Article

Maladaptive Appraisals as a Risk Factor for Posttraumatic Stress: A Study of Trainee Firefighters

School of Psychology, University of New South Wales, Sydney, Australia.
Psychological Science (Impact Factor: 4.43). 11/2005; 16(10):749-52. DOI: 10.1111/j.1467-9280.2005.01608.x
Source: PubMed

ABSTRACT

This study tested the proposal that catastrophic appraisals are a risk factor for developing stress reactions after trauma. Trainee firefighters (N = 82) were assessed during training (and before trauma exposure), and 68 firefighters were subsequently reassessed 6 months after commencing firefighter duty (after trauma exposure). Initial assessment included the Clinician Administered PTSD Scale, the Traumatic Events Questionnaire, and the Posttraumatic Cognitions Inventory. The Clinician Administered PTSD Scale was again administered approximately 20 months after initial assessment and after trauma exposure. Posttraumatic stress at follow-up was predicted by pre*trauma catastrophic thinking (24% of variance). These findings accord with cognitive models predicting that a tendency to catastrophize about negative events is a risk factor for developing posttraumatic stress symptoms.

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    • "The vast majority of studies in children and adolescents have focused on single-incident trauma (most commonly motor vehicle and other accidents), with fewer investigations of longer-term exposures, for example to sexual or physical abuse. Events that affect large groups, like natural disasters or war, may be appraised differently than those affecting individuals ; intentional acts of interpersonal violence may be interpreted more negatively than natural disasters or accidents (Bryant and Guthrie 2005; Meiser-Stedman et al. 2009b; Trickey et al. 2012). To our knowledge, only a handful of studies, in adults, have directly compared the effects of different types of trauma on either negative appraisals or psychopathological outcomes. "
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    ABSTRACT: The cognitive model posits that negative appraisals play an important role in posttraumatic stress disorder, in children as well as in adults. This study examined correlates of negative appraisals in relation to trauma exposure and their relationship to posttraumatic stress symptoms (PTSS) in 414 Sri Lankan adolescents, aged 12 to 16, living in areas impacted in varying degrees by the 2004 tsunami. In 2008, participants completed measures of negative appraisals, lifetime traumatic events, posttraumatic stress symptoms, internalizing symptoms, ongoing adversity, and social support. The majority (70 %) of the participants reported multiple traumatic events; 25 % met DSM-IV criteria for full or partial PTSD. Adolescents who had experienced more severe events, abusive events, greater cumulative trauma, or greater current adversity reported more negative appraisals. In regression analyses controlling for known risk factors such as female gender, cumulative trauma, ongoing adversity, and low social support, negative appraisals were the best predictor of PTSS, explaining 22 % of the variance. This relationship appeared specific to PTSS, as negative appraisals did not predict internalizing symptoms. Findings confirm the link between negative cognitions concerning traumatic events and persistent PTSS in adolescents, but longitudinal studies are needed to determine whether appraisals contribute to symptom maintenance over time.
    Full-text · Article · Feb 2015 · Journal of Abnormal Child Psychology
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    • "These three types of cognitions are believed to be maladaptive interpretations of trauma experiences leading to the maintenance of PTSD. The PTCI has been shown to be related to PTSD symptoms (Bryant & Guthrie, 2005; Foa et al., 1999) and predicts persistence of symptoms over time (O'Donnell, Eliot, Wolfgang, & Creamer, 2007). In addition, prolonged exposure therapies have been shown to result in reductions in posttraumatic cognitions, which in turn are related to subsequent reductions in PTSD symptoms (Foa & Rauch, 2004). "
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    ABSTRACT: Researchers have been investigating possible pathways to negative (posttraumatic stress disorder [PTSD]) and positive (posttraumatic growth [PTG]) reactions to trauma in recent decades. Two cognitive constructs, event centrality and posttraumatic cognitions, have been implicated to uniquely predict PTSD symptoms in an undergraduate sample. The current pair of studies attempted to (a) replicate this finding in an undergraduate sample, (b) replicate this finding in a treatment-seeking sample, and (c) explore whether these 2 cognitive constructs uniquely predict PTG. The first study consisted of 500 undergraduate students, whereas the second study consisted of 53 treatment-seeking clients. Results indicated both posttraumatic cognitions and event centrality uniquely predicted PTSD in the undergraduate (R(2) = .46) and treatment-seeking samples (R(2) = .46). These 2 cognitive constructs also predicted PTG in the undergraduate sample (R(2) = .37), but only posttraumatic cognitions predicted PTG in the treatment-seeking sample (R(2) = .17). The relationships between PTG varied, depending on whether PTG for high or low event-centrality events were assessed. The original model was supported within both populations for PTSD symptoms, and its extension to PTG was supported within the treatment-seeking sample. These results underscore cognitive and narrative factors in the progression of trauma.
    Full-text · Article · Dec 2013 · Journal of Traumatic Stress
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    • "Another study in 47 probationary male firefighters found 16.3% met PTSD criteria after 2 years as a firefighter, compared with 0% PTSD prevalence after completing initial training (Heinrichs et al., 2005). These prospective studies allowed identification of pre-exposure risk factors for post-traumatic stress, such as increased arousal (Guthrie & Bryant, 2005), negative selfappraisals (Bryant & Guthrie, 2007), high hostility (Heinrichs et al., 2005) and low selfefficacy (Heinrichs et al., 2005). "
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    ABSTRACT: This study compared psychological distress and coping strategies for three different permanent firefighter groups in South-East Queensland, Australia: recruits (n = 42), on-shift firefighters (n = 51), and firefighters who had recently attended one of 13 fatal incidents (n = 52). Older firefighters reported more general distress but no increase in posttraumatic stress symptoms. Coping strategies tended to be associated with higher distress and posttraumatic stress, but once this general tendency was taken into account, seeking instrumental support was associated with lower posttraumatic stress symptoms. Results support previous findings that cumulative exposure and events outside work contribute to distress in firefighters.
    Full-text · Article · Nov 2010 · Journal of Loss and Trauma
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