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THE TEMPORAL RELATIONSHIP BETWEEN MENTAL HEALTH AND DISABILITY AFTER INJURY
Author(s) -
Schweininger Stephanie,
Forbes David,
Creamer Mark,
McFarlane Alexander C.,
Silove Derrick,
Bryant Richard A.,
O'Donnell Meaghan L.
Publication year - 2015
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.22288
Subject(s) - psychopathology , depression (economics) , anxiety , clinical psychology , mental health , psychiatry , psychology , longitudinal study , cohort , cohort study , medicine , pathology , economics , macroeconomics
Objective This longitudinal study investigated the temporal relationship patterns between disability and mental health after injury, with a focus on posttraumatic stress disorder (PTSD), depression, and anxiety. Method We conducted a multi‐sited longitudinal cohort study with a large sample of hospital patients admitted after injury ( N = 1,149, mean age = 37.9, 73.6% male). Data were collected prior to discharge from hospital, and follow‐up assessments took place 3 and 12 months postinjury. A cross‐lagged structural equation model (SEM) was used to assess the prospective relationship between posttraumatic stress, anxiety, and depression symptoms and disability while controlling for demographic characteristics and objective measures of injury severity. Results Acute depression significantly predicted 3‐month disability, and 3‐month PTSD severity significantly predicted 12‐month disability. Premorbid disability had a significant effect on acute anxiety, depression, and posttraumatic stress symptoms, and 3‐month depression but disability after the injury did not predict 12‐month psychopathology. Conclusions We did not find a reciprocal relationship between disability and psychopathology. Rather we found that depression played a role in early disability while PTSD played a role in contributing to long‐term delays in the recovery process. The results of this study highlight the need for mental health screening for symptoms of PTSD and depression in the acute aftermath of trauma, combined with early intervention programs in injury populations.