Examining moral injury and posttraumatic stress among firefighters, emergency medical services personnel, and emergency dispatchers.

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Title: Examining moral injury and posttraumatic stress among firefighters, emergency medical services personnel, and emergency dispatchers.
Alternate Title: Análisis del daño moral y el estrés postraumático entre los bomberos, personal de servicios médicos de emergencia, y los operadores de emergencia.
Authors: Woller, Savannah J. (AUTHOR), Hall, Kayla E. (AUTHOR), McGrew, Shelby J. (AUTHOR), Anderson-Fletcher, Elizabeth (AUTHOR), Norman, Sonya B. (AUTHOR), Vujanovic, Anka A. (AUTHOR)
Source: European Journal of Psychotraumatology. Dec2025, Vol. 16 Issue 1, p1-6. 6p.
Subjects: Post-traumatic stress, First responders, Emergency management, Harm (Ethics), Psychotherapy, Emergency medical services, Psychosocial factors, Fire fighters
Abstract (English): Background: First responders encounter chronic exposure to stressful and potentially traumatic experiences due to the nature of their jobs. First responders are also often confronted with the dilemma of following organisational protocols and/or using personal judgment to respond in high stress situations. Thus, posttraumatic stress disorder (PTSD) and moral injury (MI), defined as the negative impact of witnessing, perpetrating, or failing to prevent an act that violates one's moral beliefs, are potential psychological responses to potentially traumatic events. Objective: The present study evaluated MI severity among firefighters, emergency medical services (EMS) personnel, and dispatchers with and without probable PTSD. Method: The sample included 283 personnel (Mage = 46.53; 83.7% male) from nine fire departments, primarily in the western US. Results: Consistent with hypotheses, first responders who met screening criteria for probable PTSD, as compared to those who did not, reported significantly higher MI total scores, MI-shame subscale scores, and MI-trust-violation subscale scores, with large effect sizes (η2's ≤.22). Conclusions: Results suggest that MI may play a role in the characterisation of the clinical picture of first responders. Future studies should continue to evaluate associations between PTSD and MI in first responders, using interview-based and longitudinal methodologies, to better inform specialised clinical interventions. HIGHLIGHTS: Moral injury is defined as the negative impact of witnessing, perpetrating, or failing to prevent an act that violates one's moral beliefs. It is plausible that PTSD and moral injury are common experiences for first responders. In this sample, first responders who had PTSD, as compared to those who did not, reported higher levels of moral injury. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Antecedentes: Los trabajadores de primera línea experimentan exposición crónica a experiencias estresantes y potencialmente traumáticas debido a la naturaleza de su trabajo. Los trabajadores de primera línea también se enfrentan con el dilema de seguir protocolos organizacionales y/o usar su criterio personal para responder en situaciones de alto estrés. Así, el trastorno de estrés postraumático (TEPT) y el daño moral (DM), definida como el impacto negativo de ser testigo, perpetrar, o fallar en prevenir un acto que viola las propias creencias morales, son respuestas psicológicas potenciales a eventos potencialmente traumáticos. Objetivo: El presente estudio evaluó la severidad de DM entre bomberos, personal de servicios de emergencia médica (EMS en su sigla en inglés), y los operadores de emergencia con y sin probable TEPT. Método: La muestra incluyó 283 personal (Medad = 46.53; 83.7% hombres) de nueve departamentos de bomberos, principalmente de la zona oeste de Estados Unidos. Resultados: Consistente con las hipótesis, los profesionales de primera línea que cumplieron con el criterio de tamizaje de posible TEPT, en comparación con aquellos que no, reportaron puntajes totales de DM, puntajes de la subescala de vergüenza de DM, y los puntajes de la subescala de violación de la confianza de DM significativamente más altos, con tamaños del efecto grandes (ɳ2's ≤.22). Conclusiones: Los resultados sugieren que el DM podría jugar un rol en la caracterización del cuadro clínico de los profesionales de primera línea. Las investigaciones futuras deberían continuar evaluando las asociaciones entre TEPT y DM en los profesionales de primera línea, usando metodologías longitudinales y basadas en entrevistas, para fundamentar mejor las intervenciones clínicas especializadas. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:Background: First responders encounter chronic exposure to stressful and potentially traumatic experiences due to the nature of their jobs. First responders are also often confronted with the dilemma of following organisational protocols and/or using personal judgment to respond in high stress situations. Thus, posttraumatic stress disorder (PTSD) and moral injury (MI), defined as the negative impact of witnessing, perpetrating, or failing to prevent an act that violates one's moral beliefs, are potential psychological responses to potentially traumatic events. Objective: The present study evaluated MI severity among firefighters, emergency medical services (EMS) personnel, and dispatchers with and without probable PTSD. Method: The sample included 283 personnel (Mage = 46.53; 83.7% male) from nine fire departments, primarily in the western US. Results: Consistent with hypotheses, first responders who met screening criteria for probable PTSD, as compared to those who did not, reported significantly higher MI total scores, MI-shame subscale scores, and MI-trust-violation subscale scores, with large effect sizes (η2's ≤.22). Conclusions: Results suggest that MI may play a role in the characterisation of the clinical picture of first responders. Future studies should continue to evaluate associations between PTSD and MI in first responders, using interview-based and longitudinal methodologies, to better inform specialised clinical interventions. HIGHLIGHTS: Moral injury is defined as the negative impact of witnessing, perpetrating, or failing to prevent an act that violates one's moral beliefs. It is plausible that PTSD and moral injury are common experiences for first responders. In this sample, first responders who had PTSD, as compared to those who did not, reported higher levels of moral injury. [ABSTRACT FROM AUTHOR]
ISSN:20008066
DOI:10.1080/20008066.2025.2510019