Avoidance coping, stressors and post-traumatic stress disorder symptoms in Croatian firefighters

BACKGROUND: Firefighting involves repeated exposure to traumatic and occupational stressors, increasing vulnerability to post-traumatic stress disorder (PTSD). Clarifying psychosocial factors underlying these outcomes is crucial for targeted prevention. AIMS: To examine associations between perceived stressors, social support, coping strategies, and PTSD symptoms among professional and volunteer firefighters in Croatia, within the Job Demands-Resources model. METHODS: A cross-sectional survey was conducted with 266 firefighters (44% professional). Participants completed measures of perceived occupational stressors, social support, coping, and PTSD symptoms. Non-parametric tests and regression models with robust (HC3) standard errors were applied. RESULTS: Greater perceived stressors were positively associated with PTSD, whereas social support showed a negative association. Avoidance coping was the strongest predictor (β = 0.56, 95% confidence interval [CI] [0.39, 0.74], P < 0.001; odds ratio [OR] = 6.75, 95% CI [2.79, 16.34]). Stressors were also significant (β = 0.30, 95% CI [0.19, 0.42], P < 0.001; OR = 4.64, 95% CI [1.95, 11.08]). Social support was protective (β = -0.11, 95% CI [-0.21, -0.01], P = 0.025; OR = 0.43, 95% CI [0.21, 0.87]). The stressors × support interaction was significant (β = -1.81, 95% CI [-3.55, -0.07], P = 0.042), indicating a buffering effect. Eleven percent met the clinical PTSD threshold. Perceived stressors, support, and coping jointly explained 50% of the variance (R² = 0.503). CONCLUSIONS: Avoidance coping, occupational stressors, and social support jointly account for substantial variance in PTSD symptoms among firefighters. Targeting maladaptive coping and strengthening social support may foster resilience across professional and volunteer units.