Longitudinal course and predictors of posttraumatic stress symptoms after spinal cord injury.

Objective: This study examined longitudinal changes in post-traumatic stress symptoms (PTSS) in individuals newly diagnosed with spinal cord injury (SCI) and tested various psychosocial and injury-related characteristics as predictors for interindividual differences in symptom courses.

Design: Longitudinal data from the larger Swiss Spinal Cord Injury Cohort Study were used. The sample consisted of 269 patients (70.6% male; = 53.21) admitted for inpatient rehabilitation to SCI rehabilitation centers.

Main Outcome Measure: PTSS were measured at one and six months after injury using the Impact of Event Scale-6.

Results: Latent change score modelling revealed no average change in PTSS in the sample, but significant variability in the individual symptom courses. Reliable change index analyses suggest that among individuals with an initial PTSS severity of clinical concern ( = 65), only 27.7% showed clinically significant decreases over time. Predictors explained 34% of the variance in PTSS change. Loss appraisals ( = .30,  < .001) and cause of injury ( = .16,  = .018) emerged as unique predictors.

Conclusion: Clinically elevated PTSS one month after SCI typically remain across the following months highlighting the need for early screening and intervention. Low loss appraisals were related to decreases in symptom severity and might therefore be a suitable intervention target for reducing PTSS after SCI.