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The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters

  • Michelle L. Pennington (a1), Thomas P. Carpenter (a2), Samantha J. Synett (a1), Victoria A. Torres (a1), Jennifer Teague (a3), Sandra B. Morissette (a4), Jeffrey Knight (a5) (a6), Barbara W. Kamholz (a5) (a6), Terence M. Keane (a5) (a6), Rose T. Zimering (a5) (a6) and Suzy B. Gulliver (a1) (a7)...



Firefighters represent an important population for understanding the consequences of exposure to potentially traumatic stressors.


The researchers were interested in the effects of pre-employment disaster exposure on firefighter recruits’ depression and posttraumatic stress disorder (PTSD) symptoms during the first three years of fire service and hypothesized that: (1) disaster-exposed firefighters would have greater depression and PTSD symptoms than non-exposed overall; and (2) depression and PTSD symptoms would worsen over years in fire service in exposed firefighters, but not in their unexposed counterparts.


In a baseline interview, 35 male firefighter recruits from seven US cities reported lifetime exposure to natural disaster. These disaster-exposed male firefighter recruits were matched on age, city, and education with non-exposed recruits.


A generalized linear mixed model revealed a significant exposure×time interaction (e coef =1.04; P<.001), such that depression symptoms increased with time for those with pre-employment disaster exposure only. This pattern persisted after controlling for social support from colleagues (e coefficient=1.05; P<.001), social support from families (e coefficient=1.04; P=.001), and on-the-job trauma exposure (coefficient=0.06; e coefficient=1.11; P<.001). Posttraumatic stress disorder symptoms did not vary significantly between exposure groups at baseline (P=.61).


Depression symptoms increased with time for those with pre-employment disaster exposure only, even after controlling for social support. Posttraumatic stress disorder symptoms did not vary between exposure groups.

Pennington ML , Carpenter TP , Synett SJ , Torres VA , Teague J , Morissette SB , Knight J , Kamholz BW , Keane TM , Zimering RT , Gulliver SB . The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters. Prehosp Disaster Med. 2018;33(1):102108.


Corresponding author

Correspondence: Suzy B. Gulliver, PhD Baylor Scott & White Health Warriors Research Institute 2201 MacArthur Drive, Suite 2200 Waco, Texas 76708 USA E-mail:


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Conflicts of interest/funding/disclaimer: This research was supported by a research grant from National Institute of Mental Health (NIMH; Bethesda, Maryland USA; R01-MH-73808) to Suzy B. Gulliver entitled “Pathways of Risk and Resilience in Firefighter Recruits.” The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of NIMH, Veterans Affairs, or the United States government. The authors have no conflicts of interest to declare.



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The Influence of Exposure to Natural Disasters on Depression and PTSD Symptoms among Firefighters

  • Michelle L. Pennington (a1), Thomas P. Carpenter (a2), Samantha J. Synett (a1), Victoria A. Torres (a1), Jennifer Teague (a3), Sandra B. Morissette (a4), Jeffrey Knight (a5) (a6), Barbara W. Kamholz (a5) (a6), Terence M. Keane (a5) (a6), Rose T. Zimering (a5) (a6) and Suzy B. Gulliver (a1) (a7)...


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