A Multiple-Indicator Multiple-Cause Model for Posttraumatic Stress Reactions: Personality, Coping, and Maladjustment

Objective: This study aimed to develop a multiple-indicator multiple-cause model (MIMIC) to describe the relationship among posttraumatic stress (PTSD) responses, general health problems, death anxiety, personality factors, and coping strategies among community residents exposed to the technological disasters of aircraft and train crashes. Materials and Methods: One hundred forty-eight community residents, after exposure to the aircraft or train crash, were assessed using the Impact of Event Scale, the General Health Questionnaire-28, the Death Anxiety Scale, the Eysenck Personality Questionnaire, and the Ways of Coping Checklist. The control group (n = 90) comprised members of the general public, who had not been exposed to the disasters, from another city. Results: The model showed significant associations between the impact of the disaster and general health problems, which varied depending on where community residents lived in relation to the disaster site, whether they were present when the disaster occurred, and the type of disaster. The model also suggested that death anxiety was associated with type of disaster and neuroticism. The model supported the interactive model in that personality factors interacted with coping strategies in maintaining or generating PTSD and general health problems. Conclusions: After exposure to technological disasters, community residents could develop PTSD and general health problems; however, increased death anxiety was a separate psychological reaction. The interaction between certain personality traits and coping strategies was one reason for PTSD and general health problems. MIMIC = multiple-indicator multiple-cause model; PTSD = posttraumatic stress disorder; POWS = prisoners of war; IES = The Impact of Event Scale; GHQ-28 = The General Health Questionnaire; DAS = The Death Anxiety Scale; EPQ-R = The Eysenck Personality Questionnaire-R Short Scale; WOC = The Ways of Coping Checklist; ANOVA = analysis of variance; RMSEA = root mean square error of approximation.

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