title: Trauma exposure and health: the role of depressive and hyperarousal symptoms.
abstract: Posttraumatic stress disorder (PTSD) and depressive symptoms have been theorized to mediate the relationship between trauma exposure and physical health symptoms. Although empirical evidence supports this premise, studies conducted to date have employed statistical mediation analyses that are now broadly criticized. Furthermore, the mediating roles of both PTSD and depressive symptoms have seldom been examined concurrently, and it remains unclear which PTSD symptom clusters uniquely mediate this relationship. The aim of the present study was to examine the mediating role of reexperiencing, avoidance/numbing, hyperarousal, and depressive symptoms in the relationship between trauma exposure and physical health symptoms. Participants were 516 Spanish female undergraduate students. Physical health symptoms were compared between those who reported trauma exposure (n = 266) and those who did not (n = 250). Data from trauma-exposed participants were analyzed using regression models with bootstrapping to test mediation. Results of the analyses showed that the trauma-exposed group reported significantly more physical health symptoms (r(2)  = .035). Hyperarousal and depressive symptoms uniquely mediated the relationship between trauma exposure and physical health symptoms. Our findings clarify some of the mechanisms by which negative health consequences occur subsequent to trauma exposure.
authors.affiliation: Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada. lydia.gomez.perez@uregina.ca
authors.forename: Lydia Goméz
authors.initials: LG
authors.lastname: Pérez
authors.forename: Murray P
authors.initials: MP
authors.lastname: Abrams
authors.forename: Alicia E
authors.initials: AE
authors.lastname: López-Martínez
authors.forename: Gordon J G
authors.initials: GJ
authors.lastname: Asmundson
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D055815:Young Adult