The hidden price of repeated traumatic exposure

Figures & data

Table 1. Demographic characteristics of trauma exposed firefighters and trauma-unexposed matched controls.

	Firefighters(N = 32)	Controls (N = 31)
Age (years)	36.47 (8.5)	38.6 (8.07)
Male/female	27/5	26/5
Education (years)	12.44 (0.88)	12.42 (0.81)
Medications (N)*	4/32	2/31
SCID-NP-PTSD	24.28 (6.62)	N/A
Time in fire and rescue service (years)	10.47 (9.39)	N/A

SCID-NP-PTSD: Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorders-Forth Edition (DSM–IV), Non-Patients PTSD module.

*Firefighters: one participant received non-selective beta-blockers and three received other supplementary medications such as benzodiazepines; control group: two received other supplementary medications such as benzodiazepine.

Table 2. Mean number of exposures to different potential traumatic events per year in the past 10 years in Israel southern fire and rescue stations.

Type of event	Mean number of potential traumatic events
Car fires	179
Building fires	246
Factory fires	10
Bush fires	1548
Car accidents	116
Spilling of toxic/combustion substances	7
Gas leak	109
Breaking and entering due to fear of a lost life	249
Missile attacks	290–1096*
Attempted suicide	17
Animal rescue mission	18
Rescuing trapped people	32

*There were no significant differences between the numbers of potential traumatic events across the years in all types of traumatic events but missile attacks. Data on this section refers to the past seven years only. The range of events is due to significant differences between quiet years (3 of 7 years) and years of emergency circumstances (4 of 7 years). All participants in the study experienced at least one year of extensive missile attacks.

Figure 1. Example of the stimuli in the two phases of the Cue–Context Reversal Task.

Figure 2. Example of experimental trials in which participants chose to (a) open a positive-outcome box and (b) open a negative-outcome box.

Table 3. Schematic description of the Cue–Context Reversal Task.

Figure 3. Percentage of correct responses to the four original boxes as a function of Phase (Acquisition vs. Retention), Outcome (Positive vs. Negative) and Experimental Group (Trauma Exposed Firefighters vs. Trauma-Unexposed Controls).

Figure 4. Percentage of correct responses for the new associations as a function of Reversal Type (Cue vs. Context), Outcome (Reversal from Positive to Negative vs. Reversal from Negative to Positive) and Experimental Group (Trauma Exposed Firefighters vs. Trauma-Unexposed Controls). Cue reversal refers to conditions of old cue, which is presented against a new context; Context reversal refers to conditions of new cue, which is presented against an old context.

Figure 5. Individual differences in percentage of correct responses (below and above median) in reversing the negative outcome of contextual information as a function of experimental group (Trauma Exposed Firefighters vs. Trauma-Unexposed Controls).

Table 4. Questionnaires and cognitive assessment (means and standard deviation) of trauma exposed firefighters and trauma unexposed matched controls.

	Firefighters	Controls
BDI-II	3.72 (4.46)	4.16 (3.56)
STAI-state	27.38 (8.17)	24.74 (3.92)
STAI-trait	26.72 (8.48)	25.65 (4.62)
IQ score	10.72 (1.69)	10.35 (1.28)

BDI-II: The Beck Depression Inventory (Beck, 1996).

STAI: State–Trait Anxiety Inventory (Spielberger et al., 1983).

IQ scores as measured by the WAIS-III vocabulary subtest.

Beck AT, Steer RA, Brown GK. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation

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Spielberger CD, Gorsuch RL, Lushene RE, Vagg PR. (1983). State-Trait Anxiety Inventory (STAI). Bib 2010:180

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