Review Question - QID 211683

A 27-year-old female presents to your clinic for 3 month follow-up after involvement in an MVC. She sustained multiple injuries including a type IIIa open right both bone forearm fracture, closed right femur fracture, bilateral pulmonary contusions, and a grade 3 splenic laceration. She underwent operative stabilization of her orthopedic injuries the following day without complication. Post-operatively, she transitioned to an inpatient rehab facility for two months. During an office visit, she tells you that for the past month she becomes very anxious when riding in a car and has been avoiding driving. Her past medical history is significant for hypertension, anxiety, and obesity. Social history includes a 15 pack-year smoking history and consumption of 3 glasses of wine per day. Which of the following is a risk factor for developing post-traumatic stress disorder (PTSD) in this patient?