@article{antonioLatentClassesProximal2026,

title = {Latent Classes of Proximal Traumatic Exposure Among Portuguese Police and Security Professionals: Associations with PTSD Symptoms and Psychological Distress},

author = {H. António and S. Albuquerque and M. Vieira de Castro and S. Bouchard and P. Gamito and R. J. Pinto},

url = {https://www.scopus.com/pages/publications/105048524559?origin=resultslist},

doi = {10.3390/psychiatryint7040173},

issn = {26735318 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Psychiatry International},

volume = {7},

number = {4},

publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},

abstract = {Background: Police and security professionals are routinely exposed to potentially traumatic events as part of occupational duties, placing them at increased risk for post-traumatic stress and broader psychological difficulties. This study aimed to identify latent classes of proximal traumatic exposure among Portuguese police/security professionals and examine their associations with PTSD symptoms and general psychological distress. Methods: A cross-sectional online survey was conducted with Portuguese police/security professionals (N = 644). Latent class analysis (LCA) was applied to 17 indicators of potentially traumatic events coded as directly experienced or witnessed, derived from the Life Events Checklist for DSM-5. PTSD symptoms were assessed using the PTSD Checklist for DSM-5, and general psychological distress was assessed using the Brief Symptom Inventory. Exploratory receiver operating characteristic (ROC) analyses examined whether counts of proximal traumatic events could approximate the LCA-derived classes. Results: A three-class solution was identified, comprising low proximal exposure (37.3%), moderate proximal exposure (40.7%), and high proximal/cumulative exposure (22.0%) classes. The classes reflected a graded cumulative pattern of exposure across traumatic event categories, rather than clearly distinct qualitative configurations defined by specific event types. Higher exposure classes were associated with progressively higher PTSD symptoms and psychological distress, and these associations remained significant after adjustment for sociodemographic and occupational variables. Exploratory receiver operating characteristic (ROC) analyses showed that a simple count of proximal traumatic event categories closely approximated the empirically derived class structure within the present sample. However, the resulting thresholds are sample-specific, exploratory, and should not be interpreted as validated screening cutoffs. Conclusions: Proximal traumatic exposure among police/security professionals appears to follow a graded cumulative structure associated with increased PTSD symptoms and psychological distress. The person-centered analysis provided an empirical test of whether exposure was organized according to qualitatively distinct event configurations or primarily along a cumulative gradient. In this sample, cumulative exposure burden emerged as the dominant organizing dimension. The count-based approximation requires external validation before any screening or decision-making application can be considered. © 2026 by the authors.},

keywords = {adult, Anxiety, article, cross-sectional study, decision making, Depression, DSM-5, female, Global Severity Index, hostility, human, human experiment, Latent Class Analysis, LEC-5, major clinical study, male, paranoia, phobia, police, Positive symptom distress index, Positive symptom total, posttraumatic stress disorder, posttraumatic stress disorder checklist, Proximal Traumatic Exposure, psychological distress, psychosis, PTSD, questionnaire, receiver operating characteristic, Security, security professionals, self report, sociodemographics, trauma exposure},

pubstate = {published},

tppubtype = {article}

}

@article{antonio_traumatic_2025,

title = {Traumatic Events, Psychopathology, and Post-Traumatic Stress Disorder in the General Community and First Responders: Presence of Symptoms and Associated Factors},

author = {H. António and P. Gamito and S. Bouchard and S. A. Mansuklal and J. Cardoso and M. Vieira de Castro and R. Pinto},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105026495354&doi=10.3390%2Fejihpe15120241&partnerID=40&md5=ff9135a8c22252b8623a20ad1bec11a1},

doi = {10.3390/ejihpe15120241},

issn = {21748144 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {European Journal of Investigation in Health, Psychology and Education},

volume = {15},

number = {12},

abstract = {Most individuals experience at least one traumatic event during their lifetime, which can lead to the development of psychopathological symptoms and Post-Traumatic Stress Disorder (PTSD). First responders (e.g., police officers, firefighters, emergency medical professionals) are exposed to traumatic events daily, making them particularly vulnerable to developing such symptoms. Using an online questionnaire, this study aimed to compare self-reported exposure to traumatic events and the presence of psychopathological and PTSD symptoms between a sample from the general community (n = 137) and first responders (n = 672) residing in Portugal. We also sought to identify factors associated with the development of PTSD symptoms. Results showed that although first responders reported higher exposure to traumatic events, there were no significant differences in PTSD symptoms between first responders and the general community. However, general psychopathological symptoms, particularly anxiety and depression, were higher in the general community than among first responders. Symptoms of anxiety, depression, obsessive–compulsive tendencies, hostility, paranoid ideation, psychoticism, and personally experienced traumatic events emerged as significant predictors of PTSD symptoms, whereas demographic variables showed no significant predictive value. The potential influence of factors such as terror management theory, training and education, professional selection, the “hero lifestyle”, and the “police culture” is discussed, along with implications and directions for future research. © 2025 by the authors.},

keywords = {first responders, general community, psychopathology, PTSD, traumatic events},

pubstate = {published},

tppubtype = {article}

}

@article{antonioTraumaticEventsPsychopathology2025,

title = {Traumatic Events, Psychopathology, and Post-Traumatic Stress Disorder in the General Community and First Responders: Presence of Symptoms and Associated Factors},

author = {H. António and P. Gamito and S. Bouchard and S. A. Mansuklal and J. Cardoso and M. Vieira de Castro and R. Pinto},

url = {https://www.scopus.com/pages/publications/105026495354?origin=resultslist},

doi = {10.3390/ejihpe15120241},

issn = {21748144 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {European Journal of Investigation in Health, Psychology and Education},

volume = {15},

number = {12},

publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},

abstract = {Most individuals experience at least one traumatic event during their lifetime, which can lead to the development of psychopathological symptoms and Post-Traumatic Stress Disorder (PTSD). First responders (e.g., police officers, firefighters, emergency medical professionals) are exposed to traumatic events daily, making them particularly vulnerable to developing such symptoms. Using an online questionnaire, this study aimed to compare self-reported exposure to traumatic events and the presence of psychopathological and PTSD symptoms between a sample from the general community (n = 137) and first responders (n = 672) residing in Portugal. We also sought to identify factors associated with the development of PTSD symptoms. Results showed that although first responders reported higher exposure to traumatic events, there were no significant differences in PTSD symptoms between first responders and the general community. However, general psychopathological symptoms, particularly anxiety and depression, were higher in the general community than among first responders. Symptoms of anxiety, depression, obsessive–compulsive tendencies, hostility, paranoid ideation, psychoticism, and personally experienced traumatic events emerged as significant predictors of PTSD symptoms, whereas demographic variables showed no significant predictive value. The potential influence of factors such as terror management theory, training and education, professional selection, the “hero lifestyle”, and the “police culture” is discussed, along with implications and directions for future research. © 2025 by the authors.},

keywords = {first responders, general community, psychopathology, PTSD, traumatic events},

pubstate = {published},

tppubtype = {article}

}

@article{antonioTraumaticEventsPsychopathology2025a,

title = {Traumatic Events, Psychopathology, and Post-Traumatic Stress Disorder in the General Community and First Responders: Presence of Symptoms and Associated Factors},

author = {H. António and P. Gamito and S. Bouchard and S. A. Mansuklal and J. Cardoso and M. Vieira de Castro and R. Pinto},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105026495354&doi=10.3390%2Fejihpe15120241&partnerID=40&md5=ff9135a8c22252b8623a20ad1bec11a1},

doi = {10.3390/ejihpe15120241},

issn = {21748144 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {European Journal of Investigation in Health, Psychology and Education},

volume = {15},

number = {12},

abstract = {Most individuals experience at least one traumatic event during their lifetime, which can lead to the development of psychopathological symptoms and Post-Traumatic Stress Disorder (PTSD). First responders (e.g., police officers, firefighters, emergency medical professionals) are exposed to traumatic events daily, making them particularly vulnerable to developing such symptoms. Using an online questionnaire, this study aimed to compare self-reported exposure to traumatic events and the presence of psychopathological and PTSD symptoms between a sample from the general community (n = 137) and first responders (n = 672) residing in Portugal. We also sought to identify factors associated with the development of PTSD symptoms. Results showed that although first responders reported higher exposure to traumatic events, there were no significant differences in PTSD symptoms between first responders and the general community. However, general psychopathological symptoms, particularly anxiety and depression, were higher in the general community than among first responders. Symptoms of anxiety, depression, obsessive–compulsive tendencies, hostility, paranoid ideation, psychoticism, and personally experienced traumatic events emerged as significant predictors of PTSD symptoms, whereas demographic variables showed no significant predictive value. The potential influence of factors such as terror management theory, training and education, professional selection, the “hero lifestyle”, and the “police culture” is discussed, along with implications and directions for future research. © 2025 by the authors.},

keywords = {first responders, general community, psychopathology, PTSD, traumatic events},

pubstate = {published},

tppubtype = {article}

}

@article{belleville_efficacy_2023,

title = {Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD, Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial},

author = {G. Belleville and M. -C. Ouellet and V. Békés and J. Lebel and C. M. Morin and S. Bouchard and S. Guay and N. Bergeron and S. Ghosh and T. Campbell and F. P. Macmaster},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140981202&doi=10.1016%2fj.beth.2022.08.004&partnerID=40&md5=261383919bbdaa149ac0eeb6d3317fc0},

doi = {10.1016/j.beth.2022.08.004},

issn = {00057894 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Behavior Therapy},

volume = {54},

number = {2},

pages = {230–246},

publisher = {Elsevier Inc.},

abstract = {This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128},

note = {Publisher: Elsevier Inc.},

keywords = {adult, Anxiety, article, clinical effectiveness, clinical feature, cognitive behavioral therapy, controlled study, Depression, disaster, Disasters, disease severity, e-mental health, female, human, Humans, insomnia, Internet-Based Intervention, major clinical study, male, Middle Aged, natural disaster, physical disability, Post-Traumatic, posttraumatic stress disorder, psychotherapist, PTSD, randomized controlled trial, risk factor, Sleep Initiation and Maintenance Disorders, Stress Disorders, telepsychotherapy, treatment outcome, wildfire},

pubstate = {published},

tppubtype = {article}

}

@article{bellevilleEfficacyTherapistAssistedSelfHelp2023,

title = {Efficacy of a Therapist-Assisted Self-Help Internet-Based Intervention Targeting PTSD, Depression, and Insomnia Symptoms After a Disaster: A Randomized Controlled Trial},

author = {G. Belleville and M. -C. Ouellet and V. Békés and J. Lebel and C. M. Morin and S. Bouchard and S. Guay and N. Bergeron and S. Ghosh and T. Campbell and F. P. Macmaster},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85140981202&doi=10.1016%2fj.beth.2022.08.004&partnerID=40&md5=261383919bbdaa149ac0eeb6d3317fc0},

doi = {10.1016/j.beth.2022.08.004},

issn = {00057894 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Behavior Therapy},

volume = {54},

number = {2},

pages = {230–246},

publisher = {Elsevier Inc.},

abstract = {This study aimed at evaluating the efficacy of an online CBT intervention with limited therapist contact targeting a range of posttraumatic symptoms among evacuees from the 2016 Fort McMurray wildfires. One hundred and thirty-six residents of Fort McMurray who reported either moderate PTSD symptoms (PCL-5 ≥ 23) or mild PTSD symptoms (PCL-5 ≥ 10) with moderate depression (PHQ-9 ≥ 10) or subthreshold insomnia symptoms (ISI ≥ 8) were randomized either to a treatment (n = 69) or a waitlist condition (n = 67). Participants were on average 45 years old, and mostly identified as White (82%) and as women (76%). Primary outcomes were PTSD, depression, and insomnia symptoms. Secondary outcomes were anxiety symptoms and disability. Significant Assessment Time × Treatment Condition interactions were observed on all outcomes, indicating that access to the treatment led to a decrease in posttraumatic stress (F[1,117.04] = 12.128},

keywords = {adult, Anxiety, article, clinical effectiveness, clinical feature, cognitive behavioral therapy, controlled study, Depression, disaster, Disasters, disease severity, e-mental health, female, human, Humans, insomnia, Internet-Based Intervention, major clinical study, male, Middle Aged, natural disaster, physical disability, Post-Traumatic, posttraumatic stress disorder, psychotherapist, PTSD, randomized controlled trial, risk factor, Sleep Initiation and Maintenance Disorders, Stress Disorders, telepsychotherapy, treatment outcome, wildfire},

pubstate = {published},

tppubtype = {article}

}

@article{katzman_canadian_2014,

title = {Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders},

author = {M. A. Katzman and P. Bleau and P. Blier and P. Chokka and K. Kjernisted and M. Van Ameringen and M. M. Antony and S. Bouchard and A. Brunet and M. Flament and K. Rabheru and S. Grigoriadis and P. M. A. Richter and S. Mendlowitz and K. O'Connor and M. Robichaud and J. R. Walker and G. Asmundson and L. R. Klassen and R. W. Lam and R. S. McIntyre and I. Szpindel},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903778611&doi=10.1186%2f1471-244X-14-S1-S1&partnerID=40&md5=4787fc6f97c204c1428770a5e4a57a00},

doi = {10.1186/1471-244X-14-S1-S1},

issn = {1471244X (ISSN)},

year  = {2014},

date = {2014-01-01},

journal = {BMC Psychiatry},

volume = {14},

number = {SUPPL.1},

publisher = {BioMed Central Ltd.},

abstract = {Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.},

note = {Publisher: BioMed Central Ltd.},

keywords = {agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine},

pubstate = {published},

tppubtype = {article}

}

@article{katzmanCanadianClinicalPractice2014,

title = {Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders},

author = {M. A. Katzman and P. Bleau and P. Blier and P. Chokka and K. Kjernisted and M. Van Ameringen and M. M. Antony and S. Bouchard and A. Brunet and M. Flament and K. Rabheru and S. Grigoriadis and P. M. A. Richter and S. Mendlowitz and K. O'Connor and M. Robichaud and J. R. Walker and G. Asmundson and L. R. Klassen and R. W. Lam and R. S. McIntyre and I. Szpindel},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84903778611&doi=10.1186%2f1471-244X-14-S1-S1&partnerID=40&md5=4787fc6f97c204c1428770a5e4a57a00},

doi = {10.1186/1471-244X-14-S1-S1},

issn = {1471244X (ISSN)},

year  = {2014},

date = {2014-01-01},

journal = {BMC Psychiatry},

volume = {14},

number = {SUPPL.1},

publisher = {BioMed Central Ltd.},

abstract = {Background: Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated.Methods: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980-2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.Results: These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions.Conclusions: Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. © 2014 Katzman et al.},

keywords = {agoraphobia, Anxiety disorder, Anxiety Disorders, benzodiazepine derivative, buspirone, Canada, clinical trial, clomipramine, comorbidity, duloxetine, escitalopram, fluoxetine, fluvoxamine, fluvoxamine maleate, GAD, generalized anxiety disorder, guidelines, human, Humans, obsessive compulsive disorder, Obsessive-Compulsive Disorder, OCD, panic, Panic Disorder, paroxetine, periodic medical examination, pharmacotherapy, Post-Traumatic, posttraumatic stress disorder, practice guideline, Practice Guidelines as Topic, psychotherapy, PTSD, recommendations, review, sertraline, social anxiety disorder, social phobia, special populations, Specific phobia, Stress Disorders, venlafaxine},

pubstate = {published},

tppubtype = {article}

}