J Korean Neuropsychiatr Assoc.  2014 Mar;53(2):122-133.

The Psychological Characteristics and Functional Magnetic Resonance Imaging Findings in Firefighters with Partial Posttraumatic Stress Disorder and the Effect of Treatment by Using Eye Movement Desensitization and Reprocessing

• Chung Y
• Kim NH
• Kim D
• Bae JH
• Kwon JS
• Jang JH
• Jung WH
• Kim SH
• Kim JK
• Oh DH
• Shin DJ
• Cho KI

Abstract

OBJECTIVES
This study investigated the clinical characteristics and functional magnetic resonance imaging (fMRI) findings of firefighters suffering from partial posttraumatic stress disorder (partial PTSD). They were treated by eye movement desensitization and reprocessing (EMDR) and the treatment effect was evaluated.
METHODS
A total of 116 firefighters were screened and 15 of them were diagnosed as partial PTSD. 1) We compared sociodemographic and psychological characteristics between the firefighter partial PTSD group and the firefighter control group. 2) Subjects in the firefighter partial PTSD group (n=10), firefighter control group (n=8), and general control group (n=12) underwent fMRI with traumatic, negative, positive, and neutral picture stimuli. We compared clinical characteristics and fMRI findings among these three groups. 3) Seven firefighters in the partial PTSD group were treated by EMDR and the treatment effect was evaluated according to psychological scales.
RESULTS
In fMRI analysis, there was a left middle temporal/occipital activation in the order of the general control group, firefighter control group, than the firefighter partial PTSD group for the Traumatic-Baseline contrast. For the Negative-Baseline contrast, there was an increased left middle temporal/occipital activation in the general control group versus decreased activation in the firefighter control group and the firefighter partial PTSD group. All firefighters in the partial PTSD group treated by EMDR showed significant improvement of Clinician-Administered PTSD Scale scores.
CONCLUSION
These results show high incidence rate of partial PTSD in firefighters. In addition, partial PTSD firefighters exhibited distinct clinical characteristics and fMRI findings and showed significant improvement by EMDR treatment.

Keyword

Firefighters; Partial posttraumatic stress disorder; Functional magnetic resonance imaging; Occipital lobe; Temporal lobe; Eye movement desensitization and reprocessing

MeSH Terms

Eye Movement Desensitization Reprocessing
Eye Movements*
Firefighters*
Humans
Incidence
Magnetic Resonance Imaging*
Occipital Lobe
Stress Disorders, Post-Traumatic*
Temporal Lobe
Weights and Measures

Figure

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  Fig. 1 Flow chart of firefighter control group, partial PTSD group, and general control group. LEC : Life Events Checklist, IES-R : Impact of Event Scale-Revise, PTSD : Posttraumatic stress disorder, fMRI : Functional magnetic resonance imaging, CAPS : Clinician-Administered PTSD Scale.

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  Fig. 2 The visual stimulation paradigm.

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  Fig. 3 A : Left middle occipital/temporal activation in the order of general control group, firefighter control group, than firefighter partial PTSD group for the Traumatic-Baseline contrast. B : Left middle temporal/occipital activation in the order of general control group, firefighter control group, than firefighter partial PTSD group for the Negative-Baseline contrast. ANOVA test. Statistical threshold, p<0.005 uncorrected and voxel threshold was 20. PTSD : Posttraumatic stress disorder, ANOVA : Analysis of variance.

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  Fig. 4 A : Regions demonstrating significantly greater activity in general control group than firefighter control group and firefighter partial PTSD group for the Traumatic-Baseline contrast. B : Regions demonstrating significantly greater activity in general control group than firefighter control group and firefighter partial PTSD group for the Negative-Baseline contrast. Post-hoc t-test. PTSD : Posttraumatic stress disorder.

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