Latent profiles of psychological distress in emergency professionals: Associations with emotion regulation, posttraumatic stress, social support, and performance in a virtual reality task

Professionals in high-risk occupations, such as firefighters and emergency medical personnel, are repeatedly exposed to potentially traumatic events that may affect psychological functioning and decision-making under pressure. However, responses to occupational stress are heterogeneous, and their implications for performance remain insufficiently understood. The present study used a person-centred approach to identify latent profiles of psychopathological symptoms and examine their associations with emotional, social, and behavioural functioning during a virtual reality (VR) emergency simulation. A sample of 395 Portuguese firefighters completed the Brief Symptom Inventory (BSI), measures of emotion regulation difficulties, posttraumatic stress symptoms, and perceived social support, and a VR-based medical emergency task assessing decision-making accuracy under stress. Latent profile analysis identified four symptom profiles: Low Psychological Distress, Moderate Internalizing Distress, High Global Psychological Distress, and Mixed/Interpersonal Distress. The profiles differed significantly in emotion regulation difficulties, posttraumatic stress symptoms, perceived social support, and VR task performance. Participants in the Mixed/Interpersonal Distress profile, characterized by elevated interpersonal sensitivity, hostility, and paranoid ideation, made significantly more decision-making errors in the VR simulation than those in the Low Psychological Distress profile, although the effect was small. By contrast, high global psychological distress was not uniformly associated with poorer performance. These findings suggest that decision-making under stress in emergency contexts may be shaped less by generalized psychopathology than by specific interpersonal and affective symptom configurations. The study supports the value of person-centred approaches and immersive VR methods for identifying psychologically meaningful risk patterns, with implications for assessment, training, and targeted intervention in emergency service professions.