title: Family psychiatric history, peritraumatic reactivity, and posttraumatic stress symptoms: a prospective study of police.
abstract: BACKGROUND
  Family history of psychiatric and substance use disorders has been associated with posttraumatic stress disorder (PTSD) in cross-sectional studies.
  
  
  METHODS
  Using a prospective design, we examined the relationships of family history of psychiatric and substance use disorders to posttraumatic stress symptoms in 278 healthy police recruits. During academy training, recruits were interviewed on family and personal psychopathology, prior cumulative civilian trauma exposure, and completed self-report questionnaires on nonspecific symptoms of distress and alcohol use. Twelve months after commencement of active duty, participants completed questionnaires on critical incident exposure over the previous year, peritraumatic distress to the worst critical incident during this time, and posttraumatic stress symptoms.
  
  
  RESULTS
  A path model indicated: (1) family loading for mood and anxiety disorders had an indirect effect on posttraumatic stress symptoms at 12 months that was mediated through peritraumatic distress to the officer's self-identified worst critical incident, (2) family loading for substance use disorders also predicted posttraumatic stress symptoms at 12 months and this relationship was mediated through peritraumatic distress.
  
  
  CONCLUSIONS
  These findings support a model in which family histories of psychopathology and substance abuse are pre-existing vulnerability factors for experiencing greater peritraumatic distress to critical incident exposure which, in turn, increases the risk for development of symptoms of posttraumatic stress disorder. Replication in other first responders, military and civilians will be important to determine generalizability of these findings.
authors.affiliation: San Francisco VA Medical Center, San Francisco, CA 94121, USA. Sabra.Inslicht@ucsf.edu
authors.forename: Sabra S
authors.initials: SS
authors.lastname: Inslicht
authors.forename: Shannon E
authors.initials: SE
authors.lastname: McCaslin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Metzler
authors.forename: Clare
authors.initials: C
authors.lastname: Henn-Haase
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Hart
authors.forename: Shira
authors.initials: S
authors.lastname: Maguen
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
mesh_terms: D000328:Adult; D015897:Comorbidity; D004198:Disease Susceptibility; D005192:Family Health; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010555:Personality Inventory; D016495:Police; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D019966:Substance-Related Disorders / Q000523:psychology*; D055815:Young Adult
references.citation: J Nerv Ment Dis. 1989 Mar;177(3):147-53
references.pmid: 2918298
references.citation: Twin Res. 2003 Jun;6(3):218-26
references.pmid: 12855071
references.citation: Biol Psychiatry. 1999 May 15;45(10):1259-70
references.pmid: 10349032
references.citation: Drug Alcohol Depend. 2000 Dec 22;61(1):95-102
references.pmid: 11064187
references.citation: Am J Psychiatry. 2001 Sep;158(9):1480-5
references.pmid: 11532735
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2009 Jan 5;150B(1):41-9
references.pmid: 18449865
references.citation: Am J Psychiatry. 2002 Oct;159(10):1675-81
references.pmid: 12359672
references.citation: Monogr Soc Res Child Dev. 1994;59(2-3):3-6
references.pmid: 7984166
references.citation: J Nerv Ment Dis. 2002 Apr;190(4):209-18
references.pmid: 11960081
references.citation: Psychiatry Res. 2001 Sep 20;103(2-3):133-45
references.pmid: 11549402
references.citation: Monogr Soc Res Child Dev. 1994;59(2-3):73-100
references.pmid: 7984169
references.citation: Arch Gen Psychiatry. 1995 Dec;52(12):1048-60
references.pmid: 7492257
references.citation: J Psychiatr Res. 2001 Sep-Oct;35(5):261-70
references.pmid: 11591428
references.citation: JAMA. 2008 Mar 19;299(11):1291-305
references.pmid: 18349090
references.citation: Biol Psychiatry. 2005 Jan 1;57(1):27-32
references.pmid: 15607297
references.citation: Acta Psychiatr Scand. 1996 Feb;93(2):105-12
references.pmid: 8686479
references.citation: J Consult Clin Psychol. 2000 Apr;68(2):290-5
references.pmid: 10780129
references.citation: Ann N Y Acad Sci. 2006 Jul;1071:255-66
references.pmid: 16891576
references.citation: J Trauma Stress. 2001 Apr;14(2):259-75
references.pmid: 11469155
references.citation: Curr Psychiatry Rep. 2002 Aug;4(4):254-63
references.pmid: 12126593
references.citation: Nat Neurosci. 2005 Jun;8(6):828-34
references.pmid: 15880108
references.citation: Arch Gen Psychiatry. 2000 Jul;57(7):675-82
references.pmid: 10891038
references.citation: Science. 2002 Jul 19;297(5580):400-3
references.pmid: 12130784
references.citation: Am J Psychiatry. 1971 Jun;127(12):1653-8
references.pmid: 5565851
references.citation: Clin Psychol Rev. 2002 Mar;22(2):163-88
references.pmid: 11806018
references.citation: J Trauma Stress. 1996 Jan;9(1):63-85
references.pmid: 8750452
references.citation: J Affect Disord. 2009 Nov;118(1-3):166-72
references.pmid: 19230982
references.citation: J Clin Psychiatry. 2001;62 Suppl 17:47-54
references.pmid: 11495097
references.citation: J Behav Health Serv Res. 2005 Apr-Jun;32(2):113-27
references.pmid: 15834262
references.citation: Behav Res Ther. 1996 Aug;34(8):669-73
references.pmid: 8870294
references.citation: Compr Psychiatry. 2004 Mar-Apr;45(2):77-82
references.pmid: 14999656
references.citation: Ann N Y Acad Sci. 2006 Jul;1071:1-18
references.pmid: 16891557
references.citation: J Clin Psychiatry. 2001 Sep;62(9):715-20
references.pmid: 11681768
references.citation: Psychol Bull. 1985 Sep;98(2):310-57
references.pmid: 3901065
references.citation: Arch Gen Psychiatry. 1993 Apr;50(4):257-64
references.pmid: 8466386
references.citation: Dev Psychopathol. 1998 Fall;10(4):793-809
references.pmid: 9886227
references.citation: J Am Acad Child Adolesc Psychiatry. 2007 Feb;46(2):197-204
references.pmid: 17242623
references.citation: J Psychiatr Res. 1998 Sep-Oct;32(5):301-9
references.pmid: 9789209
references.citation: Alcohol Clin Exp Res. 2001 May;25(5):661-6
references.pmid: 11371714
references.citation: Psychol Med. 2007 Feb;37(2):181-92
references.pmid: 17052377
references.citation: Am J Psychiatry. 1999 Jan;156(1):34-40
references.pmid: 9892295
references.citation: Psychol Bull. 1996 Jul;120(1):83-112
references.pmid: 8711018
references.citation: J Trauma Stress. 2003 Oct;16(5):495-502
references.pmid: 14584634
references.citation: Mol Psychiatry. 2005 Dec;10(12):1058-9
references.pmid: 16088328
references.citation: J Nerv Ment Dis. 2006 Aug;194(8):591-7
references.pmid: 16909067
references.citation: Psychol Bull. 2003 Jan;129(1):52-73
references.pmid: 12555794
references.citation: Psychol Med. 1991 Aug;21(3):713-21
references.pmid: 1946860
references.citation: Am J Psychiatry. 2001 Aug;158(8):1184-90
references.pmid: 11481147
references.citation: J Abnorm Psychol. 2007 May;116(2):352-61
references.pmid: 17516767
references.citation: Dev Psychopathol. 2001 Summer;13(3):733-53
references.pmid: 11523857