The Contribution of Socioeconomic Level and Personal Characteristic and Conditions Resources to Post-Traumatic Stress Disorder Symptoms Among Emergency Medical Personnel

Post-traumatic stress disorder (PTSD) is a mental health diagnosis that may appear following an event in which an individual experiences or witnesses an actual threat of death or serious injury to themselves or to others. The disorder includes various distress symptoms such as intrusive memories, avoidance, and hyperarousal. One population characterized by a relatively high prevalence of these symptoms is emergency medical personnel, due to their repeated exposure to the severe cases they treat. This population consists of men and women trained to provide urgent medical care in field conditions, who handle a wide range of medical incidents.

Research literature shows that despite exposure to traumatic events, most individuals do not develop PTSD symptoms. Conservation of Resources (COR) Theory explains that individuals who experience a traumatic event differ in their ability to cope with it depending on the resources available to them at the time of the event. The theory describes four categories of resources, including personal characteristics, demographic and economic factors. A review of the literature indicates that previous research has examined associations between personality traits, such as self-efficacy, and PTSD symptoms. However, the relationship between economic characteristics and PTSD symptoms has received only limited attention, and knowledge about this association is scarce.

Accordingly, the present study examined the relationship between different types of resources and post-traumatic symptoms among emergency medical personnel, with particular emphasis on economic characteristics. Independent variables were selected from the four resource categories defined by COR Theory: energy resources (income level and education level); object resources (home ownership); personal resources (self-efficacy and emotion regulation); and condition resources (peer support, alongside demographic variables). The study hypotheses were that lower levels of PTSD symptoms would be associated with higher self-efficacy, higher emotion regulation, and higher peer support among emergency medical personnel. In addition, the study examined whether socioeconomic characteristics are associated with PTSD symptoms among emergency medical personnel, and whether these characteristics moderate the relationships between other resource variables and PTSD symptoms.

This study employed a quantitative cross-sectional design. Participants were 207 emergency medical personnel from United Hatzalah, a leading emergency medical organization in Israel. During February-March 2024, participants completed online questionnaires distributed by the organization’s management. The questionnaires assessed associations between personal, social, and socioeconomic resources and PTSD symptoms.

The findings indicated significant negative associations between peer support, self-efficacy, and cognitive reappraisal (an emotion-regulation strategy) and PTSD symptoms. A significant positive association was found between expressive suppression (another emotion-regulation strategy) and PTSD symptoms. Significant differences in symptom levels were also found across geographic regions, with participants from the southern region reporting higher symptom levels than those from the northern region. Regarding economic characteristics, moderating effects were observed: home ownership and income level moderated the relationships between personal resources (self-efficacy) and social resources (peer support) and PTSD symptoms.

The present study reinforces the crucial importance of the resources available to an individual, and specifically to emergency medical personnel, when exposed to traumatic events. It demonstrates that adaptive emotion-regulation strategies and peer support can mitigate PTSD symptoms. Furthermore, addressing a gap in the research field, the study shows that examining the relationship between socioeconomic status and PTSD symptoms requires distinguishing between different economic characteristics. Its principal contribution lies in demonstrating that economic characteristics (home ownership and non-low income) serve as moderating factors in well-established relationships between other resources and PTSD symptoms. Moreover, we found that the relationship between personal resources (self-efficacy and emotion regulation) and PTSD symptoms is economically context dependent. Specifically, significant associations were found only among participants with low income and without home ownership. In this way, the study expands and deepens Conservation of Resources Theory, showing that resources do not operate independently but interact dynamically through moderation and compensation. The study therefore highlights the necessity of a holistic perspective when considering individuals exposed to trauma in general, and emergency medical personnel in particular, and underscores the critical role of socioeconomic characteristics in the development of PTSD symptoms.