Posttraumatic stress and suicidality among firefighters: The moderating role of distress tolerance.

Firefighters report high rates of suicidality and posttraumatic stress disorder (PTSD). This investigation explored the moderating role of distress tolerance (DT) in the association between PTSD symptomatology and suicidality in firefighters. Covariates included trauma load, depressive symptom severity, gender, race, age, and education. The sample was comprised of 765 (94.0% male; M_age = 38.8, SD = 8.6) trauma-exposed firefighters who completed a questionnaire battery. Structural equation modeling was employed. PTSD symptom severity was significantly, positively associated with global suicide risk, suicidal ideation/attempt, frequency of suicidal ideation, lifetime threat of suicide, and perceived likelihood of future suicide attempts. Lower levels of DT were significantly associated with higher frequency of past-year suicidal ideation. Significant interactive effects were noted; firefighters with higher levels of PTSD symptom severity and low levels of DT had the highest levels of global suicide risk and perceived likelihood of future suicide attempt. Clinical and research implications are discussed.