(PS13-72) A Longitudinal Analysis of Peritraumatic Distress, Anger, and Emotion Dysregulation on PTSD Symptoms in 911 Telecommunicators

Introduction

Peritraumatic distress (PD) has been found to significantly increase risk for developing post-traumatic stress disorder (PTSD) across populations (Ozer et al., 2023), including 911 telecommunicators (Pierce & Lilly, 2012). Physical distance from, coupled with limited control over, the traumatic events may lead to differences in PD and subsequent outcomes among 911 telecommunicators. Indeed, compared to police officer and civilian samples, 911 telecommunicators reported higher levels of peritraumatic helplessness, sadness, anger, and guilt (Pierce & Lilly, 2012). Research suggests that peritraumatic anger can lead to poorer global functioning (Lancaster & Larsen, 2016), especially for individuals high in emotion dysregulation (EDR) immediately following traumatic experiences (Bardeen et al., 2013). However, much of the existing literature has been limited to cross-sectional data; thus, the current study aims to examine the impact of PD, anger, and EDR on PTSD symptoms longitudinally among 911 telecommunicators.   

Method

A sample of 204 911 telecommunicators across the United States completed the Posttraumatic Diagnostic Scale (PDS; Foa et al., 2013), and Peritraumatic Distress Inventory (PDI; Brunet et al., 2001) in response to their perceived worst duty-related call, as well as the State-Trait Anger Expression Inventory-2 (STAXI-2; Spielberger, 1999) and Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004). All measures were completed three times at six-month intervals over a one-year period via anonymous online surveys. Most of the sample identified as White (N = 186; 91.2%) and the majority was female (N = 149, 73%).

Results

A bootstrapped analysis (5,000 iterations) using PROCESS MACRO revealed a significant indirect effect of baseline PD on PTSD symptoms at one-year post-baseline through state anger at six months post-baseline, ab = .06, SE = .04 [95% CI: .01, .15]. A moderated mediation analysis was then conducted to examine the impact of emotion dysregulation, finding a significant moderated pathway between baseline PD and PTSD symptoms one-year post-baseline, b = .01, t(198) = 2.30, p = .02, such that individuals with medium, b = .43, p < .001, and high, b = .65, p < .001, levels of emotion dysregulation reported greater PTSD symptoms than individuals with low, b = .21, p = .13, levels of emotion dysregulation. A significant moderated pathway between baseline PD and six-month state anger was not found, b = .00, t(199) = -.39, p = .70.

Discussion

Higher PD at baseline predicted higher state anger six months post-baseline, and higher state anger predicted more severe PTSD symptoms one-year post-baseline. Due to the nature of their job and its limitations, 911 telecommunicators may experience cumulative peritraumatic distress, leading to continuous feelings of anger. Interestingly, EDR did not significantly influence the relationship between baseline PD and state anger six months post-baseline; however, individuals with greater EDR experienced more severe PTSD symptoms one year later. Future research should explore specific PD components (e.g., cognitive and physical reactions) that may implicate other processes that impact this relationship.