View source for The Stress Response Following Serious Injury or Illness: A Biopsychosocial Approach

=== External Factors ===
[[File:Stress responses.jpeg|thumb|Stress effects]]
Acute bouts of stress and anxiety affect one’s mental health following severe illness/injury. These conditions were commonly identified at 1 month post injury/illness, and although their prevalence decreased over time, their incidence still remains high at 12 months.<ref>Kellezi B, Coupland C, Morriss R, Beckett K, Joseph S, Barnes J, Christie N, Sleney J, Kendrick D. The impact of psychological factors on recovery from injury: a multicentre cohort study. Social psychiatry and psychiatric epidemiology. 2017 Jul 1;52(7):855-66.</ref> 

Following severe illness/trauma the combination of several external factors such as a lack of family and social support, financial and/or insurance issues, or contextual conditions (such as deployment and subsequent return home in military personnel) can lead to anxiety and depression, and impact on physical function, pain, and often affecting one’s return to work.

Family and social support play a key role in the recovery of mental health following severe injury. Family support In particular is of great importance since they provide a large portion of the care: they may offer transportation, finances, leisure, and emotional support.<ref>Kellezi B, Coupland C, Morriss R, Beckett K, Joseph S, Barnes J, Christie N, Sleney J, Kendrick D. The impact of psychological factors on recovery from injury: a multicentre cohort study. Social psychiatry and psychiatric epidemiology. 2017 Jul 1;52(7):855-66.</ref> Moreover, they are often involved in the rehabilitation goal planning, which may be adapted based on the resources available at their own home. Family stress and unhealthy family communication were found to impair the rehabilitation process.<ref name=":5">Shoulson I, Wilhelm EE, Koehler R, editors. Cognitive rehabilitation therapy for traumatic brain injury: evaluating the evidence. National Academies Press; 2012 Jan 28.</ref> 

Insurance and compensation-seeking behaviour have also been shown to impact on psychological well-being. Previous studies showed longer lasting symptoms for compensation seekers or litigants, and can cause delayed work return as well as increased levels of psychological stress secondary to the unresolved financial issues, the injury, or a combination of both factors.<ref name=":5" /> 

Contextual factors can affect one’s psychological well-being following a road traffic accidents (RTA). Being involved in an RTA can be both stressful and psychologically traumatic, and it has been reported that many individuals involved in RTA’s do not have their psychological reactions attended. This has been suggested to trigger a psychological stress response when these individuals are exposure to environments associated with the traumatic memory.<ref>Smith B, Mackenzie-Ross S, Scragg P. Prevalence of poor psychological morbidity following a minor road traffic accident (RTA): The clinical implications of a prospective longitudinal study. Counselling Psychology Quarterly. 2007 Jun 1;20(2):149-55.</ref>