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Mental Health of Protective Services Workers: Results From the National Epidemiologic Survey on Alcohol and Related Conditions

Published online by Cambridge University Press:  25 April 2013

Abstract

Objectives

To determine the prevalence of mental disorders in a nationally representative sample of protective services workers (PSWs), compare it to that of adults in other occupations, and determine if an association exists between trauma exposure and 3-year incident psychiatric disorders in PSWs.

Methods

Data from the longitudinal US National Epidemiologic Survey on Alcohol and Related Conditions waves 1 (fielded 2001-2002) and 2 (fielded 2004-2005) were used to compare the prevalence of mental disorders at baseline in a representative sample of PSWs to that of adults in other occupations. Among PSWs, we also explored the association between recent exposure to potentially traumatic events and the development of mood, anxiety, and alcohol-use disorders over a 3-year follow-up period.

Results

At baseline, PSWs had a lifetime prevalence of mental and alcohol-use disorders similar to that of adults in other occupations. However, PSWs experienced a greater variety of potentially traumatic events between baseline and follow-up. Exposure to a greater number of different trauma types was associated with increased odds of incident mood (adjusted odds ratio [AOR] = 1.87, 95% CI = 1.09-3.22, P = .024), and alcohol-use disorders (AOR = 1.84, 95% CI = 1.16-2.91, P = .011). These associations were particularly strong among early career PSWs who joined the profession between waves 1 and 2 (AOR = 2.30, 95% CI = 1.26-4.19, P = .008, for mood disorders; AOR = 2.44, 95% CI = 1.30-4.58, P = .007, for alcohol-use disorders).

Conclusions

While PSWs do not appear to have a higher prevalence of mental health problems than workers in other occupations, they are more likely to experience multiple types of potentially traumatic events. PSWs who are exposed to multiple types of potentially traumatic events are at increased risk of developing new mental disorders, particularly in the early stages of their careers. Developing curricula in coping skills and providing timely interventions for early career PSWs may help reduce future psychiatric morbidity in these workers. (Disaster Med Public Health Preparedness. 2013;7:36-45)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013

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References

1.Centers for Disease Control and Prevention (CDC). Injuries and illnesses among New York City Fire Department rescue workers after responding to the World Trade Center attacks. MMWR Morb Mortal Wkly Rep. 2002;51(Spec No):1-5.Google Scholar
2.Centers for Disease Control and Prevention (CDC). Physical health status of World Trade Center rescue and recovery workers and volunteers - New York City, July 2002-August 2004. MMWR Morb Mortal Wkly Rep. 2004;53(35):807-812.Google Scholar
3.Kokayi, K, Altman, CH, Callely, RW, Harrison, A. Findings of and treatment for high levels of mercury and lead toxicity in ground zero rescue and recovery workers and lower Manhattan residents. Explore (NY). 2006;2(5):400-407.Google Scholar
4.Dahlgren, J, Cecchini, M, Takhar, H, Paepke, O. Persistent organic pollutants in 9/11 world trade center rescue workers: reduction following detoxification. Chemosphere. 2007;69(8):1320-1325.Google Scholar
5.Izbicki, G, Chavko, R, Banauch, GI, etal. World Trade Center “sarcoidlike” granulomatous pulmonary disease in New York City Fire Department rescue workers. Chest. 2007;131(5):1414-1423.Google Scholar
6.Morren, M, Dirkzwager, AJ, Kessels, FJ, Yzermans, CJ. The influence of a disaster on the health of rescue workers: a longitudinal study. CMAJ. 2007;176(9):1279-1283.Google Scholar
7.Wheeler, K, McKelvey, W, Thorpe, L, etal. Asthma diagnosed after 11 September 2001 among rescue and recovery workers: findings from the World Trade Center Health Registry. Environ Health Perspect. 2007;115(11):1584-1590.Google Scholar
8.Papageorgiou, V, Frangou-Garunovic, A, Iordanidou, R, Yule, W, Smith, P, Vostanis, P. War trauma and psychopathology in Bosnian refugee children. Eur Child Adolesc Psychiatry. 2000;9(2):84-90.Google Scholar
9.Lacoursiere, RB, Godfrey, KE, Ruby, LM. Traumatic neurosis in the etiology of alcoholism: Viet Nam combat and other trauma. Am J Psychiatry. 1980;137(8):966-968.Google Scholar
10.North, CS, Tivis, L, McMillen, JC, etal. Coping, functioning, and adjustment of rescue workers after the Oklahoma City bombing. J Trauma Stress. 2002;15(3):171-175.Google Scholar
11.North, CS, Tivis, L, McMillen, JC, etal. Psychiatric disorders in rescue workers after the Oklahoma City bombing. Am J Psychiatry. 2002;159(5):857-859.Google Scholar
12.Ozen, S, Sir, A. Frequency of PTSD in a group of search and rescue workers two months after 2003 Bingol (Turkey) earthquake. J Nerv Ment Dis. 2004;192(8):573-575.Google Scholar
13.Perrin, MA, DiGrande, L, Wheeler, K, Thorpe, L, Farfel, M, Brackbill, R. Differences in PTSD prevalence and associated risk factors among World Trade Center disaster rescue and recovery workers. Am J Psychiatry. 2007;164(9):1385-1394.Google Scholar
14.Stellman, JM, Smith, RP, Katz, CL, etal. Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster. Environ Health Perspect. 2008;116(9):1248-1253.Google Scholar
15.Centers for Disease Control and Prevention (CDC). Health hazard evaluation of police officers and firefighters after Hurricane Katrina—New Orleans, Louisiana, October 17-28 and November 30-December 5, 2005. MMWR Morb Mortal Wkly Rep. 2006;55(16):456-458.Google Scholar
16.Fullerton, CS, McCarroll, JE, Ursano, RJ, Wright, KM. Psychological responses of rescue workers: fire fighters and trauma. Am J Orthopsychiatry. 1992;62(3):371-378.Google Scholar
17.Fullerton, CS, Ursano, RJ, Wang, L. Acute stress disorder, posttraumatic stress disorder, and depression in disaster or rescue workers. Am J Psychiatry. 2004;161(8):1370-1376.Google Scholar
18.Hasin, D, Carpenter, KM, McCloud, S, Smith, M, Grant, BF. The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a clinical sample. Drug Alcohol Depend. 1997;44(2-3):133-141.Google Scholar
19.Pull, CB, Saunders, JB, Mavreas, V, etal. Concordance between ICD-10 alcohol and drug use disorder criteria and diagnoses as measured by the AUDADIS-ADR, CIDI and SCAN: results of a cross-national study. Drug Alcohol Depend. 1997;47(3):207-216.Google Scholar
20.Grant, BF, Dawson, DA, Stinson, FS, Chou, PS, Kay, W, Pickering, R. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug Alcohol Depend. 2003;71(1):7-16.Google Scholar
21.Ruan, WJ, Goldstein, RB, Chou, SP, etal. The alcohol use disorder and associated disabilities interview schedule-IV (AUDADIS-IV): reliability of new psychiatric diagnostic modules and risk factors in a general population sample. Drug Alcohol Depend. 2008;92(1-3):27-36.Google Scholar
22.Grant, BF, Hasin, DS, Stinson, FS, etal. Prevalence, correlates, and disability of personality disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. J Clin Psychiatry. 2004;65(7):948-958.Google Scholar
23.Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ, Pickering, RP. Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61(4):361-368.Google Scholar
24.Grant, BF, Hasin, DS, Stinson, FS, etal. Co-occurrence of 12-month mood and anxiety disorders and personality disorders in the US: results from the national epidemiologic survey on alcohol and related conditions. J Psychiatr Res. 2005;39(1):1-9.Google Scholar
25.Grant, BF, Stinson, FS, Dawson, DA, Chou, SP, Ruan, WJ. Co-occurrence of DSM-IV personality disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Compr Psychiatry. 2005;46(1):1-5.Google Scholar
26.Benedek, DM, Fullerton, C, Ursano, RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007;28:55-68.Google Scholar
27.Wakefield, JC, Schmitz, MF, First, MB, Horwitz, AV. Extending the bereavement exclusion for major depression to other losses: evidence from the National Comorbidity Survey. Arch Gen Psychiatry. 2007;64(4):433-440.Google Scholar
28.Centers for Disease Control and Prevention (CDC). CDC grand rounds: prescription drug overdoses - a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61(1):10-13.Google Scholar
29.Rutkow, L, Gable, L, Links, JM. Protecting the mental health of first responders: legal and ethical considerations. J Law Med Ethics. 2011;39(Suppl 1):56-59.Google Scholar
30.HIPAA, Pub. L. No 104-191, 110 Stat. 1936 (1996).Google Scholar
31.Everly, GS Jr, Beaton, RD, Pfefferbaum, B, Parker, CL. On academics: training for disaster response personnel: the development of proposed core competencies in disaster mental health. Public Health Rep. 2008;123(4):539-542.Google Scholar
32.Brymer, M, Jacobs, A, Layne, C, etal. Psychological First Aid Field Operations Guide, 2nd ed.Los Angeles, CA: National Child Traumatic Stress Network and National Center for PTSD; 2006.Google Scholar
33.Everly, GS Jr, Barnett, DJ, Sperry, NL, Links, JM. The use of psychological first aid (PFA) training among nurses to enhance population resiliency. Int J Emerg Ment Health. 2010;12(1):21-31.Google Scholar
34.Stea, JB, Anderson, MA, Bishop, JM, Griffith, LJ. Behavioral health force protection: optimizing injury prevention by identifying shared risk factors for suicide, unintentional injury, and violence. Mil Med. 2002;167(11):944-949.Google Scholar
35.Wang, PS, Lane, M, Olfson, M, Pincus, HA, Wells, KB, Kessler, RC. Twelve month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):629-640.Google Scholar