Family psychiatric history, peritraumatic reactivity, and posttraumatic stress symptoms: a prospective study of police.
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.
Inslicht
Sabra S
SS
San Francisco VA Medical Center, San Francisco, CA 94121, USA. Sabra.Inslicht@ucsf.edu
McCaslin
Shannon E
SE
Metzler
Thomas J
TJ
Henn-Haase
Clare
C
Hart
Stacey L
SL
Maguen
Shira
S
Neylan
Thomas C
TC
Marmar
Charles R
CR
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
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