Posttraumatic Stress Disorder Mediated by Exposure Level in French Civil Firefighters Following a Terrorist Attack: Some Hypotheses towards a Structural Model

To date, few studies have investigated the impact of organizational factors such as organizational status or the rank of firefighters on the development of posttraumatic stress disorder (PTSD) following a terrorist attack. To fill this gap in the scientific literature, this field study aimed to investigate the consequences of terrorist attacks on firefighters’ psychological health in terms of PTSD. Data were collected in France following two terrorist attacks. PTSD was assessed with the PCL-S (DSM-IV) 3 to 6 months after the events. Confirmatory factor analyses (CFAs) with existing PTSD models were inconclusive, leading us to find a two-factor model via an exploratory factor analysis (EFA). A cluster analysis showed different symptom profiles that were influenced by the exposure level. Elements for a structural model explaining PTSD symptoms are proposed and suggest a central role of the exposure level. Firefighters I/II represented an at-risk sub-population, suggesting that PTSD was mainly experienced among those who performed tasks not common to their occupation.