PTSD Symptom Severity, Pain Intensity, and Pain-Related Disability Among Trauma-Exposed Firefighters: the Moderating Role of Mindfulness

Objectives Firefighters are regularly exposed to potentially traumatic and injurious events and are at increased risk for developing posttraumatic stress disorder (PTSD) symptoms, pain, and pain-related disability. Mindfulness (i.e., present-oriented awareness and nonjudgmental acceptance of cognitions and bodily sensations) may influence PTSD-pain relations in firefighter populations and inform mutual maintenance models. The current cross-sectional study sought to examine the moderating role of mindfulness on the associations between PTSD symptom severity and pain-related disability and intensity among trauma-exposed firefighters. Methods Firefighters (N = 266; M-age = 40.48, SD = 9.70; 92.5% male) were recruited from a large, southwestern metropolitan area and voluntarily completed an online, self-report survey advertised throughout the fire department. Results Accounting for covariates (i.e., age, years in the fire service, trauma load), a significant interactive effect of PTSD symptom severity and mindfulness on pain-related disability (Delta R-2 = 0.05, B = - 0.16, p < .001), but not pain intensity, emerged. Simple slope analyses revealed that PTSD symptom severity was associated with pain-related disability for those with low, but not high mindfulness. Post hoc analyses examining mindfulness facets revealed significant main effects of acting with awareness, non-judging of inner experience, and nonreactivity to inner experience on pain-related disability. Significant interactive effects of observing, describing, and nonreactivity to inner experience with PTSD symptom severity on pain-related disability emerged. Conclusions Mindfulness moderates PTSD symptom severity and pain-related disability associations in trauma-exposed firefighters. Future work should further examine these associations among first responders, using experimental and/or longitudinal methodologies.

Automated summary

This study examined the moderating role of mindfulness on the associations between PTSD symptom severity and pain-related disability and intensity among trauma-exposed firefighters. Results showed that mindfulness significantly interacted with PTSD symptom severity to affect pain-related disability, particularly in individuals with low mindfulness. Different aspects of mindfulness also had significant effects on pain-related disability in firefighters.