Exploring the contribution of psycho-social mechanisms to recovery following traumatic injury

Background

Traumatic physical injury is associated with negative psychological outcomes such as depression, anxiety and PTSD. Many survivors of major trauma experience problems returning to work which also has a negative impact on quality of life and psychosocial outcomes. There has been little theoretical consideration of the psycho-social mechanisms which may underpin the psychological outcomes of traumatic injury survivors. Empirical evidence of the relationships between health threat appraisal, coping strategies and psychological outcomes (Common Sense Model, Leventhal et al) indicates possible mediation by social context.

Within the social identity approach to health (SIAH, Haslam et al, 2018) it has been argued that the variation in psychological outcomes following trauma exposure is not fully explained by either individual or demographic factors (Muldoon, 2019). The SIAH approach has a strong evidence base linking physical and psychological wellbeing with the psychological benefits gained from the groups we identify ourselves as belonging to.

Aim

To explore the impact of social identity context on cognitive appraisals of traumatic physical injury

Methods

Three qualitative studies with major trauma stakeholders were used to explore the possible contribution of social identity context to cognitive appraisals of stress (threats) and capacity to cope. Semi-structured interviews and focus groups were conducted with two stakeholder types: trauma survivors injured while of working age (n=40) provided lived experience perspectives; service providers (n=35) provided the perspective of relevant professionals with a trauma caseload in either healthcare (including psychological care), research or other roles focused on aiding return to work. Data were analysed using reflexive thematic analysis to allow for a combined an inductive and theory informed deductive approach to the material.