Evolution of Anxiety Disorder Prevalence and Associated Factors in First Responders in Both the Medium and Long Terms after the January 2015 Terrorist Attacks in France

Abstract

First responders intervening in crisis situations are likely to subsequently develop mental disorders. We aimed to identify factors associated with anxiety disorders after a terrorist attack in both the medium and long terms. We used data collected on 180 first responders (medical/psychological health professionals and emergency rescue teams) interviewed face to face at 6-10 months (medium term) and 18-22 months (long term) after the January 2015 terrorist attacks in France. Anxiety disorders were measured using the Mini-International Neuropsychiatric Interview V6 and several other variables including terror exposure (comprising perceived level of exposure and real exposure level), sociodemographic characteristics, social support, mental health history, and access to psychological support resources. We developed a structural equation model to examine the interactions between these different factors. Postattack anxiety disorder prevalence in the medium and long terms was 16% and 14%, respectively. The main associated factors in the medium term were barriers to social support, perceived level of exposure, and a lack of psychological support resources. In the long term, the presence of anxiety disorders in the medium term and barriers to social support were directly associated with having anxiety disorders, while reexposure was indirectly associated. Barriers to social support played a crucial role in the prevalence of anxiety disorders in first responders following this traumatic event, both in the medium and long terms. Promoting stronger social cohesion and providing more psychological support resources following a disaster could help prevent anxiety disorders in this population.