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Predictors of Emotional Adjustment following Traumatic Injury: Personal, Social, and Material Resources

Published online by Cambridge University Press:  28 June 2012

Matthew J. Cordova*
Affiliation:
Veterans Administration Palo Alto Health Care System, Pacific Graduate School of Psychology, Palo Alto, California, USA
Robyn Walser
Affiliation:
Veterans Administration Palo Alto Health Care System, National Center of Post-Traumatic Stress Disorder, Menlo Park, California, USA
Janet Neff
Affiliation:
Stanford University Medical Center, Palo Alto, California, USA
Josef I. Ruzek
Affiliation:
Veterans Administration Palo Alto Health Care System, Pacific Graduate School of Psychology, Palo Alto, California, USA Veterans Administration Palo Alto Health Care System, National Center of Post-Traumatic Stress Disorder, Menlo Park, California, USA
*
VAPAHCS, 3801 Miranda Avenue (116B), Palo Alto, CA 94304USA E-mail: [email protected]

Abstract

Introduction:

The identification of factors influencing emotional adjustment after injury may elucidate the design of assessment and treatment procedures in emergency medicine settings and suggest targets for early intervention to prevent the later development of psychological impairment. Personal, social, and material resources may be influential factors and require further evaluation.

Hypotheses:

Greater experiential avoidance, social constraints on discussing the trauma experience, and loss of material resources would be associated with more of the symptoms of posttraumatic stress and depression following traumatic injury.

Methods:

Participants (n = 47) at a mean of 7.4 months post-injury, completed a telephone interview assessment, including evaluation of sociodemographic characteristics, conservation of resources, social constraints, acceptance and commitment, and symptoms of post-traumatic stress disorder (PTSD) and depression. Hypotheses were tested using multivariate regression analyses.

Results:

Only greater social constraints were uniquely predictive of greater PTSD symptomatology. Higher levels of experiential avoidance, social constraints, and loss of material resources all were associated with greater levels of depression.

Conclusion:

Assessment of personal coping style, receptivity of social network, and loss of potential material resources following traumatic injury may facilitate identification of individuals at-risk for poorer post-injury adaptation. Psychosocial interventions targeting such individuals may be promising.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2005

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References

1. Ehlers, A, Mayou, RA, Bryant, B: Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents. J Abnor Psychol 1998;107:508519.CrossRefGoogle ScholarPubMed
2. Mayou, RA, Ehlers, A, Bryant, B: Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study. Behav Res Ther 2002;40:665675.CrossRefGoogle ScholarPubMed
3. Michaels, AJ, Michaels, CE, Zimmerman, MA et al. : Posttraumatic stress disorder in injured adults: Etiology by path analysis. J Trauma 1999;47: 867873.CrossRefGoogle ScholarPubMed
4. Zatzick, DF, Kang, SM, Muller, HG et al. : Predicting posttraumatic distress in hospitalized trauma survivors with acute injuries. Am J Psychiatry 2002; 159:941946.CrossRefGoogle ScholarPubMed
5. Shalev, AY, Freedman, S, Peri, T et al. : Prospective study of posttraumatic stress disorder and depression following trauma. Am J Psychiatry 1998;155:630637.CrossRefGoogle Scholar
6. Maes, M, Mylle, J, Delmeire, L, Altamura, C: Psychiatric morbidity and comorbidity following accidental man-made traumatic events: Incidence and risk factors. Eur Arch of Psychiatry and Clin Neurosci 2000;250:156162.CrossRefGoogle ScholarPubMed
7. Holbrook, TL, Anderson, JP, Sieber, WJ et al. : Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. Journal of Trauma-Injury Infection and Critical Care 1999; 46:765773.CrossRefGoogle ScholarPubMed
8. Jurkovich, G, Mock, C., MacKenzie, E et al. : The Sickness Impact Profile as a tool to evaluate functional outcome in trauma patients. J Trauma 1995;39:625631.CrossRefGoogle ScholarPubMed
9. Kuhn, E, Blanchard, EB, Hickling, EJ: Posttraumatic stress disorder and psychosocial functioning within two samples of MVA survivors. Behav Res Ther 2003;41:11051112.CrossRefGoogle ScholarPubMed
10. Michaels, AJ, Michaels, CE, Moon, CH et al. : Psychosocial factors limit outcomes after trauma. J Trauma 1998;44:644648.CrossRefGoogle ScholarPubMed
11. Dougall, AL, Ursano, RJ, Posluszny, DM et al. : Predictors of posttraumatic stress among victims of motor vehicle accidents. Psychosom Med 2001;63:402411.CrossRefGoogle ScholarPubMed
12. Shalev, AY, Peri, T, Canetti, L, Schreiber, S: Predictors of PTSD in injured trauma survivors: A prospective study. Am J Psychiatry 1996;153:219225.Google ScholarPubMed
13. McCarthy, ML, MacKenzie, EJ, Edwin, D et al. : Psychological distress associated with severe lower-limb injury. J Bone Joint Surg 2003;85:16891697.CrossRefGoogle ScholarPubMed
14. Creamer, M, Burgess, P, Pattison, P: Reaction to trauma: A cognitive processing model. J Abnorm Psychol 1992;101:452459.CrossRefGoogle ScholarPubMed
15. Foa, EB, Kozak, MJ: Emotional processing of fear: Exposure to corrective information. Psychol Bull 1986;99:2035.CrossRefGoogle ScholarPubMed
16. Horowitz, MJ: Stress Response Syndromes (3rd ed). New York: Aronson, 1997.Google Scholar
17. Baum, A, Cohen, L, Hall, M: Control and intrusive memories as possible determinants of chronic stress. Psychosom Med 1993;55:274286.CrossRefGoogle ScholarPubMed
18. Walser, RD, Hayes, SC: The Effects of Acceptance and Suppression on Thought and Emotions: Analysis of a Talk-aloud Procedure. Association for Advancement of Behavior Therapy (AABT), Washington, DC, 1922 November 1998.Google Scholar
19. Hayes, SC, Wilson, KG, Gifford, EV et al. : Emotional avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol 1996;64:11521168.CrossRefGoogle ScholarPubMed
20. Bryant, RA, Harvey, AG: Avoidant coping style and post-traumatic stress following motor vehicle accidents. Behav Res and Ther 1995;33:631635.CrossRefGoogle ScholarPubMed
21. Follette, V, Ruzek, JI, Abueg, FR: A Contextual Approach to Trauma: Assessment and Treatment. In: Follette, VM, Ruzek, JI, Abueg, FR (eds), Cognitive-behavioral Therapies for Trauma. New York:Guildford, 1998.Google Scholar
22. Lepore, SJ: A Social–Cognitive Processing Model of Emotional Adjustment to Cancer. In: Baum, A, Andersen, B (eds), Psychosocial Interventions for Cancer. Washington, DC: American Psychological Association, 2001, pp 99118.CrossRefGoogle Scholar
23. Lepore, SJ, Silver, RC, Wortman, CB, Wayment, HA: Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. J Pers Soc Psychol 1996;70:271282.CrossRefGoogle ScholarPubMed
24. Lepore, SJ, Helgeson, VS: Social constraints, intrusive thoughts, and mental health after prostate cancer. J Soc Clin Psychol 1998;17:89106.CrossRefGoogle Scholar
25. Bolton, EE, Glenn, DM, Orsillo, S et al. : The relationship between self-disclosure and symptoms of posttraumatic stress disorder in peacekeepers deployed to Somalia. J Trauma Stress 2003;16:203210.CrossRefGoogle ScholarPubMed
26. Halligan, SL, Michael, T, Clark, DM, Ehlers, A: Posttraumatic stress disorder following assault: The role of cognitive processing, trauma memory, and appraisals. J Consult Clin Psychol 2003;71:419431.CrossRefGoogle ScholarPubMed
27. Hobfoll, SE: Conservation of resources: A new attempt at conceptualizing stress. Am Psychol 1989;44:513524.CrossRefGoogle ScholarPubMed
28. Hobfoll, SE, Johnson, RJ, Ennis, N, Jackson, AP: Resource loss, resource gain, and emotional outcomes among inner city women. J Pers Soc Psychol 2003; 84:632643.CrossRefGoogle ScholarPubMed
29. Freedy, JR, Saladin, ME, Kilpatrick, DG et al. : Understanding acute psychological distress following natural disaster. J Trauma Stress 1994;7:257273.CrossRefGoogle ScholarPubMed
30. MacKenzie, EJ, Shapiro, S, Smith, RT et al. : Factors influencing return to work following hospitalization for traumatic injury. Am J Public Health 1987;77:329334.CrossRefGoogle ScholarPubMed
31. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders–Fourth Edition (DSM-IV). Washington, DC: APA, 1994.Google Scholar
32. Hayes, SC, Strosahl, KD, Wilson, KG et al. : Measuring experiential avoidance: A preliminary test of a working model. The Psychological Record. In press.Google Scholar
33. Lepore, SJ, Ituarte, PHG: Optimism about cancer enhances mood by reducing negative social relations. Cancer Research, Therapy and Control 1999;8:165174.Google Scholar
34. Hobfoll, SE, Lilly, RS: Resource conservation as a strategy for community psychology. J Community Psychol 1993;21:128148.3.0.CO;2-5>CrossRefGoogle Scholar
35. Weathers, FW, Huska, JA, Keane, TM: The PTSD Checklist—Civilian Version (PSTD Checklist-Civilian), 1991. (Available from FW Weathers, National Center for PTSD, Boston Veterans Affairs Medical Center, 150 S. Huntington Avenue, Boston, MA 02130 USA)Google Scholar
36. Weathers, FW, Litz, BT, Herman, DS et al. : The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the International Society for Traumatic Stress Studies, San Antonio, Texas, 1993.Google Scholar
37. Blanchard, EB, Jones-Alexander, J, Buckley, TC, Forneris, CA: Psychometric properties of the Post-traumatic Stress Disorder Checklist (PCL). Behav Res Ther 1996;34:669673.CrossRefGoogle ScholarPubMed
38. Blake, DD, Weathers, FW, Nagy, LM et al. : The development of the clinician-administered Post-traumatic Stress Disorder scale. J Trauma Stress 1995;8:7590.Google Scholar
39. Radloff, L: The Center for Epidemiologic Studies Depression Scale Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement 1977;1:385401.CrossRefGoogle Scholar
40. Husaini, BA, Neff, JA, Harrington, JB et al. : Depression in rural communities: Validating the Center for Epidemiologic Studies Depression Scale scale. J Community Psychol 1980;8:2027.3.0.CO;2-Y>CrossRefGoogle Scholar
41. Weissman, MM, Sholomskas, D, Pottenger, M et al. : Assessing depressive symptoms in five psychiatric populations: A validation study. Am J Epidemiol 1977;106:203214.CrossRefGoogle ScholarPubMed
42. Kliewer, W, Lepore, SJ, Oskin, D, Johnson, PD: The role of social and cognitive processes in children's adjustment to community violence. J Consult Clin Psychol 1998;66:199209.CrossRefGoogle ScholarPubMed
43. Manne, SL, Pape, SJ, Taylor, KL, Dougherty, J: Spouse support, coping, and mood among individuals with cancer. Ann Behav Med 1999;21:111121.CrossRefGoogle ScholarPubMed
44. Cordova, MJ, Cunningham, LL, Carlson, CR, Andrykowski, MA: Social constraints, cognitive processing, and adjustment to breast cancer. J Consult Clin Psychol 2001;69:706711.CrossRefGoogle ScholarPubMed
45. Schmidt, JE, Andrykowski, MA: The role of social and dispositional variables associated with emotional processing in adjustment to breast cancer: An Internet-based study. Health Psychology 2004;23:259266.CrossRefGoogle ScholarPubMed
46. Zakowski, SG, Harris, C., Krueger, N et al. : Social barriers to emotional expression and their relations to distress in male and female cancer patients. Br J Health Psychol 2003;8:271286.CrossRefGoogle ScholarPubMed
47. Sattler, DN, Preston, AJ, Kaiser, CF et al. : Hurricane Georges: A cross-national study examining preparedness, resource loss, and psychological distress in the US Virgin Islands, Puerto Rico, Dominican Republic, and the United States. J Trauma Stress 2002;15:339350.CrossRefGoogle Scholar