Post-Traumatic Stress Symptoms and Dissociation in Emergency Medical Service Personnel

Background: Emergency medical service (EMS) personnel and volunteers are frequently exposed to traumatic events, placing them at elevated risk for psychological distress, including post-traumatic stress symptoms (PTSSs), depression, and dissociation. This study examined the relationships among PTSS, depression, and dissociation in Israeli EMS personnel, with a particular focus on whether dissociation mediates the association between depression and PTSS. Methods: A cross-sectional study was conducted with 60 EMS personnel in Israel, including 7 paid employees, 37 volunteers, and 16 participants who did not report their employment status. PTSSs were assessed using the Impact of Event Scale-Revised (IES-R), depressive symptoms were measured with the Depression, Anxiety, and Stress Scale (DASS-21), and dissociative experiences were evaluated using the Dissociative Experiences Scale-II (DES-II). Correlational analyses and mediation analyses were performed. Results: Significant positive correlations were found among PTSS, depression, and dissociation. However, mediation analysis indicated that dissociation did not significantly mediate the relationship between depression and PTSS. Conclusions: Although depression and dissociation were both strongly associated with PTSS, dissociation did not account for the association between depression and PTSS in this sample of EMS personnel. These findings suggest that other psychological mechanisms may underlie the relationship between depression and trauma-related symptoms in emergency responders. Further research is warranted to identify these mechanisms and to inform targeted interventions aimed at promoting the mental health and resilience of EMS personnel.