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Acute Stress Symptoms in Seriously Injured Patients: Precipitating Versus Cumulative Trauma and the Contribution of Peritraumatic Distress
Author(s) -
Briere John,
Dias Colin P.,
Semple Randye J.,
Scott Catherine,
Bigras Noémie,
Godbout Natacha
Publication year - 2017
Publication title -
journal of traumatic stress
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.259
H-Index - 134
eISSN - 1573-6598
pISSN - 0894-9867
DOI - 10.1002/jts.22200
Subject(s) - distress , acute stress disorder , medicine , injury prevention , poison control , posttraumatic stress , psychiatry , clinical psychology , emergency medicine
The relationship between type of trauma exposure, cumulative trauma, peritraumatic distress, and subsequent acute stress disorder (ASD) symptoms was examined prospectively in 96 individuals presenting with acute medical injuries to a Level 1 emergency/trauma department. Common precipitating traumas included motor vehicle‐related events, stabbings, shootings, and physical assaults. At 2 to 3 weeks follow‐up, 22.9% of participants had developed ASD. Univariate analysis revealed no relationship between type of precipitating trauma and ASD symptoms, whereas robust path analysis indicated direct effects of gender, lifetime cumulative trauma exposure, and peritraumatic distress. Peritraumatic distress did not mediate the association between cumulative trauma and symptoms, but did mediate the association between gender and symptomatology. These results, which account for 23.1% of the variance in ASD symptoms, suggest that ASD may be more due to cumulative trauma exposure than the nature of the precipitating trauma, but that cumulative trauma does not exert its primary effect by increasing peritraumatic distress to the most recent trauma.