金额: $ 23.23万
• 依托单位: TEXAS A&M UNIVERSITY HEALTH SCIENCE CTR
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-02 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7904220
• 关键词: Acute; Address; Affect; Aggressive behavior; Alcohol or Other Drugs use; Anxiety; Characteristics; Childhood; Chronic; Clinical; Coping Behavior; Data; Databases; Dependency; Development; Diagnosis; Diagnostic; Disease; Dissociation; Distress; Employment; Environment; Epidemiology; Equation; Evaluation; Event; Exposure to; Family; Family history of; Genes; Genetic; Genetic Markers; Genetic Risk; Goals; Growth; Guidelines; Hurricane; Individual; Interruption; Investigation; Lead; Life; Life Experience; Literature; Measurement; Measures; Mediating; Mediator of activation protein; Mental disorders; Modeling; Natural Disasters; Nature; Occupations; Pathology; Pathway interactions; Pattern; Personality; Population; Post-Traumatic Stress Disorders; Prevention; Psychopathology; Recording of previous events; Recovery; Recruitment Activity; Relapse; Research; Retirement; Risk; Risk Factors; Safety; Sampling; Social support; Stress; Stress and Coping; Substance Use Disorder; Symptoms; Testing; Time; Training; Trauma; base; biopsychosocial; career; coping; data sharing; depressive symptoms; design; disorder risk; experience; family genetics; functional disability; functional status; high risk; interest; prospective; resilience; response; social

DESCRIPTION (provided by applicant): Over half of all U.S. citizens will be exposed to a potentially traumatic event (PTE) during their lifetime. The recent, unprecedented man-made and natural disasters of 9/11 and Hurricane Katrina catastrophically illustrate that lifetime trauma exposure rates are rising. The psychiatric response associated with traumatic exposure involves post-traumatic stress disorder (PTSD), substance-use disorder (SUD), or co-occurring psychopathology (i.e., PTSD-SUD). However, not all individuals will develop psychiatric disorders in response to PTE exposure, underscoring the question: What are the factors that lead some individuals who are exposed to traumatic events down the path to resilience and other individuals down the path to risk for these disorders? This question can be examined effectively in a sample of firefighter (FF) recruits who will experience life-threatening events on a day-to-day basis as a result of their profession. FFs exposed to PTEs may follow a number of pathways towards pathology or wellness. Unfortunately, the variables and parameters that predict risk and resilience for PTSD, SUD, and PTSD-SUD symptoms and diagnostic caseness, as well as the patterns of recovery and relapse related to these disorders, are not well understood. In the proposed study, 400 urban, professional FF recruits will be followed from selection and training, through their early careers as FFs in a prospective, longitudinal evaluation. Resilience to, or development of, PTSD, SUD, or PTSD-SUD will be examined, as well as temporal patterns of symptom expression, recovery, and relapse. Biopsychosocial variables that influence post-exposure pathways and increase or decrease the likelihood of developing PTSD, SUD, or PTSD-SUD symptoms and/or caseness will be evaluated. Following a multi-dimensional pre-employment baseline assessment (i.e., genetic markers, family history, personality factors, prior PTE exposure and substance use), PTSD and SUD symptomatology plus empirically-derived predictor variables (i.e., trauma characteristics, acute peritraumatic responses, coping, and social support) will be measured at 3-month intervals for 3 successive years. Latent growth curve analyses, structural equation modeling, multigroup structural equation modeling, and cross-lag panel analytic approaches will test temporal dependency as well as postulated relationships between risk and resilience factors. This application is the next step in our research team's programmatic investigation of trauma-related disorders among FFs, with an emphasis on factors that may inform prevention and treatment guidelines for both FFs and other trauma-exposed populations. The long-term goal of this study is to build a FF database from recruitment through retirement in order to identify patterns of risk and resilience in this highly-exposed, essential public safety population.

描述（由申请人提供）：超过一半的美国公民在其一生中会经历潜在的创伤事件（PTE）。最近发生的前所未有的人为和自然灾害（9/11 和卡特里娜飓风）灾难性地表明，终生创伤暴露率正在上升。与创伤暴露相关的精神反应包括创伤后应激障碍（PTSD）、物质使用障碍（SUD）或同时发生的精神病理学（即 PTSD-SUD）。然而，并非所有个体都会因 PTE 暴露而出现精神疾病，这凸显了一个问题：是什么因素导致一些暴露于创伤事件的个体走上恢复之路，而其他个体则走上患这些疾病的风险之路？这个问题可以在新招募的消防员 (FF) 样本中得到有效检验，这些新兵将因其职业而每天经历危及生命的事件。暴露于 PTE 的 FF 可能会遵循多种病理或健康途径。不幸的是，预测 PTSD、SUD 和 PTSD-SUD 症状和诊断病例的风险和恢复力的变量和参数，以及与这些疾病相关的恢复和复发模式，尚不清楚。在拟议的研究中，将对 400 名城市专业 FF 新员工进行前瞻性纵向评估，从选拔和培训到他们作为 FF 的早期职业生涯。将检查对 PTSD、SUD 或 PTSD-SUD 的恢复力或发展，以及症状表达、恢复和复发的时间模式。将评估影响暴露后途径并增加或减少发生 PTSD、SUD 或 PTSD-SUD 症状和/或病例的可能性的生物心理社会变量。在进行多维就业前基线评估（即遗传标记、家族史、性格因素、既往 PTE 暴露和物质使用）后，将连续 3 年每隔 3 个月测量 PTSD 和 SUD 症状以及经验得出的预测变量（即创伤特征、急性创伤周围反应、应对和社会支持）。潜在增长曲线分析、结构方程模型、多组结构方程模型和交叉滞后面板分析方法将测试时间依赖性以及风险和弹性因素之间的假设关系。该应用程序是我们研究团队对 FF 中创伤相关疾病进行计划性调查的下一步，重点关注可能为 FF 和其他遭受创伤人群提供预防和治疗指南的因素。本研究的长期目标是建立一个从招聘到退休的 FF 数据库，以便确定这一高度暴露的重要公共安全人群的风险和复原力模式。

项目成果

Differences in drinking patterns, occupational stress, and exposure to potentially traumatic events among firefighters: predictors of smoking relapse.

消防员饮酒模式、职业压力和接触潜在创伤事件的差异：吸烟复发的预测因素。

• DOI: 10.1111/j.1521-0391.2012.00282.x
• 发表时间: 2012
• 期刊: The American journal on addictions
• 作者: VanderVeen,JosephW;Gulliver,SuzyB;Morissette,SandraB;Kruse,MarcI;Kamholz,BarbaraW;Zimering,RoseT;Knight,Jeffrey;Keane,TerenceM
• 通讯作者: Keane,TerenceM

Negative Emotionality Interacts with Trauma Exposure to Prospectively Predict Posttraumatic Stress Disorder Symptoms During Firefighters' First 3 Years of Service.

消极情绪与创伤暴露相互作用，可前瞻性预测消防员服役前三年的创伤后应激障碍症状。

• DOI: 10.1002/jts.22632
• 发表时间: 2021
• 期刊: Journal of traumatic stress
• 影响因子: 3.3
• 作者: Meyer,EricC;Zimering,RoseT;Knight,Jeffrey;Morissette,SandraB;Kamholz,BarbaraW;Coe,Elizabeth;Carpenter,ThomasP;Keane,TerenceM;Kimbrel,NathanA;Gulliver,SuzyB
• 通讯作者: Gulliver,SuzyB