title: Contributions of risk and protective factors to prediction of psychological symptoms after traumatic experiences.
abstract: Traumatic experiences cause considerable suffering and place a burden on society due to lost productivity, increases in suicidality, violence, criminal behavior, and psychological disorder. The impact of traumatic experiences is complicated because many factors affect individuals' responses. By employing several methodological improvements, we sought to identify risk factors that would account for a greater proportion of variance in later disorder than prior studies.
  
  
  
  In a sample of 129 traumatically injured hospital patients and family members of injured patients, we studied pre-trauma, time of trauma, and post-trauma psychosocial risk and protective factors hypothesized to influence responses to traumatic experiences and posttraumatic (PT) symptoms (including symptoms of PTSD, depression, negative thinking, and dissociation) two months after trauma.
  
  
  
  The risk factors were all significantly correlated with later PT symptoms, with post-trauma life stress, post-trauma social support, and acute stress symptoms showing the strongest relationships. A hierarchical regression, in which the risk factors were entered in 6 steps based on their occurrence in time, showed the risks accounted for 72% of the variance in later symptoms. Most of the variance in PT symptoms was shared among many risk factors, and pre-trauma and post-trauma risk factors accounted for the most variance.
  
  
  
  Collectively, the risk factors accounted for more variance in later PT symptoms than in previous studies. These risk factors may identify individuals at risk for PT psychological disorders and targets for treatment.
authors.affiliation: National Center for Posttraumatic Stress Disorder, VA Palo Alto Health Care System. Electronic address: eve.carlson@va.gov.
authors.forename: Eve B
authors.initials: EB
authors.lastname: Carlson
authors.affiliation: Center for the Treatment and Study of Traumatic Stress, Summa Health System.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Palmieri
authors.affiliation: Palo Alto University.
authors.forename: Nigel P
authors.initials: NP
authors.lastname: Field
authors.affiliation: Alliant International University San Diego.
authors.forename: Constance J
authors.initials: CJ
authors.lastname: Dalenberg
authors.affiliation: Palo Alto University.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Macia
authors.affiliation: Department of Surgery, Stanford University School of Medicine.
authors.forename: David A
authors.initials: DA
authors.lastname: Spain
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D065840:Protective Factors; D012307:Risk Factors; D012944:Social Support; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D014193:Trauma Centers; D014754:Violence / Q000523:psychology; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult