Abstract

Firefighters experience elevated suicide risk; however, factors influencing this risk remain understudied among this frontline population. Distress overtolerance (DO), or enduring high emotional distress, may represent a novel risk factor in the fire service, where occupational norms reinforce persistence under stress. The present study examined whether DO subfactors (Capacity for Harm [CH]: persisting through distress despite harm to one’s well-being; Fear of Negative Evaluation [FNE]: persisting through distress to avoid negative judgment) predicted variance in suicidal ideation and suicide risk. Firefighters (N = 79) were recruited from a U.S.-based national first responder service agency and completed self-report measures at baseline and follow-up as part of a larger study of mental health among first responders during the COVID-19 pandemic. Hierarchical regression models using baseline data indicated that CH accounted for significant variance in suicidal ideation (ΔR2 = 0.13) and suicide risk (ΔR2 = 0.16), while FNE accounted for variance only in suicide risk (ΔR2 = 0.07). Longitudinal models indicated that both CH and FNE were significantly and preliminarily associated with suicide risk, but only CH was significantly associated with suicidal ideation. Findings suggest that DO may represent a clinically meaningful suicide risk factor in firefighters, with implications for assessment and prevention efforts.

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