Duty-Related Stressors, Adjustment, and the Role of Coping Processes in First Responders: A Systematic Review

Objective: A core challenge in working with first responders worldwide (e.g., firefighters, emergency service personnel, police officers) is identifying theoretically and empirically based individual-level factors that are associated with adjustment and that can be translated to interventions. The transactional model of stress and coping provides an excellent framework to guide interventions with first responders, yet no review to date has explicitly and comprehensively focused on coping responses in this population. Method: The current study systematically evaluated global evidence linking primary appraisals and coping efforts to mental health and behavioral risk-taking in first responders, with an eye toward their application to interventions. Results: Seventeen studies from eight countries met review criteria and were summarized. Studies of coping efforts predominated; only two studies assessed primary appraisals. Overall, disengaged coping efforts, relative to engaged coping, were more often associated with adjustment. Further, for engaged coping, associations with adjustment largely were present for cognitive, versus behavioral, strategies; for disengaged coping. cognitive and behavioral strategies were associated equally with poorer adjustment. Two thirds of the studies assessed posttraumatic stress (PTS) symptoms. Given the nature of PTS. use of disengaged strategies may particularly exacerbate these symptoms relative to other adjustment outcomes. Conclusions: Additional research focused on both primary appraisals and coping efforts and that employs longitudinal designs would expand our understanding of the role of coping processes in first responders' adjustment to duty-related stress. Further, these data suggest that interventions targeting individuals (vs. systems or environments) should focus on replacing cognitive and behavioral disengaged coping strategies with engaged strategies that are cognitive in nature.

Automated summary

This study systematically evaluated the evidence linking coping efforts to mental health and behavioral risk-taking in first responders, and discussed their implications for interventions. The results suggest that disengaged coping efforts are more often associated with poorer adjustment, whereas engaged coping strategies, particularly cognitive ones, are related to better adjustment outcomes.