An initial application of a biopsychosocial framework to predict posttraumatic stress following pediatric injury

Meghan L. Marsac, Nancy Kassam-Adams, Douglas L. Delahanty, Jeffrey Ciesla, Danielle Weiss, Keith F. Widaman, Lamia P. Barakat

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Objective: Each year millions of children suffer from unintentional injuries that result in poor emotional and physical health. This study examined selected biopsychosocial factors (i.e., child heart rate, peritrauma appraisals, early coping, trauma history) to elucidate their roles in promoting emotional recovery following injury. The study evaluated specific hypotheses that threat appraisals (global and trauma-specific) and coping would predict subsequent posttraumatic stress symptoms (PTSS), that coping would mediate the association between early and later PTSS, and that heart rate would predict PTSS and appraisals would mediate this association. Method: Participants were 96 children hospitalized for injury and assessed at 3 time points: T1 (within 2 weeks of injury), T2 (6-week follow-up), and T3 (12-week follow-up). Participants completed measures of trauma history and appraisals at T1, coping at T2, and PTSS at T1, T2, and T3. Heart rate was abstracted from medical records. Structural equation modeling was employed to evaluate study hypotheses. Results: Heart rate was not associated with PTSS or appraisals. Models including trauma history, appraisals, coping, and PTSS were constructed to test other study hypotheses and fit the data well. T1 global and trauma-specific threat appraisals were associated with T1 PTSS; T2 avoidant coping was a significant mediator of the relation between T1 and T3 PTSS. Conclusion: Findings confirm a role for appraisals and coping in the development of PTSS over the weeks following pediatric injury. Early appraisals and avoidant coping may be appropriate targets for prevention and early intervention. Future researchers should further explicate the utility of a biopsychosocial framework in predicting PTSS.

Original languageEnglish
Pages (from-to)787-796
Number of pages10
JournalHealth Psychology
Issue number8
StatePublished - Aug 2017

Bibliographical note

Funding Information:
This work was supported by a Mentored Career Award Grant 1K23MH093618-01A1 from the United States Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health.

Publisher Copyright:
© 2017 American Psychological Association.


  • Appraisals
  • Coping
  • Injury
  • Posttraumatic stress

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health


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