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

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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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Cortisol Awakening Response Prospectively Predicts Peritraumatic and Acute Stress Reactions in Police Officers
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“However, correlational behavioral research implicates a variety of factors, including personality traits [4,5] as well as interaction of genetic factors and experiential factors, such as reduced functioning polymorphisms in the serotonin transporter (5HTTLPR), and life stress or social support at the time of stress [6…”
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“Consequently, it is not surprising that studies indicate that PTSD normally occurs in conjunction with psychopathology (Alexander & Klein, 2001; Bennett et al., 2004; Heinrichs et al., 2005), considering that negative cognitions related to self and negative representations about the world are present in distinct disor…”
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Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers
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“…professionals involved in critical incidents seem to be underrepresented in current research, as only three studies were found to be devoted to this particular area: one examined fire fighters (Heinrichs et al., 2005) and two others focused on police officers (Marmar, 2006; Mc Caslin et al., 2006).”
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“In a 2-year, prospective, follow-up study of firefighters, a low level of pretraumatic self-efficacy significantly predicted the development of PTSD symptoms (Heinrichs et al., 2005).”
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Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: A neglected problem
Kang, P., Lv, Y., Hao, L., Tang, B., Liu, Z., Liu, X., Liu, Y., & Zhang, L. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.09.047 · Cited by 55
“This retrospective study clearly showed that the prevalence of PTSD in general is 21.8%, echoing previous research that found the incidence of PTSD in rescue workers ranges from 13% to 30% (McFarlane, 1989; Dolce and Ricciardi, 2002; Heinrichs et al., 2005).”
BackgroundResultInfluential
Traumatic event exposure and depression severity over time: results from a prospective cohort study in an urban area
Tracy, M., Morgenstern, H., Zivin, K., Aiello, A. E., & Galea, S. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0884-2 · Cited by 57
“The relatively small number of studies that have used pre-trauma measures of mental health when assessing changes in depressive symptoms after prospectively measured traumatic event exposure have largely been restricted to specific subgroups, like first responders [30, 36], or have focused only on isolated traumatic e…”
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The effectiveness of Narrative Exposure Therapy with traumatised firefighters in Saudi Arabia: A randomized controlled study
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A Comparative Study on Alexithymia in Depressive, Somatoform, Anxiety, and Psychotic Disorders among Koreans
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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: Heinrichs, Markus
Soravia, Leila M.
Hellhammer, Dirk H.
Ehlert, Ulrike
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Predicting Posttraumatic Stress Symptoms From Pretraumatic Risk Factors: A 2-Year Prospective Follow-Up Study in Firefighters

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