A longitudinal study of depression, PTSD, and anxiety symptoms in first responders

First responders witness traumatic events at rates unmatched by nearly any other profession, and research has subsequently found that they exhibit elevated rates of psychopathology. Factors predicting the development of this psychopathology, however, remain largely unknown. This study longitudinally examines predictors of PTSD, depression, and anxiety symptoms in first responders. Participants included 135 emergency medical technicians and paramedics. Multiple linear regressions were used to model predictors of PTSD, depression, and anxiety symptomatology at baseline, as well as changes from baseline to 3-month follow-up. Baseline levels of social support, sleep, emotional stability, and perceived stress were examined as potential predictors. Results revealed that at baseline a) higher depression symptoms were predicted by a model that included greater sleep dysfunction, lower social support, and higher perceived stress; b) PTSD symptoms were also predicted by a model that included greater sleep dysfunction, lower social support, and higher perceived stress; and c) anxiety symptoms were predicted by a model that included greater sleep dysfunction, lower social support, higher perceived stress, as well as lower emotional stability. At 3-month follow-up a) increases in depression symptoms, b) increases in anxiety symptoms, and c) increases in PTSD symptoms were each predicted by worse sleep and lower social support at baseline. In particular, the sleep subscale of disturbed sleep and the social support subscale of appraisal appeared to be driving these effects. These results highlight the importance of social support and sleep hygiene in protecting against increases in psychopathology symptoms in first responders. Although these factors have established relationships to psychopathology in the general population, their potential to serve as risk or protective factors in first responders has been largely unexplored. Future studies should examine whether interventions targeting sleep disturbances and encouraging deeper social connections can be utilized to protect against symptoms of distress in first responders.