References
PTSD in paramedics: history, conceptual issues and psychometric measures
Abstract
Post-traumatic stress disorder (PTSD) is more common in paramedics than in the general population because of the stressful and distressing nature of their work. Forms of PTSD associated with chronic stress and repeated trauma are scarcely researched among paramedics. This is striking as this workforce is potentially more likely to be affected by these types of PTSD. Diagnostic processes are still largely based on acute rather than chronic psychological trauma. PTSD diagnosis has been influenced by sociological perceptions of mental illness and changes in diagnostic criteria. Criteria for the diagnosis of PTSD in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases have changed in the past decade, which may facilitate more appropriate diagnoses of PTSD in paramedics. Paramedics often have a complex aetiology of PTSD resulting from experiences of both chronic and acute events. Questionnaires that cover exposure to both individual and repeated stressful events are required to enable further research in the area of PTSD in paramedics.
Post-traumatic stress disorder (PTSD) is generally described as a mental disorder characterised by intrusive flashbacks, detachment from the world and disproportionately high arousal, caused by stressful external environmental events (Lasiuk and Hegadoren, 2006; Friedman, 2013). The original articulations of the definition of PTSD can be seen as historically contingent and closely related to historical events.
PTSD was classified as a mental illness in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM–III) in 1980 (American Psychiatric Association (APA), 1980) and was largely related to the aftermath of the Vietnam War (Shatan, 1973; Horowitz and Solomon, 1975; Young, 1996). Evidence suggests that seemingly relevant symptoms were indeed present in people from earlier times. However, other perhaps more colloquial descriptors would have been used such as shell shock (Meyers, 1915; Miller et al, 1992; Cantor, 2005).
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