Predicting post-traumatic stress disorder following first onset acute coronary syndrome: Testing a theoretical model


Correspondence should be addressed to Paul Bennett, Department of Psychology, University of Swansea, Singleton Park, Swansea, SA2 8PP, UK (e-mail:



This research identified which theoretically predicted factors (Joseph, Williams, & Yule, 1997) were associated with the severity of post-traumatic stress disorder (PTSD) symptoms 1 and 6 months following onset of acute coronary syndrome (ACS). Predictor variables included event factors, peri-traumatic distress; and maintaining factors including coping strategies, social support, re-appraisal of event threat, and beliefs about the nature of ACS. Associations with alexithymia were also explored.


One hundred and fifty participants completed questionnaires in hospital and at 1- and 6-month follow-up.


Hierarchical multiple regression including both baseline and contemporaneous variables explained 52 and 42% of the variance in PTSD symptoms at each follow-up. At 1-month follow-up, predictors of PTSD symptoms were as follows: peri-traumatic distress, concern over symptoms, illness comprehension, and lack of social support. At 6-month follow-up, predictors were: peri-traumatic distress, lack of social support, use of problem-focused coping, and continued symptoms.


The Joseph et al. model was generally supported. The data allow some degree of prediction of high risk individuals and suggest some possible interventions.