Examining the impact of posttraumatic stress on first responders: analysis of cortisol, anxiety, sleep impairment and pain

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First responders are an often ignored group facing emotional and physical stress that is similar to that of law enforcement personnel and military veterans. Fifty first responder employees were invited to participate in the study, of which 34 completed the following psychological and biological measures: 1) the PTSD Checklist—Civilian Version (PCL-C); 2) State Trait Inventory for Cognitive and Somatic Anxiety (STICSA); 3) the Center for Epidemiology Studies Depression Scale (CES-D); 4) the Pittsburgh Sleep Quality Index (PSQI); 5) Alcohol Use Disorders Identification Test (AUDIT); 6) Cornell Musculoskeletal Discomfort Questionnaire (CMDQ); 7) heart rate and blood pressure during two consecutive days; 8) body mass index (BMI); and 9) salivary cortisol measured once. Among participants, 18% (n=6) met criteria for anxiety, 47% for depression (n=16) and 33% (n=12) for PTSD. Comparison of statistical models assessing the predictive strength of physical and behavioural health measures found PTSD to be the strongest predictor for depression, anxiety, poor sleep quality, musculoskeletal pain, cortisol and BMI.
A substantial portion of first responders met criteria for PTSD and anxiety.
Assessing the impact of these conditions may best be achieved through physical
health measures (cortisol, BMI, heart rate) in addition to psychometric screening
tools (PCL, CESD, STICSA).
Original languageEnglish (US)
Pages (from-to)42-52
Number of pages10
JournalJournal of Paramedic Practice
Issue number3
StatePublished - 2015


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