Christopher K. Haddock

Firefighters experience frequent traumatic events and occupational stressors, increasing risk for posttraumatic stress disorder (PTSD), insomnia, and nightmares, which are frequently comorbid and interrelated. However, firefighter schedules and mental health stigma limit engagement in weekly therapy. The present study was a randomized pilot feasibility trial of an integrated, accelerated, culturally adapted treatment for firefighters with clinically significant PTSD, insomnia, and nightmare symptoms. Participants (N = 49) were randomized to immediate or delayed treatment. Treatment integrated written exposure therapy for PTSD and cognitive behavioral therapies for insomnia and nightmares and was delivered in a 4-day group therapy "workshop" with one individual session before and after the workshop. Participants completed diagnostic interviews at baseline and 1-month posttreatment and self-report surveys through 3-month posttreatment. Most indices of program feasibility were positive despite logistical challenges impacting enrollment and treatment uptake. In addition, there were large group by time interaction effects for reductions in symptoms of PTSD (g = 1.70) and insomnia (g = 1.47) and a medium effect for nightmares (g = 0.72). Improvements in symptoms of all three targeted disorders and depressive symptoms were maintained through 3-month posttreatment. This study supports the efficacy of accelerated, integrated PTSD and sleep disorder treatment. To our knowledge, this is the first controlled study of a culturally adapted mental health intervention for firefighters. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Firefighters are vulnerable to opioid misuse given the adverse effects their occupation has on mental and physical health. Yet there are limited data on opioid misuse within this population. This study examined the prevalence of illicit prescription opioid use among a nationally representative sample of U.S. firefighters and factors related to opioid misuse. Data were collected through reliable questionnaires from 617 firefighters prior to participating in an intervention designed to mitigate the negative impacts of trauma. The lifetime prevalence of illicit prescription opioid use was 14% compared to 13% in the general U.S. population. The most commonly misused opioids were hydrocodones with trade names Vicodin, Lortab, and Lorcet (72% of those illicitly using opioids). Illicit prescriptions opioid use was not significantly correlated with any demographics examined. However, firefighters who engaged in illicit opioid use exhibited poorer mental health, more alcohol-related problems, and an increased likelihood of misusing other prescription medications. In a regression analysis, alcohol consumption issues, Post-Traumatic Stress Disorder (PTSD), and the illicit use of sedatives and tranquilizers emerged as significant predictors of illicit prescription opioid use. Illicit prescription opioid use by firefighters is a potential problem especially when considered along with other factors such as mental health. Longitudinal studies are needed to further deepen our knowledge about this issue.

The Army Combat Fitness Test (ACFT) is a multi-event assessment battery designed to determine the combat readiness of U.S. Army personnel. However, for Reserve Officers’ Training Corps (ROTC) programs the logistical demands of collegiate life make repeated administration of the ACFT challenging. The present study sought to design and evaluate a single, multimodal exercise tolerance test (METT) capable of serving as a time-efficient proxy measure of combat readiness. Methods: Using a formal instrument design process, we constructed the METT to mimic the demands of the ACFT and assessed its reliability, validity, and responsiveness. Results: The METT demonstrates minimal measurement error (i.e., a 2% coefficient of variation), concurrent validity with the ACFT (R² = 0.327, F = 10.67, p < 0.001), the ability to classify cadets who may be at-risk for failing the ACFT (X² = 8.16, p = 0.017, sensitivity = 0.878, specificity = 0.667), and appropriate change following a training intervention (5.69 ± 8.9%). Conclusions: The METT has the potential to provide a means to monitor progress, identify areas for improvement, and guide informed decision-making regarding individualization of cadet combat training plans.

[Correction Notice: An Erratum for this article was reported online in Psychological Trauma: Theory, Research, Practice, and Policy on Mar 14 2022 (see record 2022-44650-001). In the original article, "for the STRONG STAR Consortium" was missing from the end of the author line. In addition, the numbering and text of the affiliations for Edward C. Wright, Brittany N. Hall-Clark, Brooke A. Fina, Brett T. Litz, Jim Mintz, Stacey Young-McCaughan, and Alan L. Peterson were incorrect because of duplicated affiliation details and associated typographical errors. Finally, in the References, "for the STRONG STAR Consortium" and "on behalf of the STRONG STAR Consortium" were missing from the ends of the author lists for Foa et al. (2018) and Resick et al. (2015), respectively. The online version of this article has been corrected.] Objective: Web-based treatments address many of the logistical and stigma-related barriers to in-person behavioral health care. Prior studies of web-based treatments for posttraumatic stress disorder (PTSD) did not employ gold-standard treatments and have not compared to in-person therapy. We compared a web version of Prolonged Exposure Therapy, "Web-PE," to in-person Present-Centered Therapy (PCT) in a randomized controlled trial (RCT) with 40 military personnel with PTSD seeking treatment at Fort Hood, Texas. Due to recruitment challenges, we terminated the RCT and subsequently examined the effects of Web-PE in an uncontrolled open trial with 34 service members and veterans recruited nationwide. Both studies assessed PTSD, depressive symptoms, and health functioning at baseline and 1 and 3 months posttreatment; the RCT also included a 6-month assessment. Results of the RCT showed no differential impact for Web-PE and PCT, although more PCT participants achieved clinically significant change at one of the follow-up assessments. Both treatment conditions significantly reduced self-reported and blind independent interviewer-assessed symptoms of PTSD. Results of the open trial showed that Web-PE was associated with significant reductions in self-reported PTSD symptoms, with a much larger effect size than in the RCT. Web-PE significantly reduced PTSD symptoms in both studies, although the reductions in PTSD symptoms were greater among open trial participants, who were specifically seeking a web-based treatment. Future research should evaluate Web-PE relative to another web-based treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: The Ugandan military medical services work together with the civilian public health system to deliver quality healthcare. This Partnership is the mainstay of health service delivery in Uganda. The burden of needle stick injuries (NSIs) is increasing in Uganda’s larger health industry; however, data on needle stick injury in military and public health facilities is lacking. No published data exist on comparative studies for a mix of facilities both military and civilian health settings. This study represents the first time this issue has been studied in a military or public health hospital in Uganda.Methods: A hospital-based, cross-sectional study was conducted in July 2018 to September 2019 in Kakiri Military and SOS Hospitals in Uganda using a structured questionnaire. Respondents were purposively selected based on the objectives of study, occupation status and department (N = 310). Results: The overall prevalence of NSIs among respondents was 27.2% and prevalence rates for the two facilities was nearly identical. The largest percentage of NSIs occurred during drawing venous blood samples (49.4%). Significant predictors of NSI were gender, occupational status, age, poor knowledge on prevention and post exposure of NSI, and less professional experience. Infection control practices were lacking in both selected health facilities. Conclusion: Over a quarter of HCWs in Uganda reported NSIs, which places them at significant health risk. Fostering the practice of universal precautions, best infection control practices and training of healthcare workers on bio-safety measures can reduce the prevalence of NSIs.Trial Registration: Not Applicable