The DOI matches its Crossref record; 95 of the 95 references it cites were found in a registry or an index.
Predicting Posttraumatic Stress Symptoms From Pretraumatic Risk Factors: A 2-Year Prospective Follow-Up Study in Firefighters
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 [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]
Citations
Cites
Self-efficacy: The exercise of control
Bandura, A., Freeman, W. H., & Lightsey, R. (1999) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.13.2.158 · Cited by 46,835
Posttraumatic Stress Disorder in the National Comorbidity Survey
Kessler, R. C. (1995) · Archives of General Psychiatry · doi:10.1001/archpsyc.1995.03950240066012 · Cited by 10,379
A self-rating depression scale
ZUNG, W. W. K. (1965) · Archives of General Psychiatry · doi:10.1001/archpsyc.1965.01720310065008 · Cited by 9,813
A scaled version of the General Health Questionnaire
Goldberg, D. P., & Hillier, V. F. (1979) · Psychological Medicine · doi:10.1017/s0033291700021644 · Cited by 5,637
Bagby, R. M., Parker, J. D. A., & Taylor, G. J. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90005-1 · Cited by 5,293
Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults
Brewin, C. R., Andrews, B., & Valentine, J. D. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.748 · Cited by 5,243
Reliability and validity of a brief instrument for assessing post-traumatic stress disorder
Foa, E. B., Riggs, D. S., Dancu, C. V., & Rothbaum, B. O. (1993) · Journal of Traumatic Stress · doi:10.1002/jts.2490060405 · Cited by 2,537
The twenty-item Toronto Alexithymia scale—II. Convergent, discriminant, and concurrent validity
Bagby, R. M., Taylor, G. J., & Parker, J. D. A. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90006-x · Cited by 2,431
Trauma and Posttraumatic Stress Disorder in the Community: The 1996 Detroit Area Survey of Trauma
Breslau, N., Kessler, R. C., Chilcoat, H. D., Schultz, L. R., Davis, G. C., & Andreski, P. (1998) · Archives of General Psychiatry · doi:10.1001/archpsyc.55.7.626 · Cited by 2,407
Salivary cortisol in psychoneuroendocrine research: recent developments and applications
Kirschbaum, C., & Hellhammer, D. H. (1994) · Psychoneuroendocrinology · doi:10.1016/0306-4530(94)90013-2 · Cited by 2,107
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Cited by
Sorted by citations
Items 301–338 of 338
The Experiences of Rural Volunteer Firefighters: a Mixed-Methods Approach.
Jones, S. K. (2016) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r39b1g
“…& McLeight, 2009), motivations (McLennan & Birch, 2008; Thompson & Bono, 1993), and psychological health outcomes (Bryant & Harvey, 1996; Heinrichs et al., 2005; Regehr, Hill, & Glancy, 2000) but fails to distinguish between volunteer and career roles as well as differences in the…”
BackgroundMENTAL HEALTH PERCEPTIONS OF RURAL COMMUNITY MEMBERS AND FIREFIGHTING PERSONNEL AFTER A WILDFIRE
Kimmel, A. (2012) · Open ULeth Scholarship (OPUS) (University of Lethbridge)
Garside, R., Näswall, K., Johal, S., & Johnston, D. M. (2013) · UC Research Repository (University of Canterbury)
Factors Affecting Burnout among Coast Guard of West Regional Headquarters in Korea
Yeom, E.-J., & Cho, S. (2017) · Korean Journal of Stress Research · doi:10.17547/kjsr.2017.25.4.220
An investigation of the rescue personality in firefighter recruits.
Fraess‐Phillips, A. (2014) · doi:10.24124/2014/bpgub984
“self-efficacy benefited from a protective effect against posttraumatic symptomology (Heinrichs et al., 2005).”
BackgroundInfluentialHeiberg, F. (2017) · UpSpace Institutional Repository (University of Pretoria)
Memory Disturbances in Schizophrenia and Post‐traumatic Stress Disorder
Galletly, C. A., & McFarlane, S. (2018) · Wiley eBooks · doi:10.1002/9781118585948.ch17
Posttraumatic Stress Disorder Risk and Chronic Course Factors: a Review of Current Findings
Čuržik, D. (2019) · Socijalna psihijatrija · doi:10.24869/spsih.2019.51
“Prema biološkim teorijama, trauma oštećuje noradrenergički sustav pri čemu povišene koncentracije noradrenalina uzrokuju da se osoba lakše prestraši i snažnije izražava emocije nego što bi to inače bilo normalno što podržavaju i empirijski nalazi (98,99).”
Background都市部男性消防職員のバーンアウト(燃えつき)に影響を及ぼす仕事ストレッサーについて
KAMIYAMA, M., 岡本, 博., 貴子, 和., & 照屋, 浩. (2019) · 杏林医学会雑誌 · doi:10.11434/kyorinmed.50.145
Predictors of post-traumatic stress symptoms after a motor vehicle accident
Meagher, B. (2006) · FedUni ResearchOnline (Federation University Australia)
La Personalidad de los Rescatistas: Una Comparación entre Rescatistas Novatos y Experimentados
Grinhauz, A. S., Azzara, S. H., & Azzollini, S. (2022) · Revista Iberoamericana ConCiencia. · doi:10.32654/concienciaepg.7-1.10
Akute und posttraumatische Belastungsstörung
Kapfhammer, H. (2016) · Springer eBooks · doi:10.1007/978-3-642-45028-0_71-1 · Cited by 1
Verhaltensmedizinische Grundlagen
Ehlert, U. (2020) · Springer eBooks · doi:10.1007/978-3-662-61814-1_10
Self-citation(2012) · Vandenhoeck & Ruprecht eBooks · doi:10.13109/9783666402074.288
(2016) · Vandenhoeck & Ruprecht eBooks · doi:10.13109/9783666401985.298
Verhaltensmedizinische Grundlagen
Ehlert, U. (2006) · Springer eBooks · doi:10.1007/978-3-540-28511-3_10
Self-citationAn Assessment of Resilience and Wellness of the Canadian Rangers
Ghazal, S. (2022) · Carleton University's Institutional Repository (MacOdrum Library, Carleton University) · doi:10.22215/etd/2022-14980
Wall, E. (2012) · UST Research Online (University of St. Thomas - Minnesota)
Stress and Resilience in the (Post-)pandemic World: Psychobiological Considerations
Ehlert, U. (2023) · Springer eBooks · doi:10.1007/978-3-031-43748-9_8 · Cited by 1
Self-citationInvestigation of stress symptoms and interventions in firefighters
Lorensen, T. (2024) · Queensland University of Technology · doi:10.5204/thesis.eprints.248234
Weathers-Meyer, A., Lowe, A. C., McGrew, S. J., Sutherland, N. E., Yann, C. M. G., Beyl, R. A., & Vujanovic, A. A. (2024) · Mindfulness · doi:10.1007/s12671-024-02419-1
“The STAI has been used in previous research to examine trait anxiety among firefighters (e.g., Guthrie & Bryant, 2005; Heinrichs et al., 2005; Wróbel-Knybel et al., 2021) and its psychometric properties have been well established (Barnes et al., 2002; Ortuño-Sierra et al., 2016).”
Suicidality in Emergency Professionals: A Systematic Review
Chambel, M. J., Carmona, L., Carvalho, V. S., & Gascón, S. (2025) · Springer eBooks · doi:10.1007/978-981-96-1403-5_14
Reducing Inoperative Days of Soldiers Under Stress: A Novel ApproachPreprint
Kirk, N. H., & Arbanasić, K. (2017) · doi:10.31234/osf.io/zv9qr_v1
Mustard, C., Dobson, K. G., Chien, Y.-C., Wodchis, W. P., & Smith, P. M. (2025) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-025-10337-9
Leadership and well-being among emergency professionals: A systematic literature review
Carmona, L., Pinheiro, R. S. A., & Chambel, M. J. (2025) · Journal of Emergency Management · doi:10.5055/jem.0924
Sarabia, J., Rojas, F. A., & Kieninger, K. (2025) · International Journal of Workplace Health Management · doi:10.1108/ijwhm-08-2024-0160 · Cited by 2
Anger in PTSD: A comparison of French military and civilian samples
Marmuse, A., Martin, S., & Trousselard, M. (2026) · European Journal of Trauma & Dissociation · doi:10.1016/j.ejtd.2026.100665
White, N. C., & Wagner, S. L. (2026) · American Journal of Industrial Medicine · doi:10.1002/ajim.70073
Zou, J., Liu, W.-Z., Li, Y.-Q., Li, Y.-Y., You, W.-J., Pan, H., Wang, C.-Y., Zhang, W., & Pan, B. (2026) · Nature Communications · doi:10.1038/s41467-026-71129-0
Caring for Refugees and Migrants: Volunteer and Professional Aid Workers
Jachmann, A., & Wahedi, K. (2026) · Sustainable development goals series · doi:10.1007/978-3-032-20707-4_9
Mental Health Risks for Journalists Covering Suicide in Times of Crisis
Korbiel, I. (2026) · Journalism and Media · doi:10.3390/journalmedia7020126
“…the nature of the incident, particularly cases involving deliberate human violence or harm to children, the duration of exposure, such as prolonged on-site reporting or continuous live coverage, and the cumulative frequency of traumatic encounters over time (McCammon, 1996; Heinrichs et al., 2005).”
German Adaptation and Validation of the Firefighter Coping Self‐Efficacy Scale
Görlich, Y., & Mitterer, D. (2026) · Mental Health Science · doi:10.1002/mhs2.70047
Azık, D. (2026) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1959216
Pre-traumatic Factors of Career-Related PTSD: A Systematic Review of the Literature
Curtis, M. G., & Hurlburt, R. T. (2014) · Digital Scholarship - UNLV (University of Nevada Reno)
Predicting Postraumatic Stress Disorder in Single-Incident Trauma Survivors with an Acute Injury
Hunt, J. C. (2015) · UWM Digital Commons (University of Wisconsin–Milwaukee)
Metadata
- Authors
- Heinrichs, M., Wagner, D., Schoch, W., Soravia, L. M., Hellhammer, D. H., & Ehlert, U.
- Affiliations
- University of Zurich (CH)
- Venue
- American Journal of Psychiatry
- Published
- 2005-12-01
- Volume
- 162
- Issue
- 12
- Pages
- 2276-2286
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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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