Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel

This study examines the longitudinal course and predictors of stress-specif ic and general symptomatic distress in emergency services personnel. A thre e-group quasiexperimental design was used to determine the responses of 322 rescue workers to the Loma Prieta earthquake Interstate 880 Freeway collap se and to unrelated control critical incidents. Self-report questionnaires, including measures of incident exposure, peritraumatic dissociation and em otional distress, and current symptoms, were administered 1.9 years (initia l) and 3.5 years (follow-up) after the freeway collapse. Despite modest sym ptom improvement at follow-up, rescue workers were at risk for chronic symp tomatic distress after critical incident exposure. Peritraumatic dissociati on accounted for significant increments in current posttraumatic stress dis order symptoms, over and above exposure, adjustment, years of experience, l ocus of control, social support, and general dissociative tendencies. The r esults suggest that rescue workers, particularly those with more catastroph ic exposure and those prone to dissociate at the time of the critical incid ent, are at risk for chronic symptomatic distress.