Predicting posttraumatic stress symptomology in emergency medical personnel : the role of perceived stress and rumination

Paramedics are frequently exposed to traumatic events on the job, and although they have higher levels of posttraumatic stress symptomology (PTSS) than the general population (Berger et al., 2012), not all paramedics experience high PTSS. Identifying factors that impact PTSS among individuals who are frequently exposed to traumatic stress is important for the development of evidence-based interventions. Using a longitudinal design, we examined relationships among rumination, perceived stress, and PTSS in 87 shift-working paramedics. Perceived stress and rumination were examined daily across a one-week period, while measurements of PTSS were assessed at baseline and at a two-year follow-up. Regression analyses indicated that perceived stress significantly predicted rumination. Rumination significantly predicted PTSS at the two-year follow-up, even after controlling for baseline PTSS, depression, and occupational stressors. Perceived stress did not directly predict PTSS at follow-up. Rather, rumination mediated the relationship between perceived stress and PTSS. Specifically, higher levels of perceived stress were associated with higher rumination, and higher rumination was associated with higher levels of PTSS at follow-up. These findings suggest the importance of targeting both perceived stress and rumination in clinical interventions for individuals who are frequently exposed to traumatic stressors.Arts, Faculty ofPsychology, Department ofGraduat