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Secondary traumatization in first responders: a systematic review.

Anja Greinacher1, Cassandra Derezza-Greeven1, Wolfgang Herzog1

  • 1Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.

European Journal of Psychotraumatology
|February 6, 2019
PubMed
Summary

Secondary traumatization is low in first responders, but social desirability may hide higher rates. Resilience factors like social support and risk factors like female gender were identified, though caution is advised due to study design.

Keywords:
First responderscompassion fatiguesecondary traumatizationsystematic reviewvicarious traumatization• First responders showed low levels of secondary traumatization, possibly due to an immunization effect. • Prevalence of secondary traumatization may be underestimated owing to social desirability and job-loss concerns. • Females show higher levels of secondary traumatization than males. • Secondary traumatization correlates with burnout and post-traumatic stress disorder (PTSD). • Risk factors include pretraumatic (e.g. higher age), peritraumatic (exposure, emotional exhaustion), and post-traumatic factors (lack of social support, alcohol and tobacco use).

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Area of Science:

  • Psychology
  • Occupational Health
  • Trauma Studies

Background:

  • Defining secondary traumatic stress, vicarious traumatization, and compassion fatigue is challenging, with inconsistent usage among researchers.
  • This review consolidates these terms under 'secondary traumatization' for clarity.
  • First responders face unique occupational stressors that may impact their psychological well-being.

Purpose of the Study:

  • To systematically review the prevalence of secondary traumatization in first responders.
  • To identify resilience and risk factors associated with secondary traumatization in this population.
  • To provide an evidence-based overview for future research and interventions.

Main Methods:

  • Systematic search of PubMed, PsychINFO, and PSYNDEX databases.
  • Inclusion of 31 studies meeting criteria for first responders and quantitative assessment of secondary traumatization.
  • Analysis of pretraumatic, peritraumatic, and post-traumatic factors.

Main Results:

  • Low prevalence rates of secondary traumatization were observed in first responders.
  • Identified protective factors include social support, while risk factors include female gender, emotional exhaustion, and substance use.
  • Prevalence may be underestimated due to social desirability and fear of job loss.

Conclusions:

  • While low prevalence is reported, potential underestimation necessitates further investigation.
  • Resilience and risk factors identified align with some existing literature but require cautious interpretation.
  • Future research should prioritize longitudinal designs and the development of preventive and curative interventions.