Physical Injury and Somatic Complaints: The Mediating Role of Posttraumatic Stress Symptoms in Young Survivors of a Terror Attack

Physically injured trauma survivors have particularly high risk for later somatic complaints and posttraumatic stress symptoms (PTSS). However, the potential mediating role of PTSS linking injury to later somatic complaints has been poorly investigated. In this study, survivors (N = 255) were interviewed longitudinally at 2 timepoints after the terror attack on Utøya Island, Norway, in 2011. Assessments included injury sustained during the attack, PTSS (after 4–5 months), somatic complaints (after 14–15 months), and background factors. Causal mediation analysis was conducted to evaluate the potential mediating role of PTSS in linking injury to somatic complaints comparing 2 groups of injured survivors with noninjured survivors. For the nonhospitalized injured versus the noninjured survivors, the mediated pathway was significant (average causal mediation effect; ACME = 0.09, p = .028, proportion = 55.8%). For the hospitalized versus the noninjured survivors, the mediated pathway was not significant (ACME = 0.04, p = .453, proportion = 11.6%). PTSS may play a significant mediating role in the development of somatic complaints among nonhospitalized injured trauma survivors. Intervening health professionals should be aware of this possible pathway to somatic complaints. Resumen Spanish s by the Asociación Chilena de Estrés Traumático (ACET) Los sobrevivientes de trauma con lesiones físicas tienen un riesgo particularmente alto de quejas somáticas y síntomas de estrés postraumático (PTSS) posteriores. Sin embargo, el potencial rol mediador de los síntomas de TEPTvinculando las lesiones sufridas a las quejas somáticas posteriores ha sido poco investigado. En este estudio, los sobrevivientes (N = 255) fueron entrevistados longitudinalmente en dos momentos, después del ataque terrorista en la isla de Utøya, Noruega, en 2011. Las evaluaciones incluyeron:lesiones sufridas durante el ataque, TEPT (después de 4 a 5 meses), quejas somáticas (después de 14 a 15 meses) y factores contextuales. Se realizó un análisis de mediación para evaluar el posible rol mediador de TEPT en el vínculo entre sufrir lesiones y las quejas somáticas, comparando dos grupos de sobrevivientes heridos y no heridos. Para los sobrevivientes heridos no hospitalizados versus los no heridos, la mediación fue significativa (efecto medio de mediación causal‐ ACME = 0,09, p = 0,028, proporción = 55,8%). Para los sobrevivientes hospitalizados versus los no heridos, la mediación no fue significativa (AC