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      Mediating Role of Anxiety and Depression in the Relationship Between Posttraumatic Stress Disorder and Aggression in Motor Vehicle Accident: A Structural Equation Modelling Approach

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          Abstract

          Objective:

          This study investigated the existence of anxiety and depression mediating effect on the relationship between PTSD and aggression in the hope of providing more comprehensive and effective trauma treatment in motor vehicle accident.

          Methods:

          The studied population of the study consisted of motor vehicles with posttraumatic stress disorder in Kashan. Three questionnaires of post-traumatic stress disorder, Hospital Anxiety and Depression Scale ( HADS ) and Aggression Questionnaire ( Buss & Perry , 1992) were used for data collection. In order to analyze the mediating effects of anxiety and depression on the relationship between PTSD and aggression, structural equation modeling(SEM) was performed with the maximum likelihood ratio as the method of estimation.

          Results:

          Evaluation of the research hypothesis model using fitness indices showed that the hypothetical model fits with the measurement model. NFI=0.96, CFI =0.95, RMSEA=0.06 and the results showed that PTSD had indirect exacerbating effects on aggression. The results also confirmed the mediating role of anxiety and depression in the relationship between post-traumatic stress disorder and aggression in motor vehicle accident.

          Conclusion:

          The findings demonstrate that anxiety mediates the relationship between PTSD and aggression. Therefore, this finding can help to prioritize therapeutic goals and determine therapeutic focus for mental health professionals. It is possible to reduce one's aggression by focusing on his anxiety and increasing his/her ability to handle and manage it.

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          Most cited references31

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          The hospital anxiety and depression scale.

          A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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            Comparative fit indexes in structural models.

            P. Bentler (1990)
            Normed and nonnormed fit indexes are frequently used as adjuncts to chi-square statistics for evaluating the fit of a structural model. A drawback of existing indexes is that they estimate no known population parameters. A new coefficient is proposed to summarize the relative reduction in the noncentrality parameters of two nested models. Two estimators of the coefficient yield new normed (CFI) and nonnormed (FI) fit indexes. CFI avoids the underestimation of fit often noted in small samples for Bentler and Bonett's (1980) normed fit index (NFI). FI is a linear function of Bentler and Bonett's non-normed fit index (NNFI) that avoids the extreme underestimation and overestimation often found in NNFI. Asymptotically, CFI, FI, NFI, and a new index developed by Bollen are equivalent measures of comparative fit, whereas NNFI measures relative fit by comparing noncentrality per degree of freedom. All of the indexes are generalized to permit use of Wald and Lagrange multiplier statistics. An example illustrates the behavior of these indexes under conditions of correct specification and misspecification. The new fit indexes perform very well at all sample sizes.
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              Structural Model Evaluation and Modification: An Interval Estimation Approach.

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                Author and article information

                Journal
                Bull Emerg Trauma
                Bull Emerg Trauma
                BEAT
                Bulletin of Emergency & Trauma
                Shiraz University of Medical Sciences (Shiraz, Iran )
                2322-2522
                2322-3960
                October 2020
                : 8
                : 4
                : 243-248
                Affiliations
                [1 ] Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [2 ] Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
                Author notes
                [* ]Corresponding Author: Hamid Soori, Address: Safety Promotion and Injury Prevention Research Center, School of Public Health, Shahid Beheshti University of Medical Sciences,Tehran, Iran. Tel: +98-912-7906251, e-mail: hsoori @yahoo.com
                Article
                10.30476/beat.2020.85690
                7783301
                307db8d2-fc36-412c-87de-5aa5ce01490d
                Journal compilation © 2020 Trauma Research Center, Shiraz University of Medical Sciences

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 March 2020
                : 8 July 2020
                : 8 September 2020
                Categories
                Original Article

                motor vehicle,structural equation modelling,posttraumatic stress disorder

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