PTSD symptoms, response to intrusive memories and coping in ambulance service workers

Br J Clin Psychol. 1999 Sep;38(3):251-65. doi: 10.1348/014466599162836.


Objectives: To examine the relationship of coping strategies and responses to intrusive memories with post-traumatic stress disorder (PTSD) and other psychiatric symptoms in ambulance service workers.

Method: Fifty-six ambulance service workers describe the most distressing aspects of their work and completed questionnaires designed to measure their coping strategies in dealing with distressing incidents. They also described their intrusive memories of particularly distressing incidents and completed a questionnaire designed to measure their interpretation of these intrusions and their responses to them. In addition, they completed the Post-traumatic Stress Symptom Scale (PSS; Foa, Riggs, Dancu & Rothbaum, 1993) and the General Health Questionnaire (GHQ; Goldberg & Hiller, 1979).

Results: Of the participants, 21% met DSM-III-R criteria for PTSD, and 22% met GHQ screening criteria for psychiatric symptoms. Wishful thinking and mental disengagement when confronted with critical incidents at work, negative interpretations of intrusive memories, and maladaptive responses to these memories (rumination, suppression and dissociation) correlated with PTSD severity.

Conclusion: The results are consistent with the hypothesis that coping strategies and responses to intrusive memories that prevent emotional processing of the distressing event maintain PTSD. They also support Ehlers & Steil's (1995) hypotheses about the role of negative interpretations of post-traumatic intrusions in PTSD. A substantial subgroup of emergency service personnel may need support in processing distressing incidents at work and may benefit from information that normalizes post-traumatic symptoms such as intrusions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Ambulances
  • Behavioral Symptoms / epidemiology
  • Behavioral Symptoms / physiopathology
  • Behavioral Symptoms / psychology
  • Defense Mechanisms*
  • Emergency Medical Technicians / psychology*
  • England / epidemiology
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Memory / physiology
  • Prevalence
  • Regression Analysis
  • Rescue Work
  • Severity of Illness Index
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / physiopathology
  • Stress Disorders, Post-Traumatic / psychology*
  • Stress, Psychological / etiology
  • Stress, Psychological / physiopathology