Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Clinical Psychology (PhD)

Department

Clinical Psychology

First Advisor/Committee Member

Keyne C. Law, Ph.D

Second Advisor/Committee Member

Thane Erickson, Ph.D., ABPP

Third Advisor/Committee Member

Michael Dolezal, Ph.D.

Abstract

First responders in the fire service and emergency medical services (EMS) are the subject of research focused on career suicide risk, occupational hazards, and psychological resilience; however, the nature of the relationships between these three variables is not well understood. This study employed a mixed methods design to test the moderating role of resilience in the relationship between the severity of critical incident exposure and two distinct processes involved in suicidality: suicidogenic cognitions and the acquired capability for suicide. A total of 248 eligible participants with experience in firefighting and/or EMS responded to an online survey. Psychological resilience was negatively associated with the severity of suicidogenic cognitions, independent of the perceived impact of critical incidents. There was a significant and conditional relationship between the perceived impact of critical incidents and the acquired capability for suicide, such that firefighters/EMS who considered themselves to be more resilient reported lower acquired capability than those with mean or lower resilience scores. Thematic analysis of 260 free-text responses identified five definitions of resilience within the firefighter/EMS population and a variety of factors involved in the resilience processes they rely upon to function in the job. These findings underscore the relevance of psychological resilience to the work and the lives of firefighters/EMS and suggest promoting resilience in this population may serve in part to decrease one’s risk for suicide. These results can supplement and inform the work of behavioral health coordinators, peer support leaders, department leadership, and other stakeholders in the health and resilience of the first responder community.

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