{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T21:09:36Z","timestamp":1782508176820,"version":"3.54.5"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T00:00:00Z","timestamp":1645488000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japanese Society for the Promotion of Science KAKENHI","doi-asserted-by":"crossref","award":["26461779"],"award-info":[{"award-number":["26461779"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Defense Medical College, Japan"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec id=\"S0007125022000022_sec_a1\"><jats:title>Background<\/jats:title><jats:p>First responders to disasters are at risk of developing post-traumatic stress disorder (PTSD). The trajectories of post-traumatic stress symptom severity differ among individuals, even if they are exposed to similar events. These trajectories have not yet been reported in non-Western first responders.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125022000022_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>We aimed to explore post-traumatic stress symptom severity trajectories and their risk factors in first responders to the 2011 Great East Japan Earthquake (GEJE) \u2013 a historically large earthquake that resulted in a tsunami and a nuclear disaster.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125022000022_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>A total of 55 632 Japan Ground Self-Defense Force (JGSDF) personnel dispatched to the GEJE were enrolled in this 7-year longitudinal cohort study. PTSD symptom severity was measured using the Impact of Event Scale-Revised. Trajectories were identified using latent growth mixture models (LGMM). Nine potential risk factors for the symptom severity trajectories were analysed using multinomial logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125022000022_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Five symptom severity trajectories were identified: \u2018resilient\u2019 (54.8%), \u2018recovery\u2019 (24.6%), \u2018incomplete recovery\u2019 (10.7%), \u2018late-onset\u2019 (5.7%), and \u2018chronic\u2019 (4.3%). The main risk factors for the four non-resilient trajectories were older age, personal disaster experiences and working conditions. These working conditions included duties involving body recovery or radiation exposure risk, longer deployment length, later or no post-deployment leave and longer post-deployment overtime.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125022000022_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The majority of first responders to GEJE were resilient and developed few or no PTSD symptoms. A substantial minority experienced late-onset and chronic symptom severity trajectories. The identified risk factors can inform policies for prevention, early detection and intervention in individuals at risk of developing symptomatic trajectories.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2022.2","type":"journal-article","created":{"date-parts":[[2022,2,22]],"date-time":"2022-02-22T11:08:41Z","timestamp":1645528121000},"page":"668-675","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":13,"title":["Risk and resilience in trajectories of post-traumatic stress symptoms among first responders after the 2011 Great East Japan Earthquake: 7-year prospective cohort study"],"prefix":"10.1192","volume":"221","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9547-6674","authenticated-orcid":false,"given":"Taku","family":"Saito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6311-605X","authenticated-orcid":false,"given":"Florentine H. 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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 licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","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"}]}}