Factors affecting the relationship between trauma and illness behavior

Abstract

Associations between the experience of traumatic events and illness behaviors such as health complaints and healthcare use are reported in recent studies. Posttraumatic Stress Disorder (PTSD) symptoms and diagnosis have been found to mediate this trauma-illness relationship. Differences in health behaviors have additionally been noted in the literature, with trauma victims engaging in more negative health behaviors, which may subsequently affect illness status. Further, illness behaviors such as somatic complaints and healthcare utilization are influenced by modeling and reinforcement of such behaviors. The current study sought to evaluate the contributions of negative health behaviors, illness-related learning history, and PTSD symptoms on trauma victims' health complaints, functional health status, and utilization of healthcare services. The final sample included 298 undergraduate students at a large southeastern university. Participants provided information about their trauma histories, health behaviors, illness-related learning history and current illness behaviors on group-administered self-report questionnaires. Consent to obtain utilization information from the university health center was also obtained. Hierarchical regression analyses were used to assess the additive contributions of the predictor variables. The results indicated that health complaints, functional health status, and utilization behavior are each influenced by trauma history, with more illness behavior associated with greater trauma severity. In addition, health behaviors, illness-related learning history and PTSD symptoms all contribute to the prediction of health complaints and functional health status. Utilization behavior, however, was predicted only by trauma history and learning history. Further, the different types of learning history (modeling, reinforcement, priming) appear to affect different illness behaviors. Implications of the study are discussed.