Emerg Med J doi:10.1136/emermed-2011-200511
  • Original article

Cognitive appraisals, objectivity and coping in ambulance workers: a pilot study

Open Access
  1. Jennifer Wild2,3
  1. 1Clinical Psychology and Neuropsychology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Department of Experimental Psychology, University of Oxford, Oxford, UK
  3. 3Department of Psychology, Institute of Psychiarty, King's College London, London, UK
  1. Correspondence to Dr Jennifer Wild, Department of Experimental Psychology, University of Oxford, South Parks Road, Oxford OX1 3UD; jennifer.wild{at}
  • Received 15 July 2011
  • Revised 15 July 2011
  • Accepted 23 November 2012
  • Published Online First 10 January 2013


Objectives Ambulance workers are regularly exposed to call-outs, which are potentially psychologically traumatic. The ability to remain objective and make adaptive appraisals during call-outs may be beneficial to this at-risk population. This pilot study investigated the links between cognitive appraisals, objectivity and coping in ambulance workers.

Methods Forty-five ambulance workers from the London Ambulance Service, UK, were studied. Trauma exposure, post-traumatic stress disorder and depression symptoms were assessed using self-report measures. Positive and negative appraisals were measured in relation to two previous call-outs: one during which they coped well and one during which they did not.

Results Enhanced coping was associated with making more positive appraisals during the call-out. Better coping was also related to greater levels of objectivity during these call-outs. Coping less well was associated with the use of more negative appraisals during the call-out.

Conclusions Ambulance workers may benefit from psychological interventions, which focus on cognitive reappraisal and enhancing objectivity to improve coping and resilience.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

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