Medicine & Health

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  • (2023) Tan, Leona
    First responders report elevated rates of posttraumatic stress disorder (PTSD) compared to the general community. Workplace preventative strategies are urgently needed to reduce this burden. Research on the prevention of PTSD remains limited, and few studies have been conducted within this high-risk population. Interventions that target modifiable risk factors for PTSD may be promising and evidence is emerging for yoga – a type of mind-body exercise (MBE) intervention – for treatment of PTSD. However, it remains unclear if this type of training may be effective in preventing the development of PTSD in first responders. This thesis aimed to address these gaps by determining (a) what modifiable cognitive-emotional risk factors are associated with PTSD in trauma-exposed first responders and (b) the effectiveness of a workplace MBE intervention in preventing the development of PTSD in active-duty first responders. These aims are met through four studies. Paper 1 detailed a cross-sectional study investigating modifiable cognitive-emotional strategies associated with PTSD in first responders. Paper 2 involved a systematic review and meta-analysis of controlled studies evaluating the effectiveness of MBE interventions in preventing the development of PTSD in trauma-exposed populations. Paper 3 evaluated the effectiveness of a workplace MBE intervention through a randomised controlled trial on active-duty first responders. Finally, Paper 4 examined the feasibility, acceptability, and usability of a web-based MBE intervention for first responders. The thesis results show the importance of a maladaptive cognitive-emotional strategies on probable PTSD amongst first responders. MBE interventions showed potential in preventing the development of PTSD in trauma-exposed populations. Further, a workplace MBE intervention was effective in reducing PTSD symptoms in active-duty first responders in the short-term as well in improving modifiable risk factors associated with PTSD. Feasibility, acceptability, and usability were demonstrated for the web-based version of the training. Overall, the results suggest that MBE is a promising intervention to prevent the development of PTSD amongst active-duty first responders. Given the current burden of mental health problems and gap in evidence-based preventative strategies, these findings provide preliminary evidence for MBE as a viable workplace preventative strategy for first responders.