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Cited by 338Posttraumatic Stress Disorder ResearchOccupational Health and PerformanceStress Responses and Cortisol

Predicting posttraumatic stress symptoms from pretraumatic risk factors: A 2-year prospective follow-up study in firefighters

Heinrichs, Markus, Wagner, Dieter, Schoch, Walter, Soravia, Leila M., Hellhammer, Dirk H., Ehlert, Ulrike·2005·American Journal of Psychiatry
DOI 10.1176/appi.ajp.162.12.2276
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Abstract

OBJECTIVE: Most studies focusing on risk factors for posttraumatic stress disorder (PTSD) have used retrospective study designs. Only a small number of studies have prospectively examined risk factors in the immediate aftermath of trauma exposure in predicting PTSD symptoms. The purpose of this study was to identify predictive risk factors for posttraumatic stress symptoms and comorbid psychopathological symptoms present during the time before exposure to traumatic stress in a high-risk population. METHOD: Forty-three professional firefighters were assessed immediately after basic training (baseline) and at 6, 9, 12, and 24 months after entry into firefighter service. Subjects were screened for psychopathological symptoms, including symptoms of PTSD, depression, and anxiety. Subjects were also characterized with regard to personality traits such as self-efficacy, hostility, and alexithymia. Neuroendocrine activity was assessed by examination of awakening and diurnal salivary cortisol profiles and 24-hour urinary catecholamine excretion. Multiple linear regression analysis was used to analyze posttraumatic stress symptoms at 24-month follow-up as a function of pretraumatic characteristics. RESULTS: A high level of hostility and a low level of self-efficacy at baseline accounted for 42% of the variance in posttraumatic stress symptoms after 2 years. Subjects who had both risk factors at baseline showed a significant increase in measures of PTSD symptoms, depression, anxiety, general psychological morbidity, global symptom severity, and alexithymia during the 2-year period. Biological characteristics were not predictive of the development of psychopathological symptoms. CONCLUSIONS: These results suggest that specific personality traits may constitute markers of vulnerability to the development of psychopathological symptoms after trauma exposure. Early identification of preexisting risk factors is needed to provide effective prevention and intervention for individuals who are at risk of developing trauma-related disorders.

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  • Specific studies have estimated the rate of PTSD symptoms to affect approximately 17% of Canadian firefighters, 18% of German firefighters, and 22% of American firefighters.

    “Specific studies have estimated the rate of PTSD symptoms to affect approximately 17% of Canadian firefighters [29], 18% of German firefighters [64], and 22% of American firefighters [29].”

    From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [64]

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Authors
Heinrichs, M., Wagner, D., Schoch, W., Soravia, L. M., Hellhammer, D. H., & Ehlert, U.
Affiliations
University of Zurich (CH)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2005-12-01
Volume
162
Issue
12
Pages
2276-2286
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.162.12.2276
OpenAlex
W2153934273
Cited by
337
References
93
Citations by year
2026: 8 · 2025: 8 · 2024: 8 · 2023: 10 · 2022: 15 · 2021: 8 · 2020: 21 · 2019: 17 · 2018: 17 · 2017: 26 · 2016: 18 · 2015: 23 · 2014: 22 · 2013: 14 · 2012: 31
FWCI
14.65
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
post-traumatic stress disorder, firefighters, hostility, self-efficacy, alexithymia, depression, anxiety, personality traits, trauma exposure, vulnerability indicators, salivary cortisol, urinary catecholamines, occupational stress
MeSH terms
Adult, Affective Symptoms, Mental Disorders, Circadian Rhythm, Cortisone, Fires, Follow-Up Studies, Health Status, Hostility, Humans, Life Change Events, Longitudinal Studies, Male, Occupational Diseases, Personality Assessment, Prospective Studies, Psychiatric Status Rating Scales, Surveys and Questionnaires, Risk Factors, Saliva, Stress Disorders, Post-Traumatic, Risk Assessment, Self Efficacy, Stress Disorders, Traumatic, Acute

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