An Initial Application of a Biopsychosocial Framework to Predict Posttraumatic Stress Following Pediatric Injury

Authors

Meghan L. Marsac, University of KentuckyFollow
Nancy Kassam-Adams, University of Pennsylvania
Douglas L. Delahanty, Kent State University
Jeffrey Ciesla, Kent State University
Danielle Weiss, The Children’s Hospital of Philadelphia
Keith F. Widaman, University of California - Riverside
Lamia P. Barakat, University of Pennsylvania

Abstract

Objectives—Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association.

Method—Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses.

Results—Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS.

Conclusions—Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS.

Document Type

Article

Publication Date

8-2017

Notes/Citation Information

Published in Health Psychology, v. 36, no. 8, p. 787-796.

© American Psychological Association, 2017. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: https://doi.org/10.1037/hea0000508

The copyright holder has granted the permission for posting the article here.

The document available for download is the authors' post-peer-review final draft of the article.

Digital Object Identifier (DOI)

https://doi.org/10.1037/hea0000508

Funding Information

This work was supported by a Mentored Career Award grant 1K23MH093618-01A1 from the National Institute of Mental Health.

Related Content

Refer to Web version on PubMed Central for supplementary material.

Repository Citation

Marsac, Meghan L.; Kassam-Adams, Nancy; Delahanty, Douglas L.; Ciesla, Jeffrey; Weiss, Danielle; Widaman, Keith F.; and Barakat, Lamia P., "An Initial Application of a Biopsychosocial Framework to Predict Posttraumatic Stress Following Pediatric Injury" (2017). Pediatrics Faculty Publications. 295.
https://uknowledge.uky.edu/pediatrics_facpub/295