Reduced cortisol response to traumatic images, self-esteem and stress levels in Emergency Medical Technicians from the Red Cross

Abstract Emergency Medical Technicians are health professionals commonly exposed to dangerous traumatic scenarios which can lead to an altered hypothalamus-pituitary-adrenal (HPA) axis and stress related symptoms; however, the stress intensity may be mediated by personality traits such as self-esteem. We tested, in a population of 96 EMTs from the National Red Cross, the hypothesis of reduced cortisol secretion after the exposition to traumatic content images that could represent a stressor in non-paramedic healthy volunteers (59 non-EMTs). We took three saliva samples to measure cortisol (basal, 15 and 30 min after the images) and quantified the levels of self-esteem, perceived and physiological stress. Results showed a peak of cortisol 15 min after the images in the non-EMTs population, whereas a decreased cortisol profile was observed in EMTs, suggesting a higher sensitivity for a negative feedback regulation of cortisol. EMTs had lower levels of perceived stress but higher physiological stress symptoms than non-EMTs. The most important predictors of cortisol levels in EMTs were the number of working days per week and self-esteem which also had a negative correlation with perceived and physiological stress. We suggested that, in general, this paramedic population is habituated and predisposed to accidental scenarios.