{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T10:48:31Z","timestamp":1781866111233,"version":"3.54.5"},"reference-count":31,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec id=\"S2056472420000812_sec_a1\" sec-type=\"other\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Occupational groups operating in dangerous environments may witness the development of acute stress reaction (ASR) in team members. Witnessing ASR in team members may increase the risk of developing subsequent post-traumatic stress disorder (PTSD) symptoms.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000812_sec_a2\" sec-type=\"other\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To describe ASR symptoms that individuals witness, assess the relationship between witnessing a team member exhibiting ASR symptoms and an individual's own PTSD symptoms, and describe common intervention responses by peers.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000812_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>Cross-sectional, anonymous surveys were conducted with US soldiers who were previously deployed (sample 1; <jats:italic>n<\/jats:italic> = 176) and currently deployed sample 2; <jats:italic>n<\/jats:italic> = 497). Surveys assessed combat experiences, PTSD (PTSD Checklist-5), ASR exposure and intervention responses. Analyses included frequencies and binary logistic regression.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000812_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Witnessing at least one ASR symptom during a combat-related event was reported by 51.7% in sample 1 and 42.4% in sample 2; the most commonly observed symptoms were being unable to function or being detached. Controlling for combat experiences, high levels of witnessing a team member exhibit ASR symptoms was associated with increased risk of subthreshold PTSD or PTSD in sample 1 (odds ratio (OR) = 8.69, 95% CI 2.29\u201342.60) and approached significance in sample 2 (OR = 1.67, 95% CI 0.98\u20132.81). Common intervention responses included providing a directive or yelling; many also reported being unsure how to respond.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472420000812_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Witnessing team members who exhibit ASR symptoms appears to be associated with screening positive for subthreshold PTSD or PTSD. Results suggest the need for further research into how to prepare individuals to manage ASR in team members and to examine ASR in other high-risk occupations.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2020.81","type":"journal-article","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T07:28:52Z","timestamp":1599118132000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":20,"title":["Post-traumatic stress disorder risk and witnessing team members in acute psychological stress during combat"],"prefix":"10.1192","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-5530","authenticated-orcid":false,"given":"Amy B.","family":"Adler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0082-0004","authenticated-orcid":false,"given":"Vlad","family":"Svetlitzky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian A.","family":"Gutierrez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"key":"S2056472420000812_ref31","doi-asserted-by":"publisher","DOI":"10.1177\/1090198117752788"},{"key":"S2056472420000812_ref29","doi-asserted-by":"publisher","DOI":"10.1080\/15564886.2015.1009593"},{"key":"S2056472420000812_ref28","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000401"},{"key":"S2056472420000812_ref10","doi-asserted-by":"publisher","DOI":"10.1037\/mil0000154"},{"key":"S2056472420000812_ref27","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20313"},{"key":"S2056472420000812_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.22612"},{"key":"S2056472420000812_ref23","doi-asserted-by":"publisher","DOI":"10.1037\/a0018438"},{"key":"S2056472420000812_ref1","volume-title":"Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines (ICD-11)","year":"2018"},{"key":"S2056472420000812_ref15","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (5th edn) DSM-5","year":"2013"},{"key":"S2056472420000812_ref2","doi-asserted-by":"publisher","DOI":"10.1080\/21635781.2019.1664356"},{"key":"S2056472420000812_ref17","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20665"},{"key":"S2056472420000812_ref21","article-title":"Witnessing acute stress reaction in team members: the moderating effect of YaHaLOM","author":"Svetlitzky","journal-title":"J Nerv Ment Dis"},{"key":"S2056472420000812_ref8","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2018.175"},{"key":"S2056472420000812_ref3","doi-asserted-by":"publisher","DOI":"10.1002\/jts.20336"},{"key":"S2056472420000812_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2016.12.004"},{"key":"S2056472420000812_ref6","first-page":"1","article-title":"Theories of human altruism: a systematic review","volume":"1","author":"Feigin","year":"2018","journal-title":"J Psychiatry Brain Funct"},{"key":"S2056472420000812_ref4","doi-asserted-by":"publisher","DOI":"10.1177\/070674371205700209"},{"key":"S2056472420000812_ref24","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0000000000000058"},{"key":"S2056472420000812_ref12","doi-asserted-by":"publisher","DOI":"10.1037\/tra0000487"},{"key":"S2056472420000812_ref30","volume-title":"Oxford Research Encyclopedia of Communication","author":"Burn","year":"2017"},{"key":"S2056472420000812_ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-015-0575-z"},{"key":"S2056472420000812_ref9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040603"},{"key":"S2056472420000812_ref7","doi-asserted-by":"publisher","DOI":"10.1038\/npp.2016.273"},{"key":"S2056472420000812_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2014.03.028"},{"key":"S2056472420000812_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/archgenpsychiatry.2010.54"},{"key":"S2056472420000812_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/mil0000154"},{"key":"S2056472420000812_ref14","unstructured":"14 Weathers, FW , Litz, BT , Keane, TM , Palmieri, PA , Marx, BP , Schnurr, PP . The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD, 2013 (www.ptsd.va.gov)."},{"key":"S2056472420000812_ref18","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22221"},{"key":"S2056472420000812_ref19","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.113.129569"},{"key":"S2056472420000812_ref20","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000360"},{"key":"S2056472420000812_ref22","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.60.110707.163604"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472420000812","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T07:28:56Z","timestamp":1599118136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472420000812\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["S2056472420000812"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2020.81","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike licence (http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0\/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the same Creative Commons licence is included and the original work is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e98"}}