Posttraumatic Stress and Family Functioning in Pediatric Spinal Cord Injuries: Moderation or Mediation?

This study assessed whether posttraumatic stress moderated or mediated the relationship between family functioning and functional independence in pediatric spinal cord injury. Family Assessment Device, Posttraumatic Diagnostic Scale/Child PTSD Symptom Scale, and Pediatric Orthopedic Surgeons of North America Pediatric Musculoskeletal Functional Health Questionnaire data were collected from 64 patients (11 to 24 years of age) and their parents. Regression analyses indicated that posttraumatic stress mediates, rather than moderates, the relationship between family functioning and functional independence. This study suggests that family functioning indirectly influences functional independence through its effects on severity of posttraumatic stress.