In this study on the effects of attributions of responsibility for traumatic events, stress, coping, and symptoms of posttraumatic stress disorder (PTSD) were measured, including intrusive thoughts among 130 victims of serious motor vehicle accidents (MVAs) 14-21 days and 3, 6, and 12 months after their accident. MVA victims and 43 control participants were categorized by accident and attribution of responsibility for their accidents (self-responsible, other-responsible, and control). Although initially all MVA victims reported higher levels of intrusive thoughts and were more likely to meet criteria for PTSD diagnoses, only other-responsible participants continued to demonstrate increased distress 6 and 12 months postaccident. Self-responsible participants used more self-blame coping than other-responsible participants, although within the self-responsible group, use of self-blame was associated with more distress.

The cumulative effects of trauma were examined in 108 workers at the site of a major air disaster at 4 time points over a year following the crash. The influence of trauma history on chronic distress and physiological arousal associated with the crash were examined. Stress levels were expected to differ on the basis of the similarity of prior trauma exposure to work at the crash site. Prior traumatic exposure that was "dissimilar" to this type of work was associated with greater vulnerability to crash-related stress, that is, more distress and crash-related intrusions during the year following the crash. Accumulation of a variety of different traumatic experiences appeared to sensitize workers to the new stressor and to perpetuate chronic stress. Understanding the role of trauma history is important for improving intervention efforts aimed at alleviating stress following a trauma.

Interest has been steadily building in the impact of stress on psychological and physiological functioning, in particular on immune system responses, furthering the concept of a strong connection between the mind and the body. Implications for prevention of disease onset or treatment of stress-induced illness or immunocompromised conditions have been explored through the implementation of stress management techniques. Cognitive behavioral stress management interventions, biofeedback, relaxation, guided imagery, hypnosis, individual and group psychotherapy, aerobic exercise, and guided self-efficacy treatment are briefly reviewed to identify possible treatment mechanisms that may affect immune function and promote quality of life. The application of behavioral techniques to reduce distress and sharpen coping skills has great promise in reducing the costs associated with chronic disease and in enhancing quality of life among those afflicted.

No abstract