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J Affect Disord. 2014 Jun;162:128-33. doi: 10.1016/j.jad.2014.02.031. Epub 2014 Mar 19.

Resilience buffers the impact of traumatic events on the development of PTSD symptoms in firefighters.

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Graduate School of Medical Science and Engineering, KAIST, Daejeon, Republic of Korea.
Department of Occupational and Environmental Medicine, Dongguk University, Ilsan Hospital, Goyang, Republic of Korea.
Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Neuropsychiatry, Eulji University School of Medicine, Eulji University Hospital, 95 Dunsanseo-ro, Seo-gu, Daejeon 302-799, Republic of Korea. Electronic address:



Resilience is considered to be a powerful protective factor in buffering the detrimental impact of traumatic stress on the development of posttraumatic stress disorder (PTSD). However, there is a striking lack of research concerning the development of a model of resilience, especially one including both risk and protective factors. The aim of this study was to investigate the possible mediators and moderators influencing the relationship between traumatic stress and PTSD using a moderated mediation analysis.


Study participants included 552 Korean firefighters from four large cities. The subjects completed a series of self-report measures including the Life Event Checklist, the Perceived Stress Scale, the Occupational Stress Scale, the Impact of Event Scale-Revised, and the Connor-Davidson Resilience Scale.


Traumatic stress had both a direct and an indirect, via perceived stress, impact on the development of PTSD symptoms. Additionally, the mediation of the association between traumatic stress and PTSD symptoms via perceived stress was moderated by individual resilience. In particular, under the same level of traumatic stress, firefighters with high levels of resilience (scores ≥75, upper 25th percentile or ≥90, upper 10th percentile) were protected from both the direct and indirect impacts of traumatic stress relative to those with lower levels of individual resilience.


The current findings provide a comprehensive picture of individuals who should be considered at high risk for the development of PTSD symptoms following traumatic stress and identify the factors that should be targeted by efforts to prevent PTSD.


Firefighters; Moderated mediation; PTSD; Perceived stress; Resilience; Traumatic stress

[Indexed for MEDLINE]

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