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Does Prior Trauma Predict Negative Posttraumatic Appraisal in Motor Vehicle Accident Survivors?

Hiroko Noguchi, Daisuke Nishi, Yoshiharu Kim, Takako Konishi and Yutaka Matsuoka

Psychological investigation by Ehlers and Clark in 2000 suggested that negative posttraumatic appraisal is associated with the development and maintenance of posttraumatic Stress Disorder (PTSD). In their cognitive model of PTSD, they propose that prior trauma predicts negative posttraumatic appraisal. Meta-analyses have shown that prior trauma is also one of the predictors of PTSD. Negative posttraumatic appraisal might then mediate the relationship between prior trauma and PTSD, but this hypothesis has yet to be examined. The aim of this study was to examine whether prior trauma predicts negative posttraumatic appraisal, through a secondary analysis of the Tachikawa Cohort of Motor Vehicle Accident Study data. The final sample with complete data at 1 and 6 months post-motor vehicle accident (MVA) comprised 96 patients. Negative posttraumatic appraisal was assessed using the post traumatic Cognitions Inventory at 1 month and 6 months post-MVA. Total number of prior traumas reported by the participants was assessed at 1 month post-MVA. After controlling for confounding variables, multiple regression analysis showed that number of prior traumas was a significant predictor of negative  posttraumatic appraisal at 1 month post-MVA (B=2.84, p= .02, 95% CI [.44, 5.24]), but not at 6 months post-MVA (B=2.10, p=0.20, 95% CI [-.96, 5.15]). The hypothesis tested was partly supported given that number of prior traumas had a significant effect on negative appraisal in the early phase among MVA survivors, but prior trauma failed to predict posttraumatic appraisal at the chronic phase.