Trauma Exposure, Posttraumatic Stress, and Preventive Health Behaviors: A Systematic Review.

Health psychology review

PubMedID: 28854859

Lee SY, Park CL. Trauma Exposure, Posttraumatic Stress, and Preventive Health Behaviors: A Systematic Review. Health Psychol Rev. 2017;1-84.
BACKGROUND
Psychological trauma has implications for many aspects of physical health, including preventive health behaviors (PHBs). However, whether trauma exposure additionally contributes to PHBs above and beyond the effects of posttraumatic stress disorder (PTSD) symptoms remains unclear.

OBJECTIVES
In this systematic review, 32 studies were analyzed to characterize: (1) the relationships between trauma exposure and PHBs, (2) the relationships between PTSD symptoms and PHBs, (3) the unique associations between trauma exposure and PHBs, independent of PTSD symptoms, and (4) the unique associations between PTSD symptoms and PHBs, independent of trauma exposure.

RESULTS
Findings were variable across the three examined PHBs (physical activity, diet, medical screening). Physical activity was largely unrelated to trauma exposure, while mixed findings emerged for diet and medical screening. With respect to PTSD symptoms, most studies found a negative or lack of association for both physical activity and diet. Studies consistently found a negative relationship between PTSD symptoms and screening frequency. Clearer relationships emerged between trauma exposure and all three PHBs when PTSD symptoms were taken into account, demonstrating that trauma exposure is related to PHB engagement above and beyond the effects of PTSD symptoms. Additionally, PTSD symptoms shared unique associations with physical activity and screening frequency, which were not explained by trauma exposure.

CONCLUSIONS
In light of mixed findings, our review reveals that teasing apart the effects of trauma exposure and PTSD symptoms on PHBs brings greater clarity to the strength and direction of these associations.