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The current study prospectively examines the predictive relationship of trait dissociation, assessed during academy training, to PTSD symptoms assessed at 12 months of active police duty in relatively young and healthy police academy recruits (N = 180). The roles of pre-academy trauma exposure, exposure to life-threatening critical incidents during police duty, and peritraumatic dissociation at the time of the officer's worst critical incident were also examined. Utilizing path analytic techniques, greater trait dissociation, assessed during academy training, was predictive of both peritraumatic dissociation, and PTSD symptoms assessed at 12 months of police service. Moreover, after accounting for trait dissociation and peritraumatic dissociation, the relationship of previous trauma to later PTSD symptoms was no longer significant, demonstrating that the effect of previous trauma on later vulnerability to PTSD symptoms in this sample may be mediated by both trait and peritraumatic dissociation.

This article describes a controlled clinical trial of cognitive-behavioral treatment (CBT) for disaster workers. Despite high rates of PTSD in disaster workers worldwide, there have been no randomized trials of PTSD treatment. Participants were randomly assigned to a 12-week cognitive-behavioral exposure treatment (CBT, N = 15) or a treatment-as-usual (N = 16) condition. Eight CBT and 14 treatment-as-usual participants completed treatment. An ANOVA examining changes in Clinician-Administered PTSD Scale scores found significant main effects of Time, Group, and a Time x Group interaction (p's0.010) with a significantly greater decline in symptom scores in the CBT group. Between-group effect sizes were large. Dropout was associated with lower income, less education, and higher alcohol consumption. This project demonstrates the feasibility of recruitment in the aftermath of a catastrophic event, the relevance of a brief focused intervention comprised of CBT and exposure, and the need to eliminate barriers to treatment retention associated with income and education.