Presence of injury is often examined as a risk factor for posttraumatic stress disorder (PTSD); however, results have been mixed regarding the relationship between injury severity and PTSD symptoms (PTSS). The present study examined subjective and objective injury severity ratings in traumatic injury victims to determine if they differentially predict PTSS. Results demonstrated that subjective, not objective, injury severity predicted PTSS at six weeks and three months post-trauma. The moderating impact of peritraumatic factors was also examined. Peritraumatic dissociation moderated the impact of subjective injury severity on PTSS. Findings indicate that subjective injury severity should be incorporated into early screeners for PTSD risk.
American Psychiatric Association (1994) DSM-IV: Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.
2.
Andrews B., Brewin CR, Rose S., and Kirk M. ( 2000) Predicting PTSD Symptoms in Victims of Violent Crime: The Role of Shame, Anger, and Childhood Abuse. Journal of Abnormal Psychology109(1): 69-73.
3.
Baker SP, O’Neill B., Haddon W., and Long WB ( 1974) The Injury Severity Score: A Method for Describing Patients with Multiple Injuries and Evaluating Emergency Care. Journal of Trauma14(3): 187-196.
4.
Baron RM and Kenny DA ( 1986) The Moderator- Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic and Statistical Considerations . Journal of Personality and Social Psychology51(6): 1173-1182.
5.
Bernat JA, Ronfeldt HM, Calhoun KS and Arias I. ( 1998) Prevalence of Traumatic Events and Peritraumatic Predictors of Posttraumatic Stress Symptoms in a Nonclinical Sample of College Students . Journal of Traumatic Stress11(4): 645-664.
6.
Breh DC and Seidler GH ( 2007) Is Peritraumatic Dissociation a Risk Factor for PTSD? Journal of Trauma & Dissociation8(1): 53-69.
7.
Brewin CR, Andrews B., and Valentine JD ( 2000) Meta-Analysis of Risk Factors for Posttraumatic Stress Disorder in Trauma-Exposed Adults. Journal of Consulting and Clinical Psychology68(5): 748-766.
8.
Brunet A., Weiss DS, Metzler TJ, et al. (2001) The Peritraumatic Distress Inventory: A Proposed Measure of PTSD Criterion A2. American Journal of Psychiatry158(9): 1480-1485.
9.
Delahanty DL, Raimonde AJ, Spoonster E., and Cullado M. ( 2003) Injury Severity, Prior Trauma History, Urinary Cortisol Levels, and Acute PTSD in Motor Vehicle Accident Victims. Journal of Anxiety Disorders17(2): 149-164.
10.
Dohrenwend BP and Shrout PE ( 1985) ‘Hassles’ in the Conceptualization and Measurement of Life Stress Variables. American Psychologist40(7): 780-785.
11.
Dougall AL, Ursano RJ, Posluszny DM, Fullerton CS, and Baum A. ( 2001) Predictors of Posttraumatic Stress among Victims of Motor Vehicle Accidents. Psychosomatic Medicine63(3): 402-411.
12.
Ehlers A. and Clark DM ( 2000) A Cognitive Model of Posttraumatic Stress Disorder. Behaviour Research and Therapy38(4): 319-345.
13.
Ehlers A., Mayou RA, and Bryant B. ( 1998) Psychological Predictors of Chronic Posttraumatic Stress Disorder after Motor Vehicle Accidents. Journal of Abnormal Psychology107(3): 508-519.
14.
Frommberger UH, Stieglitz RD, Nyberg E., Schlickewei W., Kuner E., and Berger M. ( 1998) Prediction of Posttraumatic Stress Disorder by Immediate Reactions to Trauma: A Prospective Study in Road Traffic Accident Victims . European Archives of Psychiatry and Clinical Neuroscience248(6): 316-321.
15.
Green BL ( 1994) Psychological Research in Traumatic Stress: An Update . Journal of Traumatic Stress7(3): 341-361.
16.
Haden SC, Scarpa A., Jones RT, and Ollendick TH ( 2007) Posttraumatic Stress Disorder Symptoms and Injury: The Moderating Role of Perceived Social Support and Coping for Young Adults. Personality and Individual Differences42(7): 1187-1198.
17.
Harvey AG and Bryant RA ( 2000) Memory for Acute Stress Disorder Symptoms: A Two Year Prospective Study. Journal of Nervous and Mental Disease188(9): 602-607.
18.
Jeavons S. ( 2000) Predicting Who Suffers Psychological Trauma in the First Year after a Road Accident. Behaviour Research and Therapy38(5): 499-508.
19.
Kessler RC, Sonnega A., Bromet E., Hughes M., and Nelson CB ( 1995) Posttraumatic Stress Disorder in the National Comorbidity Survey. Archives of General Psychiatry52(12): 1048-1060.
20.
Koren D., Norman D., Cohen A., Berman J., and Klein EM ( 2005) Increased PTSD Risk with Combat-Related Injury: A Matched Comparison Study of Injured and Uninjured Soldiers Experiencing the Same Combat Events. American Journal of Psychiatry162(2): 276-282.
21.
Lazarus RS and Folkman S. (1984) Stress, Appraisal, and Coping. New York: Springer Publishing Company.
22.
Marmar CR, Weiss DS, and Metzler TJ (1997) The Peritraumatic Dissociative Experiences Questionnaire. In: Wilson JP, Keane TM (eds) Assessing Psychological Trauma and PTSD. New York: Guilford Press, 412-428.
23.
National Center for Injury Prevention and Control ( 2007) WISQARS Nonfatal Injury Reports 2007. Available at: http://webappa.cdc.gov/sasweb/ncipc/nfirates2001.html
24.
O’Donnell ML, Creamer M., Bryant RA, Schnyder U., and Shalev A. ( 2003) Posttraumatic Disorders Following Injury: An Empirical and Methodological Review. Clinical Psychology Review23(4): 587-603.
25.
Ozer EJ, Best SR, Lipsey TL, and Weiss DS ( 2003) Predictors of Posttraumatic Stress Disorder and Symptoms in Adults: A Meta-Analysis. Psychological Bulletin129(1): 52-73.
26.
Perrin S., Van Hasselt VB, Basilio I., and Hersen M. ( 1996) Assessing the Effects of Violence on Women in Battering Relationships with the Keanne MMPI-PTSD Scale. Journal of Traumatic Stress9(4): 805-816.
27.
Perry S., Difede J., Musngi G., Frances AJ, and Jacobsberg L. ( 1992) Predictors of Posttraumatic Stress Disorder after Burn Injury. American Journal of Psychiatry149(7): 931-935.
28.
Pilowsky I. ( 1992) Minor Accidents and Major Psychological Trauma: A Clinical Perspective. Stress Medicine8(2): 77-78.
29.
Preacher KJ, Curran PJ, and Bauer DJ ( 2006) Computational Tools for Probing Interactions in Multiple Linear Regression, Multilevel Modeling, and Latent Curve Analysis. Journal of Educational and Behavioral Statistics31(4): 437-448.
30.
Schnyder U., Moergeli H., Klaghofer R., and Buddeberg C. ( 2001) Incidence and Prediction of Posttraumatic Stress Disorder Symptoms in Severely Injured Accident Victims. American Journal of Psychiatry158(4): 594-599.
31.
Weiss DS and Marmar CR ( 1997) The Impact of Event Scale - Revised. In: Wilson JP, Keane TM (eds) Assessing Psychological Trauma and PTSD. New York: Guilford Press, 399-411.
32.
Zatzick DF, Kang S., Muller H., et al. (2002) Predicting Posttraumatic Distress in Hospitalized Trauma Survivors with Acute Injuries. American Journal of Psychiatry159(6): 941-946.
33.
Zatzick DF, Rivara FP, Nathans AB, et al. (2007) A Nationwide US Study of Post-Traumatic Stress after Hospitalization for Physical Injury. Psychological Medicine37(10): 1469-1480.
