Latent profile analysis of post-traumatic stress and post-traumatic growth among firefighters

ABSTRACT

Background: Due to the job characteristics, firefighters are repeatedly exposed to trauma incidents. However, not all firefighters exhibit the same level of post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG). Despite this, few studies have looked into firefighters’ PTSD and PTG.

Objective: This study identified subgroups of firefighters based on their PTSD and PTG levels, and investigated the influence of demographic factors and PTSD/PTG-related factors on latent class classification.

Method: Latent profile analysis was used to examine the patterns of PTSD and PTG among 483 firefighters in South Korea. Using a cross-sectional design, demographic factors and job factors were examined as group covariates through a three-step approach. PTSD-related factors such as depression and suicide ideation, as well as PTG-related factors such as emotion-based response were analysed as differentiating factors.

Results: Four classes were identified and named ‘Low PTSD-low PTG (65.2%),’ ‘Mid PTSD-mid PTG (15.5%),’ ‘Low PTSD-high PTG (15.3%),’ and ‘High PTSD-mid PTG (3.9%).’ The likelihood of belonging to the group with high trauma-related risks increased with more rotating shift work and years of service. The differentiating factors revealed differences based on the levels of PTSD and PTG in each group.

Conclusions: 34.8% of firefighters experienced changes due to traumatic events while on the job, and some required serious attention. Modifiable job characteristics, such as the shift pattern, indirectly affected PTSD and PTG levels. Individual and job factors should be considered together when developing trauma interventions for firefighters.

HIGHLIGHTS

• Firefighters were classified into four groups based on their levels of PTSD and PTG. 65.2% of the participants belonged to the ‘Low PTSD-low PTG’ group.

• The shift pattern and years of service predicted the likelihood of group classification.

• This implies that, despite being frequently exposed to threatening events, not all firefighters experience trauma, and that job characteristics influence trauma-related vulnerabilities.

Antecedentes: Debido a las características del trabajo, los bomberos están expuestos repetidamente a incidentes traumáticos. Sin embargo, no todos los bomberos presentan el mismo nivel de trastorno de estrés postraumático (TEPT) o crecimiento postraumático (PTG). A pesar de esto, pocos estudios han investigado TEPT y PTG de los bomberos.

Objetivo: Este estudio identificó subgrupos de bomberos basados en sus niveles de TEPT y PTG e investigó la influencia de factores demográficos y factores relacionados con TEPT/PTG en la clasificación de clases latentes.

Método: Se usó análisis de perfil latente para examinar los patrones de TEPT y PTG entre 483 bomberos de Corea del Sur. Utilizando un diseño transversal, los factores demográficos y laborales se examinaron como covariables de grupo a través de un enfoque de 3 pasos. Los factores relacionados con TEPT, como depresión e ideación suicida, así como los factores relacionados con PTG como la respuesta basada en la emoción, se analizaron como factores diferenciadores.

Resultados: Se identificaron cuatro clases y se denominaron ‘TEPT bajo- PTG bajo’ (65,2%), ‘TEPT medio-PTG medio’ (15,5%), TEPT bajo- PTG alto’ (15,3%), y TEPT alto-PTG medio’ (3,9%). La probabilidad de pertenecer al grupo con alto riesgo relacionado con el trauma aumentaba con más turnos rotativos y años de servicio. Los factores diferenciadores revelaron diferencias basadas en función de los niveles de TEPT y PTG en cada grupo.

Conclusiones: 34,8% de los bomberos experimentaron cambios debido a eventos traumáticos en el trabajo y algunos requirieron atención especializada. Las características laborales modificables, como el patrón de turnos, afectaron indirectamente los niveles de TEPT y PTG. Los factores individuales y laborales deben considerarse juntos al desarrollar intervenciones de trauma para los bomberos.

背景：由于工作特点，消防员经常遭受创伤事件。 然而，并非所有消防员都表现出相同程度的创伤后应激障碍 (PTSD) 或创伤后成长 (PTG) 。 然而，很少有研究考查消防员的 PTSD 和 PTG 。

目的：本研究根据消防员的 PTSD 和 PTG 水平确定了消防员亚组，并调查了人口因素和 PTSD/PTG 相关因素对潜在类别分类的影响。

方法：使用潜在剖面分析来检查韩国 483 名消防员的 PTSD 和 PTG 模式。 使用横截面设计，通过三步法将人口因素和工作因素作为组别协变量考查。 将PTSD 相关因素（如抑郁和自杀意念）以及 PTG 相关因素（如基于情绪的反应）作为区分因素进行了分析。

结果：确定了四个类别并命名为“低 PTSD-低 PTG (65.2%)”、“中 PTSD-中 PTG (15.5%)”、“低 PTSD-高 PTG (15.3%)”和“高 PTSD-中” PTG (3.9%)'。 随着轮班工作和服务年限增加，属于创伤相关高风险组的可能性增加。 区分因素揭示了每组 PTSD 和 PTG 水平的差异。

结论：34.8% 的消防员在工作中因创伤性事件经历过变化，其中一些需要引起高度重视。 可改变的工作性质，例如轮班模式，间接影响了 PTSD 和 PTG 水平。 在为消防员制定创伤干预措施时，应同时考虑个人和工作因素。

KEYWORDS:

• Firefighters
• post-traumatic stress
• PTSD
• post-traumatic growth
• latent profile analysis

PALABRAS CLAVE:

• Bomberos
• estrés postraumático
• estrés
• TEPT
• crecimiento postraumático
• análisis de perfil latente

关键词:

• 消防员
• 创伤后应激
• PTSD
• 创伤后成长
• 潜在剖面分析

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are openly available in Harvard Dataverse at https://doi.org/10.7910/DVN/I5RSTL.

Additional information

Funding

This research has been supported by the 4·16 Foundation and Community Chest of Korea.