J Korean Med Sci.  2018 Nov;33(45):e284. 10.3346/jkms.2018.33.e284.

Mediating Role of Anxiety and Depression in the Relationship between Posttraumatic Stress Symptoms and Illness Intrusiveness

• Kim NH
• Kim SH
• Hyun SY
• Kang DR
• Oh MJ
• Kim D

• KMID: 2424308
• DOI: http://doi.org/10.3346/jkms.2018.33.e284

Abstract

BACKGROUND
Posttraumatic stress symptoms (PTSS) in patients with psychological trauma lead to poor health-related quality of life. Understanding of the relationships among PTSS, anxiety, depression, and illness intrusiveness will guide the development of efficient approaches to enhance subjective well-being in patients with psychological trauma. This study investigated whether anxiety and depression mediate the relationship between PTSS and illness intrusiveness in the hope of providing more comprehensive and effective trauma treatment.
METHODS
Psychiatric outpatients who visited the trauma clinic of a university hospital (n = 260) participated in this study. Assessments were conducted for PTSS, anxiety, depression, and illness intrusiveness. Structural equation modeling and path analysis were performed to analyze the mediating effects of anxiety and depression on the relationship between PTSS and illness intrusiveness.
RESULTS
PTSS had both direct and indirect exacerbating effects on illness intrusiveness. Anxiety exhibited the largest direct exacerbating effect on illness intrusiveness. The indirect effects of PTSS on illness intrusiveness through anxiety alone and through a depression-to-anxiety pathway were significant, but the indirect effect through depression alone was not.
CONCLUSION
The findings demonstrate that anxiety, both independently and as part of an interrelated pathway with depression, partially mediates the relationship between PTSS and illness intrusiveness. Appropriate interventions and a comprehensive approach to alleviate anxiety and depression could mitigate the negative effects of PTSS on illness intrusiveness in patients with psychological trauma.

Keyword

Posttraumatic Stress; Anxiety; Depression; Illness Intrusiveness; Psychological Trauma

MeSH Terms

Anxiety*
Depression*
Hope
Humans
Negotiating*
Outpatients
Psychological Trauma
Quality of Life