title: An examination of PTSD symptoms as a mediator of the relationship between trauma history characteristics and physical health following a motor vehicle accident.
abstract: BACKGROUND
  It has been suggested that a history of trauma exposure is associated with increased vulnerability to the physical health consequences of subsequent trauma exposure, and that posttraumatic stress symptoms (PTSS) may serve as a key pathway in this vulnerability. However, few studies have modeled these relationships using mediation, and most have failed to consider whether specific characteristics of the prior trauma exposure have a differential impact on physical and mental health outcomes.
  
  
  METHODS
  The present study examined 180 victims of a serious motor vehicle accident (MVA) who reported prior exposure to traumatic events. PTSS were assessed by clinical interview 6 weeks post-MVA, and physical health was assessed 6 months post-MVA. Using structural equation modeling, the present study examined the extent to which event (age at first trauma, number, and types of trauma) and response (perceptions of life threat, physical injury, and distress) characteristics of prior trauma were related to physical health outcomes following a serious MVA, and whether these relationships were mediated by PTSS.
  
  
  RESULTS
  Results revealed that both event and response characteristics of prior trauma history were associated with poorer physical health, and that PTSS served as a mechanism through which response characteristics, but not event characteristics, led to poorer physical health.
  
  
  CONCLUSIONS
  These results highlight the enduring impact of trauma exposure on physical health outcomes, and underscore the importance of considering multiple mechanisms through which different aspects of prior trauma exposure may impact physical health.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Leah A
authors.initials: LA
authors.lastname: Irish
authors.forename: Crystal A
authors.initials: CA
authors.lastname: Gabert-Quillen
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Ciesla
authors.forename: Maria L
authors.initials: ML
authors.lastname: Pacella
authors.forename: Eve M
authors.initials: EM
authors.lastname: Sledjeski
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Delahanty
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult