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

大约110万名消防员（FF; 35万名专业或有偿，75万名志愿者）保护 美国人，他们的家庭，企业，公路和荒地，执行紧急 尽管他们自己的健康和福祉面临重大风险，但他们仍然作出反应。尽管FF 在进入这个行业时进行心理健康风险筛查， 消防职业期间的心理健康问题，包括创伤后应激障碍（PTSD）， 酗酒抑郁和焦虑正如预期的那样， 精神健康状况，自杀风险是FF的主要关注点。总之，职业 消防工作压力对消防员的早期死亡有一定的影响，消防员比其他消防员早2年死亡， 美国男性FF必须具备更有效的情绪调节功能 在进入这个行业时，他们需要掌握一些技能，以缓冲他们将面临的各种压力。 等待心理健康挑战出现是一种有缺陷的方法。心理健康障碍 寻求治疗的FF是众多的; FF将受益最多的情感训练 在进入和社会化进入专业时由可靠的同行提供的监管技能。 这可能会防止下游产生重大负面结果，同时促进复原力 和健康培训，以防止创伤后应激障碍的发展，酒精滥用，和其他常见的 共同发生的心理健康挑战应该是transdiagnosed，重点是潜在的 情绪调节机制。拟议中的项目是我们的下一个合乎逻辑的步骤， 研究的长期目标是将重要的科学发现转化为预防 FF中的致残性心理健康挑战的发展。我们的核心假设是，对等- 发布了《情绪障碍跨诊断治疗统一协议》（BUP）， 在消防学院期间提供，将防止创伤后应激障碍和相关心理的发展， 健康成果。我们将进行一项随机分组对照试验（RCT）， 提供BUP到同龄人提供的心理健康心理教育（PSYED）到小 消防学院期间的FF学员群体，以预防创伤后应激障碍，酒精 随着时间的推移，新FF中的误用、抑郁、焦虑和功能障碍。我们将测试 神经质和情绪调节的变化是否介导了BUP对 结果。这将是第一个在FF新兵中进行心理健康预防干预的RCT， 这是一个重要但研究不足的群体，经常受到创伤， 同龄人如果成功，这种方法将提供一种文化上胜任的、可扩展的方法， 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.