title: Predictors of posttraumatic stress in police and other first responders.
abstract: We provide an overview of previous research conducted by our group on risk and resilience factors for PTSD symptoms in police and other first responders. Based on our work, the findings of other investigators on individual differences in risk for PTSD, and drawing on preclinical studies fear conditioning and extinction, we propose a conceptual model for the development of PTSD symptoms emphasizing the role of vulnerability and resilience to peritraumatic panic reactions. We tested this conceptual model in a cross-sectional sample of police officers (n = 715). Utilizing an hierarchical linear regression model we were able to explain 39.7% of the variance in PTSD symptoms. Five variables remained significant in the final model; greater peritraumatic distress (beta = 0.240, P < .001), greater peritraumatic dissociation (beta = 0.174, P < .001), greater problem-solving coping (beta = 0.103, P < .01), greater routine work environment stress (beta = 0.182, P < .001), and lower levels of social support (beta = -0.246, P < .001). These results were largely consistent with the proposed conceptual model. Next steps in this line of research will be to test this model prospectively in a sample of 400 police academy recruits assessed during training and currently being followed for the first 2 years of police service.
authors.affiliation: San Francisco Veterans Affairs Medical Center, 4150 Clement St. (116 P), San Francisco, CA 94121, USA. Charles.marmar@med.va.gov
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
authors.forename: Shannon E
authors.initials: SE
authors.lastname: McCaslin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Metzler
authors.forename: Suzanne
authors.initials: S
authors.lastname: Best
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Weiss
authors.forename: Jeffery
authors.initials: J
authors.lastname: Fagan
authors.forename: Akiva
authors.initials: A
authors.lastname: Liberman
authors.forename: Nnamdi
authors.initials: N
authors.lastname: Pole
authors.forename: Christian
authors.initials: C
authors.lastname: Otte
authors.forename: Rachel
authors.initials: R
authors.lastname: Yehuda
authors.forename: David
authors.initials: D
authors.lastname: Mohr
authors.forename: Thomas
authors.initials: T
authors.lastname: Neylan
mesh_terms: D003625:Data Collection; D004190:Disasters; D006801:Humans; D007206:Individuality; D008960:Models, Psychological; D016495:Police; D011237:Predictive Value of Tests; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*