Pre-traumatic stress and environmental hazard in a bradyseism volcanic area. Psychometric properties of the Pre-traumatic stress reactions Checklist (PreCL) and concurrent underline mechanisms of pre-traumatic stress

Background: Pre-traumatic stress is characterized by intrusiveness, avoidance, hyper-arousal and alterations of behaviors and cognitions related to future traumatic events that may actually occur. The main tool to self-assess pre-traumatic stress is the Pre-traumatic stress reactions Checklist (PreCL). To date, no study has assessed the psychometric properties of PreCL. In addition, no study has studied the pre-traumatic stress in population under the threat of natural catastrophes and the concurrent underlined mechanisms of these reactions. Objective: This study aims to analyze the psychometric properties of PreCL, and the underlying mechanisms of pre-traumatic stress reactions in a group of participants living in the Campi Flegrei (Italy), a densely populated area which is cyclically affected by bradyseism and at high risk of volcanic eruptions. Methods: Recruitment involved 432 participants. Exploratory and Confirmatory Factor Analysis (EFA/CFA) was used to assess and re-define the factorial structure of PreCL. Structural equation model was used to test the mediation effect of intensity and frequency of worry about bradyseism on the relationship between the intolerance of uncertainty's dimensions and the pre-traumatic stress factors. Results: From the EFA/CFA, a two-independent factor structure emerged: Pre-traumatic reactive responses (PreCL-R) and Pre-traumatic alterations of mood and cognitions (PreCL-A). The frequency of worry about bradyseism fully mediated the relationship between the prospective intolerance of uncertainty and PreCL-R, while the intensity of worry partially mediates between inhibitory intolerance of uncertainty and PreCL-R. No mediation effect was found for PreCL-A. Conclusion: This study provides a stable structure of PreCL supporting its use in future research, and insights into the relationship between pre-traumatic reactions, current worry, and intolerance of uncertainty —findings that are relevant for both research and clinical practice.