DOI: 10.31038/PSYJ.2025773

Abstract

Trade wars, though driven by economic objectives, had repercussions extending beyond the economy into social and political spheres. Using a qualitative research design, this study examines the connection between the 2025 trade war and the potential rise of violent extremism by interviewing two key groups: former terrorist offenders, who provide insider perspectives, and terrorism analysts, who offer outsider viewpoints on extremist groups. The findings reveal that contemporary extremists can be categorized by ideology, scope, generational cohort, and behavioral patterns. The study further highlights how global economic instability, which leads to local crises, can exacerbate extremism and criminal behavior, particularly within vulnerable communities. This study identifies three classifications of extremists based on their responses to economic crises: “deradicalized”, “exploiters”, and “vulnerable”.

Keywords

2025 Trade war, Economic crises, Extremism, Radicalism, Terrorism

Introduction

In 2025, the United States, under Donald Trump’s presidency, escalated trade tensions by imposing high tariffs on goods imported from major economies such as the European Union (EU), China, and several ASEAN countries [1]. While these protectionist policies aimed to bolster domestic industries, they inadvertently disrupted the global economy. Simultaneously, a surge in extremist activities worldwide sparked concerns that such economic measures might be fueling the spread of radical ideologies. The Trump administration adopted an aggressive trade policy approach in 2025, implementing tariffs as high as 50% on European products while significantly increasing import taxes on goods from China and ASEAN countries. These measures were originally aimed to address trade imbalances and protect domestic industries. However, the abrupt policy shifts created substantial market instability, strained international relations, and triggered retaliatory measures from affected nations. For instance, the EU considered imposing counter-tariffs targeting U.S. technology firms, while ASEAN nations sought to mitigate the economic impact by strengthening trade partnerships with China and members of the Gulf Cooperation Council [2]. The imposition of tariffs significantly disrupted global supply chains, leading to higher production costs and subsequent price increases for consumers. While U.S. consumer confidence showed modest improvement following the trade truce with China, broader economic uncertainty persisted. Internationally, economies such as Germany faced potential GDP contractions, while several African nations revised their growth forecasts downward due to tariff-related instability. These economic pressures exacerbated social tensions, creating conditions that extremist groups exploited to capitalize on public discontent [3,4].

Historical precedents demonstrate that economic hardships can fuel extremist ideologies. The economic fallout from the 2025 trade war appears to be replicating this pattern. In the United States, the Department of Homeland Security’s Homeland Threat Assessment 2025 emphasized the ongoing threat posed by domestic violent extremists, many of whom were motivated by anti-government sentiment and conspiracy theories [5]. Globally, regions experiencing economic downturns saw a resurgence of radical groups capitalizing on widespread public discontent, a pattern that, while complex, is supported by various studies. This is evident in the rise of Pentecostal affiliation and political representation in Brazil [6], the growth of radical nationalism in Finland amid economic uncertainty [7], and the “Age of Discontent” framework, which argues that economic crises trigger cultural discontent and fuel the rise of populism and the radical right across several countries [8]. The trade war’s transnational impacts have been particularly evident. In Southeast Asia, ASEAN nations grappling with economic challenges stemming from U.S. tariffs have pursued alternative alliances and trade agreements. These geopolitical realignments not only altered regional power dynamics but also created opportunities for extremist groups to exploit perceptions of Western economic aggression. Similarly, in the Middle East, economic destabilization caused by U.S. tariffs and declining foreign investment contributed to the revival of groups like the Islamic State, which strategically leveraged the resulting chaos to recruit members and expand their influence [9].

While empirical evidence on the direct impact of trade wars on extremism remains limited, economic crises are known to significantly influence political extremism and terrorism. Historical patterns demonstrate that economic downturns frequently correlate with increased support for far-right and anti-establishment movements. This phenomenon was evident in Europe during both the 1930s Great Depression and the recent global financial crisis. Supporting this observation, a longitudinal study across 23 EU countries (1995-2012) revealed that declining GDP and rising unemployment rates consistently corresponded with growing electoral support for extremist parties, particularly far-left groups [10]. However, the relationship between economic hardship and extremism demonstrates significant complexity. In the U.S. context, Republican donors residing in foreclosure-affected areas showed reduced support for Tea Party candidates during the housing crisis [11]. On the other hand, research on Russian terrorism reveals that economic crises may produce contradictory effects on extremist activities: while economic distress can fuel public anger and potentially increase terrorist motivations, it may simultaneously constrain operational capabilities by limiting available resources [12]. These findings collectively suggest that the nexus between economic crises and political extremism is context-dependent, with outcomes varying according to specific circumstances. This study seeks to examine the intricate relationship between the 2025 trade war and the potential resurgence of violent extremism, as there is currently no research on this connection, incorporating viewpoints from both extremist networks and external sources. This will constitute the novelty of this study. Through in-depth interviews with two key stakeholder groups—former terrorist offenders (providing insider perspectives) and counterterrorism experts (offering external analyses), this study examines whether the 2025 US trade war’s economic disruptions may catalyze extremist violence. By elucidating the potential correlation between trade-induced economic shocks and extremist escalation, this study hopes to contribute in the development of mitigation strategies during periods of global economic and geopolitical instability.

Trade Wars

Definition of a Trade War

Trade wars are economic conflicts where countries impose retaliatory tariffs or trade restrictions to protect domestic industries or address trade imbalances [13,14]. These conflicts can arise from various factors, including uneven trade benefits, technological rivalries, and protectionist policies. The US-China trade war demonstrates such conflicts, with the US seeing China’s growth as a threat to its trade supremacy [15]. Trade wars can significantly impact global trade, economic growth, and international relations. The dynamic process of trade wars involves gradual tariff rises by one country, eventually prompting retaliation from the affected nations [16]. Depending on market characteristics, retaliation may lead to liberalisation or escalate into a full-scale trade war. Economist Douglas A. Irwin’s definition of trade war is a situation in which countries attempt to damage each other’s economy, usually through the tariff’s imposition or quota restrictions. It often lead to economic inefficiencies and increased tensions between nations [17]. Trade wars emerge as a direct consequence of protectionist economic policies designed to shield domestic industries through import restrictions. These measures, which include tariffs, import quotas, and regulatory barriers, fundamentally alter global economic dynamics by creating uncertainty that affects business investment patterns, disrupts global value chains, and distorts market expectations.

According to Xu (2024), protectionist interventions not only impede international trade flows but also elevate production costs and generate inflationary pressures across economies. The Sino US trade war, initiated amid economic tensions and mutual allegations of unfair trade practices, has significantly impacted strategic industries and constrained international investment flows [18]. The resulting global economic uncertainty has transmitted through financial markets, affecting both advanced and emerging economies [19]. Although current protectionist measures have demonstrated limited economic disruption to date, potential escalation poses substantial risks to global growth prospects and the Euro area [20]. This protectionism induced uncertainty adversely affects economic sentiment and potentially undermines long term market confidence. Empirical evidence from microeconomic firm data and macroeconomic analyses confirms that heightened trade policy uncertainty consistently suppresses corporate investment activity [21].

Historical Overview of Trade Wars

1. The Anglo-Dutch Trade Wars (17th Century). One of the earliest examples of a trade war occurred between England and the Dutch Republic in the 17th century. These conflicts involved both military and economic rivalry, including naval battles and commercial competition. In 1651, England passed the Navigation Acts, which restricted the use of foreign ships for trade between England and its colonies. This legislation aimed to weaken Dutch maritime dominance and ultimately led to a series of naval conflicts known as the Anglo-Dutch Wars. The outcome of these trade wars helped England establish itself as a dominant maritime and commercial power for centuries to come [22].

2. The Smoot-Hawley Tariff Act (1930). One of the most infamous trade wars in modern history was triggered by the Smoot-Hawley Tariff Act during the Great Depression. Passed by the U.S. Congress in 1930, the act imposed steep tariffs on over 20,000 imported goods. In retaliation, many countries raised their own tariffs, leading to a sharp decline in global trade. As a result, world trade plummeted by an estimated 65% between 1929 and 1934, exacerbating the global economic downturn [23].

3. The Chicken War (1960s). In the early 1960s, a trade dispute known as the “Chicken War” erupted between the U.S. and the European Economic Community (EEC) over tariffs on American poultry exports. After the EEC imposed protective tariffs, the U.S. retaliated by levying duties on European imports, most notably a 25% tariff on light trucks, including the popular Volkswagen Type 2 van. This measure had lasting consequences, in which the light truck tariff, which remains in effect as of the 2020s, has profoundly influenced the structure of the U.S. automobile industry for decades [24].

4. U.S.-China Trade War (2018–2020). The most prominent and widely documented trade war in recent history began in 2018 under the Trump administration, as tensions escalated between the United States and China. The U.S. accused China of engaging in unfair trade practices, including intellectual property theft and forcing technology transfers from foreign firms. In retaliation, the U.S. imposed tariffs on hundreds of billions of dollars’ worth of Chinese imports, prompting China to respond with counter-tariffs on American goods. This trade conflict had far-reaching consequences: it disrupted global supply chains, increased costs for manufacturers and consumers, and amplified economic uncertainty worldwide [25]. Additionally, it sparked a reassessment of global trade dependencies and contributed to a resurgence of economic nationalism across multiple countries.

Consequences of Trade Wars

Trade wars typically result in several key consequences: 1) higher consumer prices due to increased costs of imported goods, 2) supply chain disruptions, reducing efficiency and eroding competitiveness, 3) retaliatory measures from trading partners, escalating international tensions, and 4) adverse effects on global economic growth, particularly in interconnected sectors such as technology, agriculture, and automotive industries. According to the International Monetary Fund [26], the trade tensions and tariffs imposed between 2018 and 2019 slowed global economic growth, ultimately reducing world GDP by approximately 0.8% by 2020.

1. Disruption of Global Supply Chains. One of the primary mechanisms through which trade wars trigger economic crises is by disrupting global supply chains. In today’s interconnected economy, production processes often span multiple countries before final assembly. Tariffs raise the cost of intermediate goods, increasing production costs and reducing operational efficiency. During the U.S.-China trade war (2018–2020), for instance, U.S. manufacturers faced higher input costs due to tariffs on Chinese components, while Chinese exporters experienced reduced demand for their goods. Sectors with complex supply chains, such as automotive and electronics, were particularly vulnerable. A Federal Reserve study found that U.S. tariffs led to significant cost increases for domestic manufacturers and a measurable decline in industrial output [27]. Long-term consequences included widespread corporate uncertainty. Many firms delayed investments, restructured operations, or relocated production, often at substantial expense, to mitigate political and trade risks. This reconfiguration of supply chains further strained global economic stability.

2. Consumer Price Inflation and Reduced Purchasing Power. Tariffs function as a tax on imported goods, typically leading to higher consumer prices. Research by Amiti et al. [28] revealed that during the 2018-2019 U.S.-China trade conflict, American consumers and firms absorbed most of the additional costs from tariffs. These price increases reduced household purchasing power, which is crucial for maintaining GDP growth. When consumers have less to spend, overall economic demand weakens, business revenues decline, layoffs often follow, and economic growth slows. Prolonged trade conflicts may even trigger stagflation, which is a dangerous combination of rising prices and economic stagnation that, while rare, can cause severe damage. Multiple studies have examined the economic consequences of the U.S.-China trade war and potential broader global trade conflicts. Simulation results indicate that in a scenario of widespread global trade tensions, world GDP could decline by up to 1.96% with global trade volumes falling by 17% over the medium term [29]. The immediate impact of the U.S.-China dispute alone reduced GDP by 0.1% in the United States and 0.2% in China. The long-term effects appear more substantial, with potential losses reaching 1.6% for the U.S. and 2.5% for China, primarily due to reduced capital investment and diminished technological collaboration between the two nations [30]. Both countries experienced decreased energy demand and slower economic growth, which could further disrupt global energy markets [31]. While some nations may benefit from trade diversion effects, the overall impact on the global economy tends to be negative [32]. The conflict altered relative prices, disrupting established production networks and shifting comparative advantages in key sectors including transportation, electronics, and machinery.

3. Investor Uncertainty and Capital Flight. Trade wars generate significant policy uncertainty that undermines investor confidence. When trade policies become unpredictable, businesses typically delay decisions regarding expansion, innovation, and workforce growth. This cautious “wait-and-see” approach reduces aggregate investment and slows productivity growth [33]. The financial repercussions extend further as international investors may divest from nations engaged in trade conflicts, particularly those exhibiting economic vulnerability or political instability. Such capital outflows can trigger currency depreciation, increase borrowing costs, and potentially spark financial crises—especially in developing economies dependent on foreign investment.

4. Vulnerability of Emerging Markets. Emerging markets face heightened vulnerability during trade wars. These economies typically depend on exports for growth and require imports for critical industrial inputs. When major economic powers like the U.S. and China engage in trade conflicts, the ripple effects are global. Nations across Africa, Southeast Asia, and Latin America frequently experience reduced demand for their exports, volatile capital flows, and currency depreciation. These combined factors significantly elevate the risk of economic crises [34].

5. Poverty. Trade wars may impact poverty levels in developing countries through complex and indirect mechanisms. While trade expansion generally promotes economic growth, its benefits are often unevenly distributed across societal groups [35]. Trade conflicts influence poverty through multiple channels: (1) price volatility for essential goods, (2) labor market disruptions, (3) reduced government fiscal capacity, (4) heightened economic uncertainty, and (5) constrained GDP growth [36]. The ultimate poverty effects depend on three key factors: the severity of market disruptions, institutional capacity for risk mitigation, and labor demand elasticity. Particular attention must be paid to vulnerable populations, including women, rural communities, informal sector workers, and other marginalized groups [37].

Extremism

Extremism represents a multifaceted threat to both societal cohesion and fundamental rights [38]. Defined by the use of coercive violence to impose ideological or belief systems [39], its manifestations challenge common assumptions—particularly regarding religious extremism’s prevalence, which stems from complex interplays between individual psychology and communal dynamics [40]. From a psychological perspective, extremism is viewed as a form of deviant behavior that arises when there is an imbalance in motivation, where one need becomes so dominant that it overrides other needs and behavioral norms [41]. To address violent extremism requires identifying the specific needs or motivations that contribute to it and recognizing the role of external agents influencing or managing the difficulty level in carrying out extremist activities [42].

Research suggests that extremism is motivated by several psychological factors. According to significance quest theory, there are three main causes: a strong need to feel important or meaningful, a belief system that justifies the use of violence, and support from others with the same views [43]. Relative deprivation – the feeling of being treated unfairly or having less than others – is identified as an important factor that helps to explain various forms of violent extremism. This includes actions to change or protect existing social or political systems [44]. Extremism can manifest in both destructive forms (such as terrorism) and constructive forms (such as scientific breakthroughs). It can influence different parts of culture as well as individual decision-making. Understanding the psychological factors that lead to extremism is important to develop effective interventions to reduce dangerous extremist behaviors and redirect them to more constructive directions. These psychological insights offer a clear framework for studying and responding to different forms of extremism in different cultural and social settings.

Methods

Design

This study employed a qualitative research design to examine the relationship between the 2025 trade war and violent extremism. The qualitative technique was employed to gather extensive information regarding the relationship between factors. Due to various challenges in terrorism research, including confidentiality concerns and skepticism from both authorities and terrorist perpetrator [45,46], a qualitative methodology is more suitable for investigating the connection between the 2025 trade war and violent extremism.

Participants

This study involved ten deradicalized Indonesian terrorist offenders, a foreign (American) terrorist suspect, and eleven analysts/experts on terrorism (Table 1). Their ages ranged from 30 to 75 years. The terrorist offenders faced charges that included the Bali bombing, robbery, obstruction of justice, financing terrorism, involvement in worldwide terrorist networks, espionage, recruitment, and military training for terrorism. They were affiliated with militant organizations such as Jamaah Islamiyah/JI/Al Qaeda, ISIS, and Hezbollah. The eleven experts comprised forensic psychologists/terrorist profilers, senior officers from the Special Task Force Anti-Terrorism/Detachment 88 of the National Police (Densus 88), and several American, Indonesian, Malaysian, and Singaporean government think tanks (security consultants and advisors working for anti-terrorism agencies and various ministries), all of whom possess esteemed credentials.

Table 1: Participants of this study.

The study participants were selected through purposive sampling. To mitigate bias in purposive sampling, we initially defined the experts in this study as those possessing over ten years of experience in economics, social sciences, and/or counterterrorism; whereas the former offenders/suspects as those who were already deradicalized and whose names were recommended/referenced by counter-terrorism agencies/organizations (e.g., BNPT, Densus 88, the Ministry of Religious Affairs, and others). Secondly, we utilized inter-rater assessment in coding, categorizing, and interpreting the data acquired from participant interviews.

Procedure and Materials

A review of participant names, initial outreach, and communication with potential participants was conducted, followed by organized interviews with individuals who consented to participate in this study. Before the interviews, participants who agreed to take part in the study provided verbal consent to be involved. Interviews were conducted in May and June 2025 by the principal researcher of this study in Indonesia and the United States. Each participant engaged in a single interview session lasting approximately 30 to 40 minutes. Interviews were conducted in Bahasa Indonesia or English, with the researcher recording responses manually as participants opted against digital recording. Prior to concluding each interview, the researcher verified the written notes with the participant for accuracy to prevent misunderstanding and bias.

Analysis

The participants’ answers were compiled in a table for qualitative analysis. This enabled researchers to identify key similar concepts. The researchers subsequently deliberated on the participants’ replies and coding to ensure inter-rater agreement. They subsequently analysed the data using an inductive approach to identify a general pattern.

Results and Discussion

Extremists’ Perspectives on the 2025 Trade War

The findings of this study suggest that up-to-date extremists can be classified based on their scope, gender, ideology, hierarchical position within terrorist organisations, role, occupation, motivations for joining terrorist groups, generational cohort, and behavioural changes (Table 2). Extremists can be categorised as female or male, leaders or non-leaders, entrepreneurs or labourers, economically or non-economically oriented, religion- or non-religion-based, non-deradicalized or deradicalized, and active or passive. Regarding scope, there exist both local/home-grown and global extremists. Generational classifications include non-Gen Z individuals, specifically Baby Boomers (born 1946–1964), Generation X (born 1965–1980), and Millennials (born 1981–1996), as well as Gen Z or younger (born 1997 or later). The participants emphasise the Gen Z and younger cohort to anticipate the post-Artificial Intelligence (AI) age, as Gen Z is seen as a ‘cyber/digital generation’, fundamentally differing from preceding generations in many aspects of life. Although previous studies have recommended many classifications of terrorists or extremists, the participants of this study advocate for more simplified categories for pragmatic investigative objectives following the disbandment of Jamaah Islamiyah (JI) and the ‘zero-attack’ phenomenon.

Table 2: Classifications of contemporary extremists.

The findings demonstrate that local extremist networks possess a limited understanding of the 2025 trade war in comparison to their global counterparts. Furthermore, extremist leaders and businessmen possess a greater understanding of the 2025 trade war and its ramifications on the daily lives of individuals, in contrast to non-leaders and labourers. Interestingly, participants of this study explain that female extremists (umahat) lack comprehension of global trends and the conflict between nations (USA/allies and China/allies), in contrast to their male kins (husband, father, son). Moreover, Gen Z extremists comprehend global news, including the 2025 trade war and its ramifications, as they consistently engage with news and podcasts on various online.

“Terrorists might be either homegrown or global. The global ones know that big countries might use them as proxies, so they might know about trade conflicts and other global problems. They are well-informed and watch the news because they will utilize any chance they have to propagate their narratives. But the ones who are homegrown don’t know anything about trade wars or geopolitics.” (A political analyst and advisor).

“We, Gen Z, watch news and listen to podcasts on YouTube, Twitter, and other sites. We know what’s going on in the world, including the 2025 Trade War and how it will affect our economy. We even keep up with many trends and know that there are numerous layoffs and campus dropouts in Indonesia because of the economic crisis.” (A former suspect/extremist).

“Our forensic clinical examination shows that these extremists and terrorists have serious problems in two parts of their brains: the ventromedial prefrontal cortex (vmPFC) and the dorsolateral prefrontal cortex (DLPFC). This means they don’t understand global issues like the 2025 trade war between the US and China. The DLPFC is a very important part of the brain that helps with memory, decision-making, emotion management, executive functioning, and behavior that is focused on goals. The DLPFC has something to do with violent behavior and terrorism. The vmPFC is a critically important part of the brain for social and emotional functioning, like empathy, controlling emotions, and moral competence. It regulates anxiety and fear. The vmPFC mixes cognitive and affective information, which includes human values.” (A forensic clinical psychologist)

“Don’t underestimate us, we follow the news. We know what’s going on in the world. We know about the trade war and other conflicts between the US and China, which affect Indonesia’s economy in the end.” (A bombing perpetrator).

“I doubt that extremists know about this thing (trade war). Their paradigm is different unless the great powers (USA and China) attack Muslim states.” (A senior military and intelligence advisor for several governments).

“They know about the 2025 trade war because their groups have a Foreign Affairs division, meaning they always monitor developments that occur abroad, including the trade war between China and America. So, they study things like this, not only local politics but also global politics. I remember when I interviewed one of the leaders of JI, he said that his division monitors global political developments and with whom they must cooperate.” (A senior journalist and analyst for governments).

The Expected Relationship Between the 2025 Trade War and the Rise of Extremism

The findings in this study show that participants split in opinions about the impact of trade war to the rise of extremism. Most participants argue that global economic challenges resulting in crises may increase the rise of extremism and criminal behaviour, especially to at-risk communities or individuals. Many of them refer to pull and push factors in criminal studies, indicating that economic or financial crises can precipitate various societal issues. They elucidated that economic difficulties may serve as catalysts or supporting factors, among other variables such as socioeconomic disparity, injustice, political instability, and so forth, in the emergence of extremism. Nevertheless, a small contingent of four individuals argues that economic issues are irrelevant to extremism, asserting that ideology is the only driver of such behaviour. These participants were former leaders or high-ranking members of JI (Table 3).

Table 3: Participants’ opinions on economic crises’ impact to the rise of extremism.

The present findings reveal a divergence in participant perspectives regarding the potential impact of the 2025 trade war on extremism. A majority of participants posit that global economic instability may exacerbate extremism and criminal behavior, particularly among vulnerable populations. Drawing upon criminological frameworks, respondents highlighted how economic crises may function as both push and pull factors, interacting with other psychosocial variables—including socioeconomic disparities, systemic injustice, and political instability—to facilitate radicalization. Notably, a minority subset (n=4) of former Jemaah Islamiyah (JI) leaders and high-ranking members maintained that economic factors bear no significant relationship to extremism, asserting ideological commitment as the sole determinant of such behavior (see Table 3). This dissenting perspective underscores the ongoing theoretical debate regarding the relative weights of material deprivation versus ideological conviction in radicalization processes.

“People in underdeveloped regions who are still struggling, poor, and starving are more likely to commit terrorist attacks and become radicalized. For example, Poso. That’s the fact. It’s not easy to get people to do violent things while their tummies are full.” (A high-ranked JI member).

“Everywhere, it has become a premise that the greater the socioeconomic inequality, the higher the crime rate.” (A senior economic advisor of the Indonesian government.

“We are really offended when our acts are linked to money issues. Not all poor individuals in developing nations become terrorists. Our acts were based on our beliefs and ideology.” (A bombing perpetrator, former JI member).

“Trade wars and economic crises cannot turn individuals into extremists, but tensions between India and Pakistan can, due to India’s attacks against Muslims in Pakistan. There is a growing argument right now among Afghanistan ex-combatants over how to get to Pakistan from Indonesia to help our brothers and sisters there.” (A former leader of JI).

“Economic crises can turn people to be extreme in mind. Financial issues are not the main driver, but can increase extremism – indirectly maybe, along with other issues such as injustice, discrepancy, and other grievances.” (A senior JI member).

“Economic crises can lead to the rise of extremism as these can enhance existing or create new grievances.” (A senior military and intelligence advisor for several governments).

“The worse the economy in a country, the higher the extremism in its people. When people have nothing to lose – poor and starving, it’s easier to provoke them and escalate extremism in them. Just look at Yemen.” (An American analyst).

This study reveals a typology of psychological responses to economic crises among individuals with extremist affiliations. The findings demonstrate three distinct patterns of reaction and adaptation. First, there are individuals who have undergone significant belief system modification, having disengaged from violence. These individuals exhibit marked affective distress when confronted with economic crises, including inflation, rising prices, increased poverty, and heightened taxation. Their distress extends beyond personal circumstances to encompass broader societal impacts, and they maintain a determined commitment to peace advocacy regardless of external conditions.

In contrast, the study identifies a second category of extremist actors who occupy leadership or senior positions within their organizations and display high levels of radicalization. These “exploiters”-typed extremists individuals strategically exploit economic difficulties, turmoil, and chaos to advance their ideological objectives. They actively disseminate propaganda and recruit new members by framing economic crises as divine punishment for societies that fail to adhere to their prescribed religious practices. This exploitative behavior reflects sophisticated cognitive framing techniques and deliberate manipulation of in-group/out-group dynamics.

A third, more passive group emerges from the findings – individuals who are ‘muted’ members on the periphery of extremist networks while experiencing significant economic hardship. These members demonstrate increased susceptibility to radicalization during periods of economic distress, though they typically refrain from active participation in organizational activities. Their vulnerability appears rooted in the intersection of material deprivation and pre-existing network affiliations.

The study’s typological framework contributes to our understanding of how economic crises function as psychological stressors that interact differentially with individuals’ positions within extremist hierarchies and their stages of radicalization. The findings suggest that economic instability does not produce uniform effects across extremist populations, but rather activates distinct psychological and behavioral patterns depending on individuals’ organizational roles, belief systems, and personal circumstances. Thus, the study has identified three classifications of extremists according to their reactions to economic crises: 1) disengaged from violence/’deradicalized’ individuals who persistently promote peace, 2) ‘exploiters’ who use economic challenges as a means to disseminate extremist narratives and recruit more followers, and 3) ‘vulnerable’ silent individuals who may adopt more radical ideologies in response to economic hardships.

“These economic issues are exploited by recruiters to spread their ideology. They argue that the crises happen because the government is secular or not applying certain religious practices across many aspects.” (A high-ranked JI member).

“Historically proven, economic crises can cause discontentment and anger against authorities which can lead to resistance, fighting, and expressions of dissatisfaction against governments. The extremists use the issue of economic crises to blame the small group of minorities, the top 10%, the capitalists who own all the land and resources, and to promote hate-filled narratives or propaganda to get more people to join them.” (A scholar of Islamic studies, high-ranked counselor to governments).

“High prices, low purchasing power of the people, and various manifestations of economic crises cause two things in vulnerable communities: 1) online gambling due to frustration, or 2) extremism as a means to transcend existence in this world and go to the afterlife.” (An eminent professor in International Relations, Military, and Defense).

“Economic crises can cause someone to become extreme, but this is a very long process. Economic motives are not the only ones; they interact with other factors that can eventually cause people to become extreme. I am one example.” (A young former ISIS member).

Urgent Policy Measures Needed to Mitigate Risks During the 2025 Trade War

The findings of this study reveal several threats that governments must confront following the 2025 trade war, based on perspectives from both internal and external extremist groups. Former terrorist offenders/suspects and experts in various fields highlight current threats/risks, including significant economic and social disparities, political instability, poverty, and the escalation of tensions between India and Pakistan into a religious conflict (Table 4).

Table 4: Current threats according to participants.

“The current threat, in my opinion as an economist, is the governments’ confusion and uncertainty in responding to BRICS versus the USA. This confusion stems from a lack of capacity.” (A senior economic advisor to the Indonesian government).

“The current threat to handle is that the fallout from the Israeli genocide against Palestinians has radicalized several Salafi groups. Although the violence has not yet happened, a new leader or coalition could trigger future jihadi attacks.” (A senior military and intelligence advisor for several governments).

“I think the current risks now are people’s frustration and distrust in their governments’ administrations. In many countries, governments have failed to win people’s hearts. They fail us. People around the world feel ignored and disrespected by their governments. Governments see their people as stupid, but actually they are not.” (A young former female ISIS member).

“Terrorism financing is now a real threat. Extremist narratives and propaganda on social media are often sponsored by terrorist groups. These groups frequently pay to spread extremist stories and propaganda online. Indonesians are generally kind and generous people, which is why these organizations collect money by tricking or manipulating ordinary citizens. They also utilize digital or cryptocurrency to transfer funds to locations like Syria.” (A forensic clinical psychologist).

This study found recommended government responses and strategies to address current threats, as proposed by former terrorist offenders and experts. These include good governance, poverty eradication, effective counternarratives and deradicalization programs, and improvements in education and healthcare systems (Table 5).

Table 5: Participants’ opinions on prompt improvement by governments globally.

“Governments everywhere should adopt a persuasive and inclusive approach, like those successfully used with Jemaah Islamiyah in Indonesia, which led to its disbandment, and should reduce counterproductive actions such as aggression and repression toward people.” (A senior former member of JI).

“The state should enhance all sectors, including eradicating corruption, advancing education to make it more affordable and accessible to the populace, and enhancing healthcare. Avoid creating frustration among people because frustration can lead to turbulence, chaos, criminality, extremism, and terrorism.” (A young former female member of ISIS).

“The dissolution of JI does not mean the end, because there is potential for new cells to emerge from those who disagree with JI’s dissolution. There are also internal dynamics within JI post-dissolution that could lead to dissatisfaction and the emergence of new cells. Additionally, JI could change its name and strategy, and infiltrate government or non-government agencies to influence policy. Regarding ISIS, it’s crucial to monitor overseas instructions, as they are still consolidating and actively recruiting at this time.” (A senior journalist and analyst for governments).

Conclusion

While trade wars may appear politically advantageous in the short term, they typically incur significant economic costs. These include disruptions to global supply chains, increased consumer prices, erosion of investor confidence, and destabilization of developing markets. The 2025 U.S. trade war, though economically motivated, produced effects extending beyond financial systems into social and political domains. The resulting economic deterioration not only exacerbated international tensions but also created conditions conducive to the proliferation of extremist ideologies. Employing a qualitative research design, this study examines the complex relationship between the 2025 U.S. trade war and potential escalations in violent extremism, incorporating both internal (terrorist group) and external (analytical) perspectives. Through in-depth interviews with former terrorist offenders (insider perspectives) and counterterrorism experts (outsider perspectives), the research investigates whether the 2025 trade war may intensify violent extremism by creating favorable sociopolitical conditions for radicalization.”

The findings have revealed that current extremists are categorised based on their role, scope, ideology, hierarchical position within terrorist organisations, occupation, drives for joining terrorist groups, generational cohort, gender, and behavioural changes. A key revelation concerns the demonstrable secondary effects of the 2025 U.S. trade war on extremism dynamics. The economic disruptions disproportionately impacted vulnerable populations, creating identifiable psychosocial conditions that facilitated radicalization among at-risk communities and individuals. This economic shock appeared to operate as both a structural enabler and psychological accelerant for extremist mobilization. Particularly salient was the emergence of three distinct behavioral phenotypes in response to economic crises. The first group comprised disengaged/“deradicalized” individuals who actively promoted peaceful alternatives despite economic hardships, representing persistent anti-violence voices. In contrast, a second category of strategic actors – termed “exploiters” – systematically leveraged economic distress to amplify extremist narratives and recruitment efforts. Perhaps most concerning was the identification of a third, “vulnerable” silent cohort characterized by heightened vulnerability to radicalization when facing economic deprivation, suggesting a latent risk pool requiring targeted intervention.

The study’s findings yield important implications for evidence-based policymaking informed by psychological principles of radicalization. Drawing on first-hand accounts from former extremists and counterterrorism specialists, the research underscores how multidimensional interventions addressing both socioeconomic conditions and individual psychological vulnerabilities may effectively counter extremist recruitment. At the core of these recommendations lies the need for poverty alleviation programs that target the sense of relative deprivation known to fuel grievances, combined with counter-narrative campaigns that apply principles of cognitive dissonance to disrupt extremist messaging. The findings further highlight the psychological importance of governance reforms that address fundamental human needs for system justification and fairness, alongside improvements to education and healthcare systems that can foster secure attachments and hopeful future orientations. These policy priorities emerge as particularly crucial in light of the socioeconomic disruptions caused by the 2025 U.S. trade war, which appear to have created fertile ground for extremist narratives targeting vulnerable populations.

From a research perspective, the study reveals critical gaps in our quantitative understanding of how macroeconomic shocks interact with known psychological risk factors for radicalization. Future investigations employing longitudinal designs and multilevel modeling could help disentangle the complex relationships between trade-induced economic indicators, individual-level radicalization processes, and community-level transmission of extremist ideologies. Such research would benefit from incorporating both behavioral measures of extremist engagement and emerging neurocognitive markers of vulnerability to radicalization, potentially yielding more precise predictive models for preventive intervention. This integrated approach, combining psychological theory with economic policy analysis, offers a promising framework for developing more effective counter-extremism strategies that address both the structural conditions and individual pathways that facilitate radicalization.

References

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11. Li Z (2023) When do campaign donors reject extremists? Evidence from the US foreclosure crisis. The Journal of Politics 85: 1548-1561.
12. Omelicheva M,Webb C (2021) Economic crises and terrorism: Analyzing competing economic pressures on terrorism in Russia. Journal of Global Security Studies 6: 3.
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DOI: 10.31038/PSYJ.2025771

Abstract

This commentary critically evaluates the empirical study An Empirical Study of Integration Models and Mechanisms for Maternity Care in Innovative Vocational Education Systems, which addresses maternal health disparities in underserved China through an integrated vocational training model. Using a mixed-methods design combining PLS-SEM and NVivo analysis, the study reveals both the promise and limitations of integrating simulation-based learning, structured supervision, and early clinical immersion. Key findings include significant improvements in patient satisfaction but no measurable impact on student engagement or maternal complications, highlighting systemic barriers to translating training into clinical outcomes. This commentary discusses the study’s methodological innovations, practical implications for vocational education reform and health policy, and identifies future research directions to enhance the model’s effectiveness.

Introduction: Background and Core Issues

Maternal health disparities persist in underserved regions of China, complication rates remain significantly higher than the national average [1]. A critical underlying factor is the fragmentation of vocational education for maternal care, characterized by three key pain points: (1) a disconnect between theoretical instruction and clinical practice, with delayed exposure to real-world scenarios; (2) fragmented simulation training, often limited to video observations rather than hands-on practice; and (3) inadequate structured supervision, leading to passive student engagement [2]. These gaps contribute to poor emergency response skills among graduates and inconsistent care delivery, exacerbating maternal health risks. Against this backdrop, the empirical study (hereafter referred to as the Study) aims to evaluate an integrated training model combining simulation-based learning, structured clinical supervision, and early clinical immersion. This commentary analyzes the Study’s contributions, limitations, and implications for addressing maternal care challenges in underserved settings.

Innovative Methodology: Mixed-Methods Design

The Study’s strength lies in its rigorous mixed-methods approach, which overcomes the limitations of single-method research:

Quantitative Analysis

Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to analyze data from 300 participants (students, nurses, patients, instructors) across experimental (integrated training) and control (traditional training) groups. This allowed the assessment of causal relationships between constructs (e.g., Staff Training → Patient Satisfaction) and multi-group comparisons to identify intervention effects.

Qualitative Analysis

Thematic analysis using NVivo 14 was applied to 14 semi-structured interviews, exploring implementation barriers and stakeholder experiences. This provided contextual depth to explain quantitative findings.

Triangulation

Convergent validation of quantitative results (e.g., patient satisfaction improvements) with qualitative insights (e.g., staff communication quality) enhanced the credibility of conclusions.

This mixed-methods design is innovative in the Chinese vocational education context, as it links training inputs to both patient-centered outcomes and institutional implementation mechanisms (Luo, 2025).

Key Findings: Promise and Limitations

The Study’s findings reveal a nuanced picture of the integrated model’s effectiveness:

Quantitative Insights

The integrated training significantly predicted higher patient satisfaction (β = 0.863, R² = 0.743), aligning with Kolb’s Experiential Learning Theory. However, no significant relationships were found between student interaction and patient satisfaction, or between patient satisfaction and maternal complications. Critically, the Staff Training construct exhibited weak psychometric validity (Composite Reliability [CR] = 0.337; Average Variance Extracted [AVE] = 0.126), indicating fragmented implementation of training components.

Qualitative Insights

Interviews highlighted key barriers: inconsistent use of simulation tools (e.g., control group students only watched videos), unclear student roles in clinical settings (“We just stood back and watched; we never practiced ourselves”), and systemic constraints like emergency delays and staffing shortages. These insights explain why patient satisfaction improvements did not translate into reduced maternal complications—perceived care quality does not address structural gaps in healthcare delivery.

Together, these findings suggest that while integrated training enhances patient perceptions, it fails to improve clinical outcomes due to poor implementation fidelity and institutional readiness.

Practical and Policy Implications

The Study offers actionable insights for vocational education reform and health policy:

Vocational Education Reform

Standardize simulation training: Mandate high-fidelity simulation实操 with structured checklists to ensure consistent implementation.

Clarify student roles: Develop guidelines for student engagement in clinical care (e.g., assisting with routine tasks under supervision) to reduce role ambiguity.

Strengthen supervision: Allocate dedicated supervisory hours and implement real-time feedback mechanisms to enhance student learning.

Health Policy

Resource allocation: Prioritize funding for simulation equipment and staff training in underserved regions to address resource scarcity.

Cross-sector collaboration: Foster partnerships between education and health sectors to align training curricula with clinical needs (e.g., joint development of maternal care training standards).

Accreditation and audit: Include implementation fidelity metrics (e.g., simulation usage rates, supervision quality) in vocational college accreditation to ensure model adherence.

These measures can bridge the gap between training inputs and clinical outcomes, enhancing maternal care quality in underserved areas.

Limitations and Future Directions

The Study has several limitations that future research should address:

Construct Measurement

The Staff Training construct requires refinement (e.g., splitting into sub-dimensions like simulation quality and supervision intensity) to improve validity.

Outcome Measurement

Maternal complication data were self-reported; future studies should use electronic medical records (EMR) to obtain objective clinical outcomes (e.g., postpartum hemorrhage rates).

Generalizability

The single-institution sample limits external validity; multi-site randomized controlled trials (RCTs) are needed to test the model’s scalability.

Longitudinal Design

A longitudinal approach can track the long-term impact of integrated training on student competence and maternal health outcomes over time.

Addressing these limitations will strengthen the evidence base for integrated vocational education models in maternal care.

Conclusion

The Study provides valuable insights into the potential of integrated vocational education to improve maternal care in underserved China. While the model enhances patient satisfaction, its clinical impact is constrained by implementation gaps and systemic barriers. To realize its full potential, reforms must focus on standardizing training, clarifying student roles, and addressing structural healthcare deficits. Future research should build on these findings to develop more robust, context-adapted models that translate training into tangible improvements in maternal health outcomes. This commentary underscores the importance of rigorous mixed-methods research in evaluating vocational education interventions and the need for systemic collaboration between education and health sectors to advance maternal health equity.

References

1. LI Y, Zhang Y, Yuan B, Wang H (2023) Analysis and thoughts on the settings of sub-campus of public hospitals directly under the National Health Commission of China. Chinese Journal of Hospital Administration, 399-403.
2. Luo W (2025) An empirical study of integration models and mechanisms for maternity care in innovative vocational education systems.

DOI: 10.31038/PSYJ.2025764

Abstract

This study explored the work-related challenges and adjustment experiences of novice firefighters in Taiwan. Using a qualitative thematic analysis design, we conducted semi-structured, in-depth interviews with four novice firefighters (one woman and three men) aged 27–33 years (M = 29.75) who had 2–3.5 years of work experience. The findings revealed several salient challenge-related themes, including perceived unfairness and oppression in the workplace, ethical dilemmas in practice, organizational and interpersonal stressors, stress associated with insufficient work resources, and pressure arising from public expectations and commentary. Regarding adjustment and coping, participants expressed substantial concerns about using formal mental health resources and therefore relied primarily on personal resources to manage stress. Implications for practice and directions for future research are discussed.

Keywords

Novice firefighters, Work challenges, Work adjustment, Resilience

Work Challenges and Adjustment among Novice Firefighters in Taiwan

In recent years, global climate anomalies have contributed to increasingly complex and unpredictable disasters. In Taiwan, economic development and population concentration—together with larger, taller, and more diverse building structures—have expanded firefighters’ operational demands and increased exposure to hazardous labor conditions [1]. To address workforce shortages, the National Fire Agency launched the “Firefighting Workforce Enhancement Initiative” in 2018 and added 3,100 firefighting personnel [2]. Under these conditions, the training and development of novice firefighters becomes especially critical. Without resilience- building opportunities and a health-supportive work environment, novice personnel may experience excessive stress and maladaptation that ultimately contribute to early exit from the profession. Despite the practical significance of this issue, research on novice firefighters’ work challenges and psychological adjustment in Taiwan remains limited. Novice firefighters may face structural, systemic, and hierarchical constraints; high job demands may intensify perceived stress, while access to organizational resources may be restricted. Over time, an imbalance between excessive demands and insufficient resources may contribute to anxiety, depression, and stress-related symptoms, increasing the risk of physical and psychological burnout. Accordingly, this study aims to describe (a) the work-related challenges novice firefighters in Taiwan encounter and (b) their experiences of adjustment and coping.

Firefighters and Their Work

Firefighters’ work encompasses a broad range of duties. In Taiwan, novice firefighters commonly perform two major categories of frontline tasks: (1) disaster response and life-saving rescue, including fire suppression, rescue operations across disaster types, and the management and deployment of rescue resources; and (2) emergency medical services (EMS), including the planning, supervision, and delivery of prehospital emergency care, as well as communication and coordination with medical institutions. In this study, we use the term fire and emergency service work experience to denote frontline operational experience spanning disaster response/rescue, life-saving or technical rescue, and EMS. Firefighting is widely recognized as a high-risk occupation characterized by substantial physical demands, heavy psychological load, and high task complexity. As disaster responders, firefighters are required to enter and operate at hazardous scenes; even under life-threatening and terrifying conditions, professional responsibility typically precludes avoiding the scene or refusing assigned duties. Firefighting work is dangerous, unpredictable, and time-sensitive. Prolonged exposure to heavy workloads, shift-related strain, and traumatic events places firefighters at elevated risk for exhaustion and compromised physical and mental health [3]. Firefighters often must remain in a continuous “combat- ready” state, making firefighting a particularly high-stress occupation [4]. Long-term on-call shift systems can disrupt sleep and interfere with normal physical and psychological recovery processes [5]. Kuo [6] further noted that, driven by a sense of mission and responsibility, firefighters must meet public expectations; at disaster scenes, they may suppress physical discomfort and psychological distress in order to execute tasks calmly and courageously. When such reactions accumulate without adequate processing, firefighters may develop PTSD-related symptoms (e.g., hypervigilance, insomnia, exaggerated startle responses, irritability, and concentration difficulties). If psychological trauma is not addressed in a timely manner, symptoms may intensify over time.

Operational conditions also constrain emotional processing. During missions, firefighters often lack the time and space to process emotions and may temporarily set aside personal feelings until tasks are completed, at which point they begin to experience and interpret the impact of the event. Frequent exposure to disaster incidents may require firefighters to re-enter distressing rescue contexts before psychological equilibrium is restored, thereby accumulating negative emotions and traumatic experiences [7]. In addition, firefighters face public pressure through media coverage and public praise or criticism, which may further intensify occupational stress [8].

Novice Firefighters

Novice firefighters are commonly defined as those with 2–4 years of service [9]. They are expected to learn and perform core duties such as fire suppression and emergency medical response while adapting to the realities of frontline work. In Taiwan, however, empirical research on novice firefighters remains limited. Existing literature has primarily examined safety and training effectiveness, the influence of overall health on performance, the effects of stress, and the development of professional knowledge [10]. Because novice firefighters often serve as frontline personnel, they may experience substantial pressure associated with disaster response. Prior evidence suggests that shorter tenure is associated with stronger stress responses among firefighters [11,12]. Novice firefighters may also report higher stress than senior firefighters [13]. Moreover, they require an adjustment period to manage challenges such as the gap between training and real-world practice and the complexity of diverse duty types [14]. At the same time, they must learn to navigate bureaucratic features of the firefighting system and pressures related to obedience and hierarchical authority [15].

Job Demands and Resource Provision

Work environments shape employees’ health, well-being, and performance [16]. The Job Demands–Resources Model (JDRM) provides a useful framework for understanding how occupational conditions influence stress and adjustment [17]. Job demands refer to aspects of a job that require sustained physical and/or psychological effort and include negative factors at physical, psychological, social, or organizational levels; such demands entail specific physiological and/ or psychological costs. Examples include workload, time pressure, emotional load, and role conflict. Although moderate job demands may stimulate motivation and alertness, chronically excessive demands can initiate a health-impairment process that depletes resources and increases burnout risk, physical and mental health problems, and performance decrements.

In contrast, job resources refer to positive job characteristics at physical, psychological, social, or organizational levels. Job resources support goal attainment, reduce job demands and their associated costs, and promote personal growth, learning, and development. Resources may operate at the task level (e.g., autonomy), organizational level (e.g., career development opportunities), interpersonal level (e.g., supervisor and coworker support), and job design level (e.g., performance feedback). Adequate resources activate a motivational process, enhance engagement, and are associated with positive outcomes such as safety behaviors, job performance, and organizational commitment.

Safety-Oriented JDRM

Building on the JDRM, scholars have proposed a safety-oriented JDRM that foregrounds safety-relevant job demands and safety- relevant resources [18]. For firefighting, this model highlights four demand dimensions: (1) Workload, referring to the speed and volume of task completion under time constraints and pressure; high time pressure has been linked to increased firefighter fatality rates. (2) Physical demands, including high-intensity biomechanical activities such as running, carrying, and ladder climbing; excessive exertion contributes to fatigue that can undermine reaction time and adherence to safety procedures. (3) Emotional demands, referring to the psychological effort required to manage emotions and cope with affective reactions (e.g., fear, suppression); sustained emotional labor may deplete energy reserves and contribute to emotional exhaustion. (4) Complexity, involving cognitive demands associated with handling multiple difficult tasks, maintaining situational awareness, making rapid decisions, and conducting risk assessments—particularly in life- threatening contexts.

Structural Insufficiency of Resources

Fire service organizations may also face structural shortages of resources. Insufficient resources have been identified as a key factor undermining firefighters’ psychological health [19]. In addition, interpersonal conflict, discrimination, harassment, and negative perceptions of organizational justice can weaken resilience and are associated with anxiety, depression, and physical illness [20]. In particular, perceptions of organizational and systemic unfairness increase mental health risks and are closely tied to hierarchical stress. In such contexts, employees may engage in proactive behaviors that reshape their work conditions. These include job crafting (actively modifying one’s job or available resources) and self- undermining (stress-related mistakes that inadvertently increase one’s own job demands). Novice personnel may adjust their work behaviors in response to hierarchical pressure, or they may reduce engagement due to fear of making mistakes. When social support is limited, interpersonal resources become scarce and fragile, and this vulnerability is closely linked to trauma-related stress symptoms, depression, and emotional exhaustion [21]. Moreover, negative views of organizational systems (e.g., unfair policies or promotion practices) may further elevate mental health risks. Interpersonal conflict can also obstruct help-seeking and support access, producing a “double hit” of resource loss. Under conditions of high hindrance, high demands, and systemic resource deficiencies, job demands may substantially exceed resource provision, creating a structural imbalance that undermines job performance directly or indirectly through psychological distress.

The Buffering Effects of Resources

The JDRM also emphasizes personal resources, defined as individuals’ beliefs about their ability to control and influence their environment. Job resources can buffer strain associated with job demands and mitigate the negative effects of work stressors. This buffering function suggests that resources may be especially protective under high-demand conditions, supporting both well-being and work performance. Common personal resources include self-efficacy, optimism, and resilience. Such resources predict work engagement by strengthening confidence in one’s capacity to manage challenges and sustain involvement. Personal resources may also operate similarly to job resources by buffering the adverse effects of job demands on stress. In sum, when employees face high demands (e.g., heavy workload or emotional load), greater resources (e.g., autonomy, social support, performance feedback, and professional development opportunities) are generally associated with lower burnout and emotional exhaustion.

Organizational Culture

Organizational culture is another critical influence on firefighters’ well-being and help-seeking. A traditional culture emphasizing “toughness, silence, and self-sacrifice,” along with emotional taboo, may inhibit seeking psychological support [22]. In contrast, framing professional psychological help-seeking as a constructive form of self- care may facilitate a healthier organizational climate [23].

Resource adequacy in the fire service also matters. The quality, quantity, and suitability of personal protective equipment are central to firefighters’ sense of safety. Station facilities, vehicles, staffing, and occupational health and safety measures represent foundational resources that directly shape the safety and comfort of the work environment. Supervisor support is likewise influential: when perceived support from managers, family, or friends decreases, depressive symptoms tend to increase. Supervisors’ support, trust, and care may strengthen subordinates’ resilience. Leadership practices— such as reward and punishment systems, internal management, duty scheduling, performance evaluation, discipline, and performance demands—may function either as resources or as stressors, depending on how they are enacted and experienced.

Firefighters’ Adjustment and Coping

Carver et al. [24] developed a coping strategies inventory that categorizes coping behaviors into problem-focused coping, cognitive restructuring coping, emotional support coping, and avoidance coping. Chung and Chiou [25] suggested that firefighters who predominantly use problem-focused coping tend to recover gradually, whereas reliance on avoidance coping may increase risk for psychological disorders. Prior research indicates that firefighters often rely on individual coping strategies to manage work stress. Lee [26] and Chen [27] found that after exposure to death or major critical incidents, firefighters often cope privately; when adjustment is insufficient or support is unavailable, some may request transfer or resign. Some firefighters manage occupational stress through a passive stance (e.g., “you get used to it over time”) [28], whereas others use strategies such as active reflection for improvement or emotional detachment [29]. Firefighters may also cope by maintaining task focus and calm during operations [30] or by adopting passive coping patterns, allowing emotions to fade over time through emotional numbing, suppression, or self-isolation. Although these strategies may stabilize functioning in the short term, they may carry negative long-term consequences.

Resilience also shapes adjustment. Firefighters with higher resilience are more likely to appraise stress as a challenge rather than a threat [31]. Firefighters commonly report using conversation, exercise, leisure activities, and faith practices to reduce stress. Professional competence also increases with accumulated experience and knowledge, which can strengthen coping capacity. Individuals with stronger self-efficacy tend to believe they can control and change situations, thereby moderating the impact of perceived stress on burnout.

Peer support functions as an important buffer by enabling emotional exchange, experience sharing, mutual reminders, and opportunities for emotional ventilation. Colleagues’ competence, knowledge, and experience can enhance individual safety, and camaraderie is a strong predictor of firefighters’ mental health. Firefighters often reduce distress through peer dialogue—talking through tasks and coping approaches—and through experiential transfer from senior peers. Everyday conversations and informal gatherings may also help relieve emotional strain. In Taiwan, fire agencies have established counseling and guidance systems and offer courses and lectures. They may provide psychiatric services, psychological counseling, and consultation, sometimes combined with medication to improve sleep conditions [32]. Overall, building a comprehensive mental health support system—including accessible psychological services, effective communication channels, regular health check-ups, financial and emotional support, and health- and law-related information—may strengthen organizational support and enhance firefighters’ resilience.

Method

This study employed thematic analysis to examine the occupational experiences of novice firefighters in Taiwan. The analytic focus was directed toward describing both the substantive content and the processes embedded in their work, thereby highlighting the complexity of frontline practice and the trajectories through which participants adapted and coped.

Participants

A purposive sampling strategy was adopted. Four frontline novice firefighters were recruited through professional networks by the first author. The sample comprised one woman and three men, aged 27–33 years (M = 29.75), with work tenure ranging from 2 to 3.5 years— consistent with the career stage of novice firefighters (defined as within four years of service). Participants were drawn from brigades located in diverse service contexts: an eastern rural area, a central semi-urban area, a central rural area, and a northern metropolitan area. Two participants held certification as Emergency Medical Technicians–Paramedic (EMT-P), and one participant held Rescue Technician certification.

Data Collection

Data were generated through semi-structured, in-depth interviews. The first author conducted one individual interview with each participant, lasting approximately 60–90 minutes. Participants were invited to narrate their occupational challenges and their experiences of adaptation and coping. The interview guide encompassed questions on: motivations and expectations for entering the fire service; job tasks and sources of stress; interpersonal interactions; utilization of organizational resources; coping strategies; and perceived impacts of work on physical and mental health. Interviews were conducted in quiet, convenient locations selected by the first author. Prior to each interview, participants were informed of the study’s purpose and procedures, potential benefits and risks, and their rights. Ethical principles were observed throughout, including respect for autonomy and confidentiality. Written informed consent was obtained before interviews commenced. All interviews were audio-recorded and subsequently transcribed verbatim by the first author.

Data Analysis

Thematic analysis was conducted following Braun and Clarke’s [33] framework. The first and second authors conducted the analysis using Braun and Clarke’s thematic analysis. They engaged in repeated reading of transcripts, open coding, identification of cross-case patterns, and iterative refinement of thematic coherence. Themes were subsequently defined, named, and integrated into the analytic report. Throughout the process, the researchers maintained an open and reflexive stance, engaging in ongoing dialogue to ensure rigor. Particular attention was devoted to issues raised by participants concerning tenure, hierarchical power relations, the novice role, and work-related challenges, including organizational and structural barriers, resource utilization, and coping/adaptation processes.

Trustworthiness and Ethics

To enhance trustworthiness, multiple strategies were employed, including triangulation, reflexivity, thick description, and cross- checking. These measures ensured coherence between themes and textual evidence, strengthened descriptive appropriateness, and enhanced credibility. Ethical standards were rigorously observed: all participants signed informed consent forms and were informed of the study’s purpose, rights, and procedures for voluntary participation and withdrawal. Audio files and transcripts were de-identified and presented using pseudonyms to ensure anonymity. All study materials were securely stored by the first author, and data were used exclusively for academic purposes.

Results

Seven themes emerged from the thematic analysis. Themes are illustrated with representative participant narratives.

Unfairness and Oppression at Work

Novice firefighters characterized their work as highly complex, unpredictable, and psychologically demanding. One participant described each dispatch as opening a “mystery box,” because incidents could involve life-threatening conditions such as earthquakes, rockfalls, or fires. This uncertainty not only tested physical limits but also created substantial psychological burden.

Beyond the inherent danger of the job, participants emphasized that risk exposure was distributed unevenly across ranks. They reported that novices were frequently assigned the most hazardous roles during operations. For example, one participant noted that junior firefighters were expected to be the first to force entry into unknown environments. He also described death-related incidents in which novices could be tasked with handling particularly distressing duties (e.g., carrying severed body parts). He described this as an unspoken rule: “the most junior firefighter is expected to face unknown risks first or bear the greatest known risks.” Such expectations reflected a power imbalance between senior and novice firefighters and contributed to participants’ perceptions of unfairness and oppressive treatment.

Ethical Dilemmas in Practice

In addition to operational danger, participants reported repeated exposure to ethical and moral shocks, especially during emergency medical work. In out-of-hospital cardiac arrest (OHCA) cases, they often faced dilemmas about whether resuscitation was clinically meaningful—particularly when family members insisted on continuing resuscitation even when firefighters perceived it as futile. In these moments, participants described feeling ethically conflicted and powerless. One participant reflected: No intubation, no defibrillation… and then when we arrived at the hospital, the doctor said there was no chance—just stop resuscitation… I kept wondering… Was my CPR and oxygen meaningful?”Participants also described moral conflict from the opposite direction: even when resuscitation was successful, severe post-resuscitation outcomes could raise questions about long- term suffering and family burden. One participant stated: “Even though I brought him back—breathing, pulse—he would only survive with those machines. Sometimes I struggle inside… Should I save him or not?” Overall, participants emphasized that firefighters often confront ethically fraught situations without clear ethical guidance or standardized norms. For novices in particular, real-world emergency care required enduring ongoing tension among professional obligations, personal values, and ethical considerations.

Systemic Organizational and Interpersonal Pressures

Participants described hierarchical pressure and workplace bullying as major sources of stress. Some supervisors were portrayed as hostile toward newcomers (described as “newcomer killers”), frequently scolding, intimidating, or imposing punitive controls. One participant recalled that during the first six months he was reprimanded almost daily and received leave restrictions for minor issues: “For about the first six months, I was getting scolded almost all day… For small things—five minutes late, missing a signature—I was banned from taking leave for two months… he wrote it down and kept scolding me.” Another participant described feeling constantly monitored and scrutinized by supervisors and senior colleagues, which made his work experience “miserable.” He gave an example of being questioned for not attending activities that occurred on his scheduled days off: “There were two activities… both fell on my days off, and then I was called in and asked, ‘Why didn’t you participate?’”

Participants further reported that some senior firefighters undermined novices’ confidence through disparaging remarks. One participant described being mocked while studying for professional exams: “A senior saw me studying… and said, ‘You won’t pass,’… those sarcastic, belittling things.” They also noted that minor station-related issues (e.g., a gym not being tidied immediately or trash temporarily left) could trigger scolding, and supervisory pressure sometimes extended into rest time. Participants reported being unable to relax even during breaks; using a phone could invite suspicion, and taking leave could lead to criticism for “not helping the team” with dispatch duties. Accumulated pressure affected both physical and psychological functioning. One participant described missing a dispatch alarm due to a malfunctioning bell near his bed; fear of being reprimanded increased stress and contributed to sleep disturbance.

In addition to interpersonal dynamics, participants described institutional unfairness that amplified helplessness. One participant stated that performance evaluations were opaque and highly subjective—dependent on “the supervisor’s mood”—yet directly influenced salary and promotion. When effort was not matched by recognition or reward, participants reported frustration and demoralization. Another participant described being reassigned to another brigade despite holding strong paramedic qualifications, which he experienced as unfair and identity-undermining.

Finally, participants described rigid systems and dysfunctional equipment as chronically depleting. They reported pressure to meet unreasonable key performance indicators and to complete large volumes of administrative tasks despite inadequate staffing and limited experience. Under directives from higher-level leadership, core emergency work was sometimes displaced by unrelated activities (e.g., sports events) and could even become entangled with election- related events—at the expense of essential rescue and EMS duties. Participants also described being constrained by outdated protocols: even after learning improved clinical approaches, they were expected to follow older procedures because regulations had not been updated and senior members insisted on “the old way.” Collectively, these systemic conditions were perceived as obstructing professional development, eroding motivation for learning and innovation, and fostering high pressure, helplessness, diminished self-efficacy, and weakened professional identification.

Scarcity of Job Resources

Participants consistently emphasized that job resources were insufficient relative to the demands they faced. At the basic operational level, one participant reported chronic shortages of essential supplies and incomplete distribution of equipment. For example, ambulance gauze ran out and was not replenished for an extended period; paramedic medication kits were not fully issued, forcing firefighters to purchase supplies themselves or seek support from physicians: “Resources are very limited—equipment, gear, consumables. The gauze on the ambulance ran out… and the whole station had none because it wasn’t issued… The medication kit wasn’t provided, so I bought it myself… This affects how well I can do the job, and it affects my quality of life.”Another participant highlighted chronic understaffing. On some days, only three personnel were on duty, increasing the likelihood of station closure or even single-person dispatch, which substantially elevated operational risk. Resource scarcity also extended to compensation. One participant stated that pay was disproportionate to high risk and long working hours, estimating an hourly wage lower than that of part-time student workers. He also described institutional limits on overtime pay, whereby excess overtime was converted to compensatory leave rather than paid overtime. Additionally, leave taken across months could reduce the salary of a given month, despite leave being largely nonvoluntary in practice. Participants experienced these arrangements as discouraging and demoralizing. Participants further described resource deficits in organizational infrastructure and administrative systems. One participant reported frequent crashes in electronic systems with little improvement. Shared computers lacked internet access and could not support routine administrative tasks; outdated equipment was neither functional nor replaced. These barriers disrupted both administrative operations and professional emergency duties, increasing stress, draining energy, and undermining morale.

Pressure From Public Expectations and Commentary

Participants described substantial pressure arising from public expectations, scrutiny, and online commentary. When rescue or response efforts were perceived as inadequate, participants experienced intense criticism and what they viewed as unreasonable accusations, which increased emotional disturbance and work stress. They noted that even cautious decision-making could be judged negatively, resulting in complaints or online attacks. One participant listed common disputes, such as being criticized for driving “too slowly,” questioned for running red lights during emergency transport, reported for siren noise at night, or asked by bystanders to move hoses during active fire response. He recalled: “Once, during a fire response, I was still dealing with it, and there was a hose on the ground. Someone said he wanted to drive home and asked me to move the hose… I said, ‘I’m still fighting a fire!’”Overall, participants expressed a sense that “whatever we do, the public will criticize.” They reported that minor mistakes could be amplified, leaving them uncertain about how to respond and pressured by constant evaluation. This perceived scrutiny affected their occupational identity and sense of meaning in the work.

Personal Ajustment and Coping

In response to the imbalance between high demands and limited resources, participants described diverse coping strategies that ranged from proactive competence-building to emotional self-protection and cognitive reframing. Proactive learning and competence-building. Some participants demonstrated strong agency. One participant repeatedly volunteered for training opportunities despite low seniority and initial supervisory rejection: “I’m pretty junior, so it wouldn’t be my turn… I recommended myself… he rejected me two or three times before finally letting me go.” Another participant described enrolling in an instructor-training program to rekindle motivation: “Last year… I changed my mindset… I decided to recover my passion… I applied for instructor training, and I got in.”

Participants also described practice-based improvement, especially in EMS. One participant reported reviewing the quality of CPR and airway management after OHCA cases, requesting simulation training, and striving to improve care quality. Another described systematically refining EMS procedures— practicing operational details, adjusting workflows, strengthening competence, and promoting team improvements. He explained how training translated to smoother field performance: “When I arrived on scene, I followed the training model… and the next time, I didn’t waste time… it went smoothly, and I completed the EMS work successfully.” He further described keeping organized records, publicly noting procedural gaps, advocating updated protocols, and optimizing team workflows. These efforts increased accomplishment and self-efficacy; when improved performance was recognized during later dispatches, confidence was reinforced in a positive feedback cycle.

Self-protective Emotional Strategies

In contrast, some coping strategies emphasized denial, minimization, or emotional detachment. One participant described himself as “digesting emotions quickly,” “letting it pass,” and being “forgetful,” noting that positive events could override work-related distress: “I digest (negative emotions) pretty fast… after sleeping a few times, I’m fine… If something happy happens, it covers up the unpleasantness.” Another participant rationalized supervisory harshness by framing militarized management as something men “should” endure, interpreting survival of strict training as evidence of becoming competent.

Compartmentalization and Technical Focus

One participant described being briefly frightened at the scene but switching immediately to professional judgment and action. After returning to the station, he reviewed dispatch footage to evaluate technical execution and team communication, using procedural focus to avoid being absorbed in distress: “Back at the station, I watch the footage again… if there are problems, we discuss and improve next time. That way, I don’t think too much… or get stuck on why it happened.”

Relational Coping and Future-oriented Strategies

Some participants described selectively collaborating with reliable senior firefighters to support smoother teamwork. Others attempted to transform unfair treatment into motivation for self-improvement— strengthening training, obtaining key EMS certifications, and preparing for potential future transfers to other units.

Cognitive Reframing

One participant reduced distress by reframing EMS work as “taxi” service: complete necessary tasks without judging whether patients were misusing EMS resources and without ruminating: “We arrive a hospital and see he (the patient) is actually okay—fine, take measurements, transport him, then happily go back to rest… I imagine my work is like a taxi driver.”

In summary, across accounts, the above strategies reflect novice firefighters’ attempts to preserve functioning, maintain competence, and sustain meaning under chronic stress in work.

Concerns About Using Counseling Resources

Although participants acknowledged that fire agencies provide mental health resources (including on-site counseling), they expressed substantial concerns about using them. One participant noted that counseling appointments required taking personal leave; after exhausting shifts, he preferred to use leave for sleep and rest. Another participant expressed fear of stigma and confidentiality breaches, reporting limited trust in counseling privacy and concern that supervisors might learn about counseling use: “Privacy… If I go talk to a counselor… will my supervisor know and ‘check on’ me?… Work stress is private… Counselors keep records—are they stored somewhere? Would people know?… Would I be labeled as having a mental problem?”

One participant questioned whether counseling could address structural sources of distress—such as authoritarian supervision, unfair treatment, or outdated equipment—given that these conditions would remain unchanged after counseling: “If I’m bullied long-term… would talking to a counselor make me better?… I still have to go back, and the supervisor is the same… So is counseling useful? I have a question mark.”

Overall, participants viewed counseling as potentially providing temporary emotional ventilation but offering limited practical benefit for stressors rooted in persistent organizational and structural conditions. Consequently, they tended to rely more on personal coping resources than on formal psychological services.

Discussion

The novice firefighters in this study characterized firefighting as an occupation involving high risk, heavy physical demands, substantial psychological load, and high complexity. They also emphasized that the work environment and organizational culture strongly shape mental health and necessitate coping strategies to manage occupational stress. These findings are consistent with Bakker and Demerouti’s argument that the work environment influences employees’ health, well-being, and performance. Taken together, the results suggest that novice firefighters’ early-career adjustment is not determined solely by the inherent dangers of frontline work, but also by organizational arrangements, leadership practices, resource provision, and public scrutiny—factors that jointly produce a structural pattern in which demands often exceed available resources. Participants described having to cope with diverse operational and administrative challenges, as well as bureaucratic features of the firefighting system and hierarchical pressures requiring obedience. Their narratives also highlighted pronounced hierarchical stress, including implicit workplace rules that positioned novices to assume high-risk and high-impact tasks, and supervisory practices experienced as punitive or oppressive. In addition, the findings echo prior evidence that firefighters are exposed to societal expectations and external evaluation—including media coverage and public praise or criticism—which can intensify occupational stress.

Smith and Dyal’s safety-oriented JD–R model is particularly useful for interpreting these results, as it emphasizes both safety- related job demands and safety-related resource provision. The current findings partially converge with this framework and with the four dimensions of firefighting job demands described by Smith and Dyal. Participants repeatedly reported working under stringent time constraints and pressure, which heightened stress. They also described emotional demands, especially in emergency medical and urgent rescue contexts, where fear, shock, and emotional suppression were common. Such emotional demands can deplete psychological energy and contribute to emotional exhaustion. In addition, participants emphasized cognitive complexity: managing multiple difficult tasks in life-threatening contexts required sustained situational awareness, rapid decision-making, risk assessment, and the execution of emergency interventions.

Notably, when these demands were experienced as persistent and cumulative, participants’ accounts suggested a health-impairment process consistent with the JD–R perspective. For example, some participants described wanting only to rest during time off and reported limited capacity for additional activities, including psychological counseling. This pattern underscores that excessive demands may constrain recovery opportunities and gradually erode psychological resources, thereby increasing risks for burnout and compromised functioning over time.

In the safety-oriented JD–R model, resource provision is not a peripheral issue but a central determinant of safety and well- being. Participants in this study described a broad range of resource constraints, including shortages of supplies, malfunctioning or obsolete systems, insufficient infrastructure (e.g., computers and internet access), and understaffing that increased operational risk. They also expressed dissatisfaction with compensation and overtime arrangements that were perceived as disproportionate to workload, risk, and time demands. These findings align with Payne and Kinman’s argument that insufficient resources represent a key factor undermining firefighters’ psychological health, and with research emphasizing that adequate equipment, facilities, staffing, and occupational health and safety measures influence the safety and comfort of firefighters’ work environments.

At the interpersonal and organizational levels, participants described authoritarian supervision, frequent reprimands for minor issues, disparaging remarks, and a sense of constant scrutiny. They also reported unfair or inconsistent evaluation and managerial practices, leaving them uncertain about behavioral standards and concerned that outcomes depended on supervisors’ subjective judgments. These experiences are consistent with prior literature identifying interpersonal conflict and low organizational justice as critical risk factors that erode resilience and increase vulnerability to anxiety, depression, and physical illness. They also reinforce the importance of supervisory support: deficiencies in managerial support have been linked to elevated depressive symptoms, whereas supervisors’ trust, care, and support may strengthen resilience. In the present study, perceived unfairness and hierarchical oppression appeared to operate as chronic “hindrance demands,” increasing stress while simultaneously restricting access to key resources such as psychological safety, guidance, and professional recognition.

A salient contribution of this study is the centrality of ethical dilemmas, particularly in OHCA cases. Participants described moral conflict when family requests for resuscitation diverged from firefighters’ assessment of futility, and they also described ambivalence when resuscitation succeeded but survival implied severe impairment and long-term dependence on life-sustaining equipment. These experiences suggest that novice firefighters may be exposed to moral distress—ethical discomfort arising when one’s professional judgment conflicts with external demands or constrained options—yet they may lack clear norms, ethical guidance, and structured opportunities to process these conflicts. Accordingly, ethical strain should be considered a meaningful component of job demands in EMS-related duties, not merely an emotional byproduct of trauma exposure.

Participants’ coping strategies reflected both active and avoidant patterns. Some described relatively active coping approaches, including cognitive reframing, transforming frustration into motivation for professional development, pursuing training and certifications, and strengthening technical competence. These strategies appeared to enhance self-efficacy, a key personal resource within the JD–R framework, and are consistent with evidence that believing one can control or change situations may mitigate the impact of stress on burnout. Participants also described drawing on interpersonal resources, such as selectively collaborating with supportive senior colleagues, which partially supports the safety-oriented JD–R proposition that social support buffers the psychological impact of high-demand work. At the same time, several participants reported passive or self-protective coping—emotional suppression, compartmentalization, denial, replacement, and self- isolation—used to maintain immediate functioning. These patterns align with prior research suggesting that some firefighters use passive stances or emotional detachment to cope, while others engage in active reflection and improvement. Although avoidant strategies may provide short-term stabilization and enable continued performance, they may carry longer-term risks. Lin similarly noted that passive coping can temporarily stabilize psychological states but may yield adverse long-term consequences for health and work functioning.

Participants also indicated that rescue and EMS work often involves immediate shock, but firefighters must rapidly regain composure to complete tasks according to standard procedures. This aligns with evidence that firefighters cope by focusing on the task and maintaining calm during operations. It also echoes Yeh’s observation that firefighters often lack time and space to process emotions during missions and must temporarily set aside feelings until tasks are completed. However, in the present study, novices did not clearly report structured post-mission emotional processing; instead, they tended to rely on compartmentalization, suppression, or redirection of attention. This suggests that novice firefighters may have limited awareness of cumulative trauma risks and may underestimate the potential harm of unprocessed emotional and psychological impact. If distress is repeatedly ignored, cumulative strain may contribute to psychological depletion, emotional exhaustion, intrusive re- experiencing, and triggered recall, with trauma-related symptoms becoming more pronounced over time.

Although participants were aware that fire agencies provide mental health services (including counseling), they tended to perceive such services as offering only temporary emotional relief and limited practical utility for problem solving. They also reported concerns about privacy and the confidentiality of counseling records, which reduced willingness to seek help. These findings imply that existing governmental and organizational mental health resources may not fully match novice firefighters’ needs. Importantly, participants’ skepticism was not solely attitudinal; it reflected a perception that counseling cannot resolve structural sources of distress (e.g., authoritarian supervision, institutional injustice, and equipment/resource deficits). Thus, improving service uptake likely requires both strengthened confidentiality safeguards and organizational reforms that address upstream stressors and demonstrate institutional accountability.

In summary, the findings indicate that novice firefighters’ job demands arise not only from the inherent danger of frontline tasks, but also from organizational oppression and institutional injustice— manifested as hierarchical pressure, workplace bullying, and opaque managerial practices—combined with structural resource deficits (e.g., shortages of supplies, malfunctioning systems, and insufficient interpersonal support). Under such conditions, personal coping and adaptation may help individuals maintain day-to-day functioning but remain insufficient to compensate for systemic problems. Novice firefighters in this study appeared to operate in a structural imbalance in which demands substantially exceeded available resources, highlighting the need for multi-level interventions that extend beyond individual resilience.

Implications

Fire service organizations should prioritize novice development by ensuring reasonable work allocation and adequate resources, supported by a constructive work environment, healthy organizational culture, and fair performance evaluation systems. Providing sufficient equipment and accessible psychological resources may foster a more supportive workplace and reduce the risk of work-related psychological harm. More specifically, leaders and supervisors should establish transparent and equitable assessment mechanisms, acknowledge and address resource shortages, and ensure stable provision of emergency medical supplies and other essential materials. Institutional protections for novice personnel should be strengthened to prevent unfair or oppressive treatment arising from hierarchical differences. Supervisors should proactively attend to novices’ needs and shift their role from “monitor” to a buffering resource—providing guidance on professional values, emotional support, and tangible resources, and helping novices navigate supports for processing distress and potential trauma-related reactions. Future research may examine the effectiveness of different coping strategies in response to specific challenges (e.g., hierarchical oppression and ethical dilemmas) and investigate how organizational resources and culture shape novice firefighters’ adjustment over time.

Conclusion

Within highly hierarchical fire service organizations, novice firefighters may experience a structural pattern of high demands and low resources, including hierarchical pressure, institutional injustice, resource scarcity, prolonged high-risk work, and compensation perceived as disproportionate to workload and risk. Despite these conditions, novice firefighters strive to adapt and often demonstrate resilience and commitment to professional practice. However, they primarily rely on individual coping strategies—such as emotional suppression, compartmentalization, and attentional redirection— to manage stress and emotional reactions, strategies that may carry hidden risks of long-term psychological depletion and escalation of trauma-related symptoms. Accordingly, supporting novice firefighters’ sustainable adaptation requires coordinated efforts that combine individual- and peer-level supports with organizational reforms in leadership practices, procedural justice, resource provision, and the design and credibility of mental health services.

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DOI: 10.31038/PSYJ.2025763

Abstract

Oppositional Defiant Disorder (ODD) is a disruptive behavioral condition characterized by persistent patterns of angry, irritable mood, argumentative behavior, and vindictiveness (APA, 2022). This comprehensive review explores the diagnostic criteria, prevalence, and developmental trajectory of ODD in youth, with a focus on the interplay of risk, protective, and ameliorating factors. The article examines the distinctions between medical and educational diagnoses, including the implications of DSM-5-TR and special education law in the United States (IDEIA). It highlights the disorder’s comorbidity with ADHD, mood disorders, and conduct disorder, and discusses how cultural, gender, and socioeconomic factors influence diagnosis and symptom presentation. The review also delves into dispositional, genetic, cognitive, neurobiological, and environmental risk factors, emphasizing the importance of early intervention and strong familial and peer relationships as protective mechanisms. Evidence-based treatments are presented as effective strategies for managing ODD symptoms. The article underscores the critical role of educators and psychologists in identifying, evaluating, and supporting students with ODD through informed assessment and intervention practices.

Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is a complex externalizing behavioral condition characterized by persistent patterns of angry or irritable mood, argumentative and defiant behavior, and vindictiveness in children and adolescents [1]. Understanding ODD requires a comprehensive, multidisciplinary approach that considers its diagnostic criteria, prevalence, and developmental trajectory, as well as the interplay of dispositional, genetic, cognitive, neurobiological, and environmental risk factors. In clinical settings, psychiatrists and licensed psychologists typically provide a medical diagnosis of ODD, while in educational contexts, school psychologists, particularly those trained in clinical assessment and diagnostic frameworks, are responsible for evaluating students for special education eligibility under the classification of emotional disability (ED) [2]. This review will provide a comprehensive overview of ODD and present the developmental trajectory of risk and protective factors for youth with ODD. The article will also explore the distinctions between medical and educational diagnoses, with particular attention to the implications of DSM-5-TR criteria and special education law in the United States (IDEIA). The article will examine how comorbid conditions such as ADHD, mood disorders, and conduct disorder complicate both identification and intervention. Additionally, it will highlight how cultural, gender, and socioeconomic factors influence symptom presentation and diagnostic outcomes, and provide a review of effective early intervention and evidence-based treatments, such as Parent-Child Interaction Therapy (PCIT) and Teacher-Child Interaction Training (TCIT), in equipping educators and psychologists to support youth with ODD effectively.

Overview of ODD

Diagnostic Features and Criteria

Oppositional Defiant Disorder (ODD) poses distinct challenges across both healthcare and educational systems. In clinical settings, professionals use standardized diagnostic tools to identify and manage the disorder. In contrast, educators must assess whether a student’s behavioral patterns meet the criteria for special education services. It’s important to distinguish between a clinical diagnosis and an educational classification: the DSM-5-TR provides the framework for diagnosing ODD in medical contexts, while eligibility for school- based support is determined by federal legislation such as the Youth with Disabilities Education Improvement Act (IDEIA) and state- specific guidelines like Indiana’s Article 7. Together, these systems help ensure that children with ODD receive comprehensive support that addresses both their behavioral health and academic needs.

DSM-5-TR

According to DSM-5-TR, ODD is characterized by a persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least six months (APA, 2022). Diagnosis requires the presence of at least four symptoms from these categories, exhibited during interactions with at least one individual who is not a sibling). Regarding angry/irritable mood, an individual may experience symptoms where they often lose their temper, are touchy or easily annoyed, and/or are often angry and resentful. An individual may also experience symptoms of argumentative/defiant behavior where they often argue with authority figures, defy or refuse to comply with requests from authority figures or with rules, deliberately annoy others, and/or often blame others for their mistakes or misbehavior. The individual may have also been spiteful or vindictive at least twice within the past six months. The disturbance in behavior must be negatively impacting their social, educational, occupational, or other important areas of functioning, and the behaviors cannot be better explained by other mental health conditions (e.g., psychotic, substance use, depressive, or bipolar disorder). Finally, the DSM-5-TR includes three specifiers: mild (symptoms are confined to one setting); moderate (symptoms are present in at least two settings); and severe (symptoms are present in three or more settings).

IDEIA and State Laws

Youth with ODD, and disruptive behaviors, are often considered for special education services under the classification of Emotional Disorder (ED). IDEIA, the federal law that governs special education in the United States, broadly defines ED as a condition that exhibits at least one of the provided characteristics for a long period of time and to a marked degree that adversely affects a child’s educational performance [3]. Characteristics include: an inability to learn that cannot be explained by intellectual, sensory, or health factors; an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; inappropriate types of behavior or feelings under normal circumstances; a general pervasive mood of unhappiness or depression; and/or a tendency to develop physical symptoms or fears associated with personal or school problems. While IDEIA provides a general overview of ED, it does not provide guidelines for how to evaluate the category.

Although IDEIA outlines the general criteria for ED, it does not provide detailed procedures for how to assess or determine eligibility. Each state in America is responsible for developing its own evaluation standards. For instance, in the state of Indiana, Article 7 serves as the state’s special education framework and builds upon the federal definition by adding further clarification. Indiana’s criteria include episodes of psychosis and emphasize the need for a comprehensive evaluation process. This process must include assessments of academic achievement and emotional functioning, a thorough developmental and social history, a functional behavior assessment, and relevant medical or psychological information. The goal is to ensure that the student’s learning challenges are not better explained by other factors such as cognitive or sensory impairments [4].

Prevalence

While there are limited population- or national-level data on the prevalence of Oppositional Defiant Disorder (ODD) in the United States, current estimates suggest a prevalence rate of approximately 3.3%, with most community samples ranging from 3% to 6% [5]. This variability may be influenced by differences in diagnostic practices, sample demographics, and access to mental health services across regions. Boys are slightly more likely than girls to develop and be diagnosed with ODD during childhood, possibly due to more overt behavioral symptoms that draw attention in educational and clinical settings. However, research indicates that gender differences in prevalence tend to diminish during adolescence and adulthood, with similar rates observed across sexes. These findings highlight the importance of early identification and culturally sensitive assessment practices to ensure accurate diagnosis and appropriate intervention.

Comorbidity

Youth with ODD are at risk of having internalizing and externalizing comorbidity. Youth with ODD have higher rates of comorbidity with attention deficit hyperactivity disorder (ADHD) and mood and anxiety disorders [6,7]. Youth who develop ODD during childhood and adolescence are at an increased risk for developing conduct disorder (CD) and/or antisocial personality disorder (APD). There is also evidence of comorbidity between posttraumatic stress disorder (PTSD) and ODD [8]. Youth with ODD are also more likely to use tobacco, alcohol, and drugs [9].

Factors Associated with ODD

Cultural Factors

Cultural differences in the diagnosis of Oppositional Defiant Disorder (ODD) may stem from misdiagnosis or overdiagnosis among youth from marginalized backgrounds. African American youth, for example, have been reported to exhibit higher rates of defiant behaviors and conduct problems in some research samples [10,11]. In special education settings, Black males are disproportionately identified as having Emotional Disturbance (ED), often due to elevated reports of behavioral concerns compared to their white peers—even when the actual intensity and frequency of behaviors are similar across racial groups. This overrepresentation may reflect systemic biases in behavioral interpretation and referral practices rather than true differences in symptom severity. As a result, culturally responsive assessment and intervention practices are essential to ensure accurate identification and equitable support for students with behavioral challenges.

Gender Differences

While the prevalence of ODD is similar among boys and girls during adolescence and adulthood, boys and girls may present differently in symptomology, severity, and associated comorbidity [12]. Boys may be found to experience symptoms that include annoying others, blaming others, being aggressive, and they may present with greater functional impairments at school and in the community than girls. Girls may demonstrate less observable oppositional characteristics, including more relational aggression (e.g., refusing to talk to someone, being malicious, avoiding blaming, spreading rumors, attempting to harm someone’s relationships with others, etc.). Additionally, boys may be more likely to have externalizing comorbidity (e.g., ADHD) while girls may be more likely to have internalizing comorbidity due to significantly diminished self-regulation skills compared to boys with ODD (e.g., anxiety, depression, and somatic complaints) [13].

Socioeconomic Differences

Children and adolescents from low-income households are more frequently identified as exhibiting symptoms associated with Oppositional Defiant Disorder (ODD) [14]. Environmental stressors common in economically disadvantaged neighborhoods, such as exposure to community violence, can contribute to the development or intensification of oppositional behaviors. Limited access to mental health resources and safe recreational spaces may further exacerbate these challenges. Additionally, lower levels of parental education are often linked to inconsistent or harsh disciplinary practices, which can influence the emergence of ODD symptoms. Factors such as food insecurity, chronic stress, and reduced access to supportive peer networks also play a role in shaping behavioral outcomes in these populations.

Developmental Pathway of ODD

Overview of Developmental Course

The first symptoms of ODD are typically present as early as preschool but rarely later than early adolescence. If left untreated, the severity of the symptoms could gradually escalate to the development of Conduct Disorder (CD) and even to the severity level of Anti-social Personality Disorder (APD) [15]. A typical developmental progression of disruptive behavior may begin with severe hyperactivity and impulsivity in early childhood, followed by the emergence of ODD symptoms during the preschool years. As the child enters elementary school, these behaviors may intensify and evolve into conduct disorder. During adolescence, the individual may begin to engage in substance- related issues, and if left untreated, these patterns can culminate in antisocial personality disorder in adulthood. Children and adolescents with ODD may experience a variety of problems in adulthood, including relational problems, lower educational attainment, and workplace stress. School psychologists and other providers should be familiar with the risk factors and the developmental trajectory of ODD when evaluating and designing interventions for students with ODD.

Dispositional Risk Factors

Emotional/Temperamental Factors

Numerous emotional risk factors have been associated with the development of ODD. Children who experience difficulties regulating their emotions are more likely to exhibit irritability and vindictiveness [16]. For example, children who have higher levels of emotional reactivity and/or have a low frustration tolerance are at risk for developing ODD. Children and adolescents who have low self-control due to ADHD may also possess issues with emotional regulation making them vulnerable to developing comorbid ODD. Callous-unemotional traits (CU), a cluster of traits of psychopathic youth that include a lack of empathy and indifference toward the feelings of others, have been seen in children and adolescents whose ODD symptoms begin to exacerbate to CD or APD. Youth who have CU traits likely have characteristics of neuroticism that cause them to demonstrate lower levels of fear and anxiety – also increasing the likelihood of their symptoms exacerbating.

Genetic Factors

The heritability estimate for ODD is around 50%. Significant levels of CU traits may be a result of genetic influences (e.g., excess methylation in the OXTR gene predisposes adolescents to CU) [17]. AVPR1A, a gene located on chromosome 2 that plays a significant role in social behavior and interaction, may be associated with aggression in early and middle childhood. Epigenetic research demonstrates that both environmental influences and additive genetic effects, where multiple genes contribute to a single trait, may be involved in the development of Oppositional Defiant Disorder (ODD). Through gene-environment interactions, environmental exposures can either enhance or suppress the expression of genetic predispositions, thereby influencing the likelihood that ODD-related traits will manifest.

Cognitive Vulnerabilities

Youth with ODD may show cognitive deficits in executive functioning (EF) and low verbal intelligence, especially if they possess CU traits. The classification of EF into ‘hot’ and ‘cool’ is a critical element of etiopathological research on externalizing disorders. “Hot” EF involves affective, motivational, and emotional aspects of cognition, whereas “cool” EF focuses on planning, cognitive flexibility, working memory, and inhibition. Children with ODD may have characteristics of greater reward-seeking behaviors and problems with emotional self-control [18]. Regarding “cool” EF, children with ODD have lower behavioral inhibition, which mixed with poor emotional control may exacerbate impulse aggression. School-referred children with disruptive behavior symptoms are associated with poor motivational and cognitive control (also referred to as executive control), and they may be incapable of cognitively processing the negative consequences of their victim’s distress.

Neurobiological Factors

Children with ODD may have neurobiological abnormalities in the amygdala and prefrontal cortex – areas responsible for reasoning, judgment, impulsecontrol, andemotionalprocessing. Morespecifically, reduction in the left amygdala, anterior insula, frontal gyrus, cingulate cortex, and/or medial prefrontal cortex might be associated with ODD. Brain regions such as the amygdala, anterior cingulate cortex, insula, and orbitofrontal cortex are primarily involved in emotional or “hot” executive functions, while the dorsolateral prefrontal cortex and cerebellum are more associated with logical, “cool” executive functions and areas, such as the precuneus, control both types of functioning. Additionally, heart rate, serotonin levels, and basal cortisol levels are often reduced in adolescents with aggressive behaviors.

Environmental Risk Factors

Familial Factors

A variety of family risk factors, including low socioeconomic status (SES), parental separation, and maternal depression, have been associated with the development of ODD. Aside from parental pathology, other family factors that could lead to symptoms of childhood/adolescent-onset of ODD include exposure to poor disciplinary practices (e.g., forms of hostility or aggression), maltreatment and neglect (e.g., sexual, physical, or psychological abuse), single parenthood, and family disharmony (e.g., argumentative parents). A combination of surrounding oneself with deviant peers and having poor parental supervision with low involvement are predictors for adolescents to engage in rebellious and/or defiant behaviors. Children who are exposed to high levels of dysfunctional parenting and maternal depression are also at a higher risk of developing symptoms of defiant and antisocial behaviors. Finally, children who are frequently emotionally dysregulated are at risk of experiencing higher child-parent conflict that could enhance ODD symptomology.

Interpersonal Vulnerabilities

Children and adolescents often face a range of interpersonal challenges, particularly when it comes to initiating and sustaining positive relationships with peers. Those who are consistently rejected by their peers—such as being disliked or excluded—and those who associate with deviant or antisocial peer groups are at increased risk for developing oppositional defiant disorder (ODD). In some cases, youth with ODD may engage in bullying behaviors themselves, contributing to a hostile social environment. However, these individuals may also be targets of bullying, which can intensify symptoms of vindictiveness, especially when they feel compelled to retaliate against those who have harmed them. This cycle of aggression and retaliation can further complicate their social interactions and emotional regulation, reinforcing the behavioral patterns associated with ODD.

Early Adverse Experience

There is a relationship between childhood externalizing problems, including ODD, and exposure to traumatic events. Interpersonal trauma, referring to harmful experiences directly inflicted by another person (e.g., physical abuse, emotional neglect, witnessing domestic violence, etc.), and non-interpersonal trauma, referring to events not involving direct human interaction (e.g., severe accident, natural disaster, loss of a loved one, etc.), are predictive of ODD symptomology in boys, while only interpersonal trauma is a predictor in girls. Children who experience interpersonal trauma are more likely to develop problems with anger, emotional regulation, and disruptive behavior. Children and adolescents who are exposed to community violence in impoverished neighborhoods have an increased risk of developing antisocial attitudes and behaviors.

Protective Factors

There are a variety of protective factors that reduce the likelihood of developing or worsening symptoms of Oppositional Defiant Disorder (ODD). Early intervention is especially important, as it can prevent ODD symptoms from escalating into more severe conditions such as Conduct Disorder (CD) or Antisocial Personality Disorder (APD). One key protective factor is the presence of high-quality relationships, both within the family and among peers. These relationships are often supported by living in safe neighborhoods, having strong family support systems, and being surrounded by prosocial peers who model positive behavior. Additionally, strong executive functioning and emotional regulation skills serve as internal protective mechanisms that help children manage impulses and navigate social challenges more effectively.

Treatment of ODD

Clinical Treatment

Because parental factors are highly associated with ODD, clinical treatments should consider strengthening the relationships between caregivers and their children. Parent-Child Interaction Therapy (PCIT) is an evidence-based therapeutic technique originally developed for children with disruptive behaviors that focuses on strengthening familial relationships by altering parent-child interactions [19]. PCIT involves having a parent and child together in a playroom while a therapist remains on the other side of a one-sided mirror where they coach the parent (by talking to them through a headset of some form) on how to positively interact and build a healthy rapport with their child. This verbal rapport is typically developed through praise, positive reinforcement, and overall parental involvement by the parent. If implemented with fidelity, PCIT is an effective treatment for decreasing ODD symptoms and preventing the development of CD by helping parents quit certain behaviors (e.g., unhealthy discipline responses) while starting other behaviors (e.g., more parental involvement) [20].

School Intervention

Similarly, school psychologists who possess the appropriate training should consider facilitating Teacher-Child Interaction Training (TCIT) with the teacher and student. In general, TCIT is a “classroom-based program designed to provide teachers with behavior management skills that foster positive teacher-student relations and to improve student behavior by creating a more constructive classroom environment” [21]. In general, there are teaching sessions that encompass learning about positive reinforcement through praise, modeling, and various classroom management strategies to decrease disruptive behaviors [22,23]. These sessions typically involve the clinician, teacher, and child, and it may also require the teacher to practice their skills in small and large group settings.

Conclusion

This review article explored Oppositional Defiant Disorder (ODD) in youth, emphasizing its diagnostic criteria, prevalence, developmental trajectory, and associated risk and protective factors. The article distinguishes between clinical and educational diagnoses in the United States, highlighting the roles of DSM-5- TR and IDEIA in shaping assessment and intervention practices. It identifies a range of dispositional, genetic, cognitive, neurobiological, and environmental risk factors that contribute to the onset and progression of ODD, while also underscoring the importance of early intervention and facilitating strong interpersonal relationships as protective mechanisms. Evidence-based treatments such as Parent- Child Interaction Therapy (PCIT) and Teacher-Child Interaction Training (TCIT) are presented as effective strategies for managing symptoms and preventing escalation into more severe disorders like Conduct Disorder (CD) or Antisocial Personality Disorder (APD). Psychologists, therapists, and educators should possess a deep understanding of the psychopathology underlying Oppositional Defiant Disorder (ODD) and be equipped with evidence-based strategies to support affected students. This includes conducting informed evaluations, implementing targeted interventions, and fostering collaborative efforts among school staff and families to address behavioral and emotional challenges effectively.

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