Prior trauma and PTSD among homeless mothers: Effects on subsequent stress appraisals, coping, posttraumatic growth, and health outcomes

There is much evidence that the experience of trauma is related to poorer subsequent outcomes, including mental health symptoms, poor physical health, and substance abuse. A high number of previous lifetime traumas and/or the experience of PTSD symptoms may contribute to difficulties adjusting to future life stress. However, some factors may protect individuals from the effects of posttraumatic stress and mediate the relationship between trauma exposure and adjustment outcomes. For instance, stress appraisals and coping behaviors may affect how an individual responds to stressful experiences. Furthermore, there is a growing interest in the potential for positive change following stressful life events (i.e., posttraumatic growth (PTG)). This longitudinal study investigated the effect of prior trauma history and PTSD symptoms on subsequent mental health, physical health, substance use, and posttraumatic growth in a sample of 70 homeless mothers. Participants\u27 appraisals and coping behaviors with regard to a future life stressor and the contribution of these factors on adjustment outcomes were examined. The potential moderating effect of social support on appraisals, coping, and subsequent outcomes was also tested. A series of hierarchical regression analyses were conducted to test the effect of the proposed predictors on each adjustment outcome separately. Results indicated that the sample reported moderate to high levels of posttraumatic growth as a result of a recent life stressor. This is the first study to demonstrate that this phenomenon is observed in homeless mothers. Higher levels of PTSD symptomatology (but not number of prior traumas) and use of avoidant coping predicted greater subsequent mental health symptoms. Appraisals of a stressor as threatening and use of active coping contributed to posttraumatic growth. The examined variables did not significantly predict physical health or substance use outcomes in this sample. No significant moderating effect of social support on any of the outcomes was found. Implications for future research and for the development of interventions aimed at reducing the negative effects of trauma and facilitating posttraumatic growth in homeless women are discussed.