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Can Resilience be Measured and Used to Predict Mental Health Symptomology Among First Responders Exposed to Repeated Trauma?

Joyce, Sadhbh, MClinNeuroPsy; Tan, Leona, MOrgPsych; Shand, Fiona, MClinPsych, PhD; Bryant, Richard A., MClinPsych, PhD; Harvey, Samuel B., FRANZCP, PhD

Journal of Occupational and Environmental Medicine: April 2019 - Volume 61 - Issue 4 - p 285–292
doi: 10.1097/JOM.0000000000001526

Objectives: To examine whether baseline measures of resilience among active first responders predicts future mental health symptomology following trauma exposure.

Methods: Multivariate linear regression examined the associations between baseline resilience and future mental health symptomatology following repeated trauma exposure. Symptomatology at 6-month follow-up was the dependent variable.

Results: The associations between baseline resilience and future posttraumatic stress disorder (PTSD) (P = 0.02) and depression (P = 0.03) symptoms were statistically significant. Those reporting higher resilience levels had lower symptomology at 6-month follow-up. Eighty percent of first-responders who screened positive for low resilience went on to develop more PTSD symptoms.

Conclusions: Examining resilience may serve as a more effective means of screening, given resilience is a malleable construct which can be enhanced via targeted interventions. Higher levels of resilience may protect the long-term mental health of first-responders, particularly in regard to future PTSD.

School of Psychiatry, Faculty of Medicine (Ms Joyce, Dr Harvey); The Black Dog Institute (Ms Tan, Dr Shand, Dr Harvey); School of Psychology, Faculty of Science (Dr Bryant), University of New South Wales (UNSW), Australia.

Address correspondence to: Sadhbh Joyce, MClinNeuroPsy, Workplace Mental Health Research Team, School of Psychiatry, Faculty of Medicine, University of New South Wales (UNSW), Sydney, Australia (

Sources of Funding: This publication was made possible by an Australian Government Research Training Program (RTP) Scholarship and the University New South Wales Brain Sciences PhD Grant in aid awarded to S.J. for her doctoral studies and funding for S.B.H. from NSW Health (grant number: RM09708). Neither RTP nor NSW Health had a role in the study design, collection, analysis, or interpretation of the data; writing the manuscript; or the decision to submit the paper for publication.

Authors Contributions: S.J. and S.B.H. devised the study. S.J. developed the program, the internet-based format, and collected, scored, and entered the data. S.J., L.T., and S.B.H. analyzed and interpreted the data, and S.J. wrote the first draft of the manuscript. All authors read and contributed to subsequent versions and approved the final manuscript.

Clinical Significance: Our results provide preliminary support for examining resilience as a construct for possible screening amongst first responders. This form of screening may help identify those who may benefit from additional support and early intervention.

Conflicts of Interest: S.J. and S.B.H. are associated with a company that offers resilience training (RAW Mind Coach). S.B.H., L.T., and F.S. work for the Black Dog Institute, a not-for-profit organization that provides mental health and resilience training to various other organizations.

Joyce, Tan, Shand, Bryant, and Harvey have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2019 by the American College of Occupational and Environmental Medicine