A Virtual Reality Simulation to Examine the Relationship Between Post-Traumatic Stress Symptoms and Decision-Making in First Responders

ABSTRACT

First responders (FRs) are continuously exposed to critical incidents, considered traumatic events (TEs). This cumulative exposure increases the risk for post-traumatic stress disorder (PTSD). However, there is no evidence about the relationship between PTSD symptoms and emergency decision-making (EDM). The objective of this study was to examine the EDM of FRs during a virtual reality through the simulation of two emergency scenarios to collect data on the reaction time and the number of incorrect decisions. We also assessed PTSD symptoms, TE, and sociodemographics. The sample included 368 Portuguese FRs, were 295 (80.20%) males and 73 (19.80%) females, with a mean age of 33.96 (SD  = 9.38). Considering the probable PTSD diagnosis according to the DSM-5, 85 (23.10%) of the FRs met the criteria. These individuals who meet the criteria exhibited higher EDM scores (M  = 19.60, SD  = 5.99) compared to those without probable PTSD (M  = 17.87, SD = .5.66) (F(1, 360) = 5.32, p = .02, partial η² = .015). We found that TEs had a direct effect on EDM, β = −.16, Z = −3.74, p < .001), and the pathway of trauma-PTSD symptoms-decision-making an indirect effect, β = .02, Z  = 3.10, p = .002). Individuals exposed to more TEs demonstrated faster and more accurate decision-making in the context of EDM. However, when these individuals developed PTSD symptoms, their decision-making became slower and less accurate. The inclusion of a trauma-informed approach for FRs to prevent individual and job-related consequences is discussed.

KEYWORDS:

• Decision-making
• first responders
• virtual reality
• post-traumatic stress symptoms

Disclosure statement

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

Additional information

Funding

This work was conducted at the Lusófona University, HEI-Lab: Digital Human-Environment Interaction Labs, Portugal, with support from Portuguese Foundation for Science and Technology (FCT) under the Strategic Funding [UIDB/05380/2020]. Additionally, this study was partially conducted at the Psychology Research Centre (CIPsi), School of Psychology, University of Minho, with support from the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020)