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Powers MB, Douglas ME, Driver S, Sikka S, Hamilton R, Swank C, Callender L, Ochoa C, Bennett M, Stewart N, Chauvin GV, Rothbaum BO, Warren AM. Prevention of posttraumatic stress during inpatient rehabilitation post spinal cord injury: Study protocol for a randomized controlled trial of Brief Prolonged Exposure Therapy (Brief PE). Contemp Clin Trials Commun 2022; 30:101030. [PMID: 36387992 PMCID: PMC9661669 DOI: 10.1016/j.conctc.2022.101030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/20/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background Scant research has focused on posttraumatic stress disorder (PTSD) in the SCI population, despite high prevalence estimates. Fortunately, prolonged exposure therapy (PE) is a well-researched and highly effective treatment for PTSD. Our recent clinical trial showed that standard 12-session PE was effective for PTSD treatment among inpatients with SCI. Early intervention with brief PE (3-sessions) delivered in the emergency department has also been effective for PTSD prevention, but has not been tested among people post-SCI. Thus, we aim to conduct the first test of the Brief PE intervention to prevent PTSD among patients with SCI. Methods Adults who have experienced a SCI (N = 200) will be randomly assigned during inpatient rehabilitation to either: (a) 3 60-min sessions of Brief PE (intervention group) or (b) treatment as usual (control group). Results The primary outcome measure (PTSD symptoms measured by the PSSI-5) and secondary outcome measures (depression, anxiety, pain, quality of life, sleep disturbance, and resilience) will be assessed at baseline, 1-month, 3-months, and 6-months. Hierarchical linear modeling (HLM) will be used to evaluate the effectiveness of the PE intervention on PTSD and secondary outcomes. Descriptive statistics will examine feasibility and will include the number of participants enrolled, the number of sessions completed, fidelity of Brief PE delivery, and average scores for difficulty and helpfulness of the intervention scales for those randomized to intervention. Conclusions Successful completion of this study will provide an evidence-based program to alleviate posttraumatic distress post spinal cord injury and prevent long-term development of PTSD.
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Affiliation(s)
- Mark B. Powers
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Corresponding author. Baylor Scott & White Spinal Cord Injury Model System, USA.
| | - Megan E. Douglas
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
| | - Simon Driver
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Seema Sikka
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Rita Hamilton
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Chad Swank
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Librada Callender
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Christa Ochoa
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Monica Bennett
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
| | - Neil Stewart
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Gregory V. Chauvin
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
- Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA
| | - Barbara O. Rothbaum
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Emory University School of Medicine, USA
| | - Ann Marie Warren
- Baylor Scott & White Spinal Cord Injury Model System, USA
- Baylor Scott and White Research Institute, Dallas, TX, USA
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Gruszka W, Owczarek AJ, Glinianowicz M, Bąk-Sosnowska M, Chudek J, Olszanecka-Glinianowicz M. Can Nutritional Status in Adults Be Influenced by Health Locus of Control? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15513. [PMID: 36497586 PMCID: PMC9740701 DOI: 10.3390/ijerph192315513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 11/09/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
The external health locus of control (HLC) is based on an assumption that obtained health results depend on the influences of external factors. As for the internal HLC-that is the effect of our own actions and capabilities. Little is known regarding how the HLC can influence body weight or the occurrence of visceral obesity. The study aimed to assess the relationship between the health locus of control and nutritional status in adults. The study included 744 adults (452 women, 292 men; 2.8% underweight, 43.8% normal weight, 29.7% overweight, and 23.7% obese). In addition to anthropometric measurement and socio-demographic data, the health locus of control, using the Multidimensional Health Locus of Control Scale (MHLC) by Wallston K, Wallston B, and DeVellis R, was assessed. The percentage of subjects with an internal HLC did not differ significantly between obese, overweight, and normal-weight groups. However, the percentage of subjects with an external HLC-dependent on the impact of others-was significantly higher in both men and women with obesity than in corresponding overweight and normal-weight groups (p < 0.01). Yet, the percentage of subjects with an external HLC subject to the impact of chance was significantly higher among overweight and obese women than in those of normal weight (p < 0.05) only. Women with overweight or obesity, with external health locus of control, experienced both the impact of others and of chance more often than women with normal weight. However, men with overweight and with obesity more often had external health locus of control influenced only by others.
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Affiliation(s)
- Wojciech Gruszka
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Aleksander J. Owczarek
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Mateusz Glinianowicz
- Department of Psychology, Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | - Monika Bąk-Sosnowska
- Department of Psychology, Social Sciences and Humanities, School of Health Sciences in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- WSB Academy, Department of Health Sciences, Cieplaka 1C Str., 41-300 Dąbrowa Górnicza, Poland
| | - Jerzy Chudek
- Pathophysiology Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
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Atilola O, Stevanovic D, Moreira P, Dodig-Ćurković K, Franic T, Djoric A, Davidovic N, Avicenna M, Noor IM, Monteiro AL, Ribas A, Stupar D, Deljkovic A, Nussbaum L, Thabet A, Ubalde D, Petrov P, Vostanis P, Knez R. External locus-of-control partially mediates the association between cumulative trauma exposure and posttraumatic stress symptoms among adolescents from diverse background. ANXIETY, STRESS, AND COPING 2021; 34:626-644. [PMID: 33650438 DOI: 10.1080/10615806.2021.1891224] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Locus of control (LOC) is a modifiable mediator of symptoms of posttraumatic stress disorder (PTSD) among traumatized individuals and a potential target of intervention. Compared with studies involving adults, the potential mediation effect of LOC on PTSD symptoms among trauma-exposed children and adolescents is relatively under-explored. This study, therefore, assessed the mediation effects of LOC on the association between lifetime cumulative trauma and PTSD symptoms among a large cohort of adolescents from different cultural background. Cross-sectional study. LOC was determined using the Multi-Dimension Locus of Control Scale; Posttraumatic stress symptoms using the UCLA PTSD Reaction Index; and other significant negative life events using the Life Events Checklist. Among 3826 adolescents who completed the study, external LOC explained 24% of variance (R2 = .24; F2,3823 = 619.01; p < .01) in PTSD symptoms and had significant indirect effect on the relationship between self-reported cumulative traumatic event exposure and PTSD symptoms (ß = .14; 95% BC CI [.10, .20]). Moderated mediation results showed significant potentiation of the moderation effects among older adolescents; boys; and those from more affluent families. The study further strengthened the hitherto limited evidence that external LOC partially mediate the relationship between cumulative trauma exposure and PTSD symptoms among adolescents.
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Affiliation(s)
- Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Paulo Moreira
- University Lusíada North (Porto), CIPD; CLISSIS, Lisboa, Portugal
| | | | - Tomislav Franic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Ana Djoric
- Department of psychology, Faculty of Humanities and Social Sciences, Rijeka, Croatia
| | - Nikolina Davidovic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Mohamad Avicenna
- Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia
| | | | | | - Adriana Ribas
- Institute of Psychology, Federal University, Rio de Janeiro, Brazil
| | - Dusko Stupar
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | | | - Laura Nussbaum
- Department of Department of Neurosciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Dino Ubalde
- Department of Psychology, St. Dominic College of Asia, City of Bacoor, Philippines
| | - Petar Petrov
- Department of Child and Adolescent Psychiatry, University Hospital St. Marina, Varna, Bulgaria
| | - Panos Vostanis
- School of Psychology, Leicester University, Leicester, UK
| | - Rajna Knez
- Medical school, University of Rijeka, Rijeka, Croatia
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Swyer A, Powers AR. Voluntary control of auditory hallucinations: phenomenology to therapeutic implications. NPJ SCHIZOPHRENIA 2020; 6:19. [PMID: 32753641 PMCID: PMC7403299 DOI: 10.1038/s41537-020-0106-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/04/2020] [Indexed: 12/11/2022]
Abstract
Auditory verbal hallucinations (AVH) have traditionally been thought to be outside the influence of conscious control. However, recent work with voice hearers makes clear that both treatment-seeking and non-treatment-seeking voice hearers may exert varying degrees of control over their voices. Evidence suggests that this ability may be a key factor in determining health status, but little systematic examination of control in AVH has been carried out. This review provides an overview of the research examining control over AVH in both treatment-seeking and non-treatment-seeking populations. We first examine the relationship between control over AVH and health status as well as the psychosocial factors that may influence control and functioning. We then link control to various cognitive constructs that appear to be important for voice hearing. Finally, we reconcile the possibility of control with the field’s current understanding of the proposed cognitive, computational, and neural underpinnings of hallucinations and perception more broadly. Established relationships between control, health status, and functioning suggest that the development of control over AVH could increase functioning and reduce distress. A more detailed understanding of the discrete types of control, their development, and their neural underpinnings is essential for translating this knowledge into new therapeutic approaches.
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Affiliation(s)
- Ariel Swyer
- Department of Behavioral Sciences, York College/CUNY, Jamaica, NY, USA
| | - Albert R Powers
- Department of Psychiatry and the Connecticut Mental Health Center, Yale University, New Haven, CT, USA.
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Conti A, Clari M, Kangasniemi M, Martin B, Borraccino A, Campagna S. What self-care behaviours are essential for people with spinal cord injury? A systematic review and meta-synthesis. Disabil Rehabil 2020; 44:991-1006. [PMID: 32602384 DOI: 10.1080/09638288.2020.1783703] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To systematically identify, evaluate, and synthesise the qualitative literature on the self-care behaviours, skills, and strategies performed by individuals with spinal cord injury (SCI).Review methods: The Joanna Briggs Institute (JBI) meta-aggregation method was followed. The search was conducted on five databases and limited to papers published from January 2000 to March 2020. Two independent reviewers screened, extracted the data from, and assessed the methodological quality of selected papers using the JBI qualitative assessment and critical appraisal instrument.Results: Eleven qualitative papers were included. Three synthesised findings with a moderate level of confidence emerged from 90 findings: people with SCI perform self-directed or directed-by-other behaviours focused on their physical condition (i); and on their social life (ii); people with SCI perform self-directed behaviours focused on their emotional well-being (iii). Individuals with SCI are aware of their condition and incorporate self-care behaviours into their routine to maintain health and prevent complications.Conclusion: This meta-synthesis provides evidence on the self-care behaviours performed by people with SCI to prevent, control, and manage the physical, emotional, and social effects of their condition. These findings may help healthcare providers to understand the self-care process in SCI survivors and tailor educational programmes to their experiences.IMPLICATIONS FOR REHABILITATIONSCI survivors are directly responsible for their health and must reach their maximum level of independence by acquiring self-care behaviours and adjusting them over time.Self-care behaviours must be incorporated into SCI survivors' daily routine to maintain their condition, promote their social participation, and prevent complications.Caregiver contributions to self-care should be given more value, as these are fundamental to maintain SCI survivors' well-being and social participation.
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Affiliation(s)
- Alessio Conti
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Marco Clari
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Barbara Martin
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Alberto Borraccino
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
| | - Sara Campagna
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy
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Boyraz G, Zhu Y, Waits JB. Avoidance coping and academic locus of control as mediators of the relationship between posttraumatic stress and academic achievement among first-year college students. ANXIETY, STRESS, AND COPING 2019; 32:545-558. [PMID: 31272203 DOI: 10.1080/10615806.2019.1638681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background and Objectives: Posttraumatic stress (PTS) has been found to be associated with poor academic performance among college students. However, our understanding of the mechanisms underlying this relationship is limited to the results of a few recent studies. The present study is aimed at expanding the literature in this area by examining whether avoidance coping and external academic locus of control (LOC) mediate the relationship between PTS and academic achievement among first-year college students. Design: A correlational study design was used. Students completed a quantitative survey in their first semester of college. After they completed their first academic year, we obtained their grade point averages (GPAs) through the university. Method: Participants included 280 first-year college students with a history of potentially traumatic events. Data obtained from these participants were analyzed using path analysis. Results: Two indirect paths from PTS to first-year GPA were significant, suggesting that external academic LOC mediated the effects of both PTS and avoidance coping on first-year GPA. Conclusion: Our findings suggest that the interventions that target external academic LOC may help reduce the detrimental effects of PTS on academic achievement among trauma-exposed college students.
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Affiliation(s)
- Güler Boyraz
- a Department of Psychology, Pace University , New York , NY , USA
| | - Yixun Zhu
- b Department of Psychology and Behavioral Sciences, Louisiana Tech University , Ruston , LA , USA
| | - J Brandon Waits
- b Department of Psychology and Behavioral Sciences, Louisiana Tech University , Ruston , LA , USA
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Etingen B, Locatelli SM, Miskevics S, LaVela SL. Examining the relationship between post-traumatic stress disorder and social participation among Veterans with spinal cord injuries and disorders. Disabil Rehabil 2017; 40:2637-2643. [PMID: 28743195 DOI: 10.1080/09638288.2017.1355938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The objectives of this study were to examine differences in social participation among Veterans with spinal cord injuries/disorders with and without post-traumatic stress disorder, and determine if lower social participation was independently associated with having post-traumatic stress disorder. METHODS A cross-sectional mailed national survey was sent to a national sample of Veterans with spinal cord injuries/disorders who received prior-year Veterans Affairs healthcare. Surveys provided data on: demographics, health conditions, injury characteristics, and social participation. Analyses included bivariate comparisons, and multivariate logistic regression to determine if lower social participation was independently associated with post-traumatic stress disorder. RESULTS Veterans with (vs. without) post-traumatic stress disorder (n = 896) reported lower social participation (40.2 vs. 43.9, p < 0.0001). Multivariate analyses showed that longer duration of injury (OR = 0.98, 95% CI: 0.97-1.00, p = 0.04) and white race (OR = 0.62, 95% CI: 0.38-1.01, p = 0.05) were associated with lower odds of post-traumatic stress disorder, while a greater number of health conditions (OR = 1.43, 95% CI: 1.25-1.64, p < 0.0001) was associated with greater odds. When controlling for covariates, lower social participation was independently associated with post-traumatic stress disorder (OR = 0.94, 95% CI: 0.90-0.98, p = 0.003). CONCLUSIONS Results indicate post-traumatic stress disorder is associated with lower social participation in Veterans with spinal cord injuries/disorders, independent of other factors that may impact participation. Efforts to screen for and treat post-traumatic stress disorder among persons with spinal cord injuries/disorders, regardless of injury-specific factors, are needed to improve participation. Implications for Rehabilitation Individuals with spinal cord injuries/disorders often have post-traumatic stress disorder; in Veterans with spinal cord injuries/disorders this may be compounded by trauma incurred through military experiences. Social participation, an important aspect of rehabilitation and community integration following spinal cord injury or disorder, may be hindered by symptoms of post-traumatic stress disorder. Our data show that post-traumatic stress disorder is associated with lower social participation in Veterans with spinal cord injuries/disorders, independent of other factors that may impact participation. These results indicate that efforts to screen for and treat post-traumatic stress disorder among persons with spinal cord injuries/disorders, regardless of injury-specific factors, are needed to improve participation in this patient population.
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Affiliation(s)
- Bella Etingen
- a Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development, Department of Veterans Affairs , Hines VA Hospital , Hines , IL , USA
| | - Sara M Locatelli
- a Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development, Department of Veterans Affairs , Hines VA Hospital , Hines , IL , USA
| | - Scott Miskevics
- a Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development, Department of Veterans Affairs , Hines VA Hospital , Hines , IL , USA
| | - Sherri L LaVela
- a Center of Innovation for Complex Chronic Healthcare (CINCCH), Health Services Research and Development, Department of Veterans Affairs , Hines VA Hospital , Hines , IL , USA.,b Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine , Northwestern University , Chicago , IL , USA
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Wagner EH, Hoelterhoff M, Chung MC. Posttraumatic stress disorder following asthma attack: the role of agency beliefs in mediating psychiatric morbidity. J Ment Health 2017; 26:342-350. [PMID: 28675709 DOI: 10.1080/09638237.2017.1340628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The link between serious illness and subsequent posttraumatic stress disorder (PTSD) and psychiatric comorbidity has been established. In populations with asthma, however, few studies have investigated this link, or what psychological mechanisms mediate it. Healthcare guidance for chronic conditions, and PTSD literature, highlight "agency beliefs" as a direction for investigation. AIMS To determine the prevalence of PTSD following asthma attack, and investigate whether agency beliefs mediate PTSD and comorbid psychiatric symptoms in this population. METHOD We recruited 110 adults with asthma from online peer support forums. Participants completed the Asthma Symptom Checklist, PTSD Checklist, GHQ-28, General Self-Efficacy scale, and Multidimensional Health Locus of Control scale. RESULTS 20% of our sample met criteria for PTSD. Regression results indicated that higher asthma severity significantly predicted PTSD and psychiatric co-morbidity. Lower self-efficacy significantly predicted PTSD symptoms while controlling for asthma severity, however Locus of Control (LoC) did not improve the model further. Self-efficacy, but not LoC, significantly partially mediated the effect of asthma severity on PTSD severity and psychiatric co-morbidity. CONCLUSIONS PTSD and other psychiatric symptoms in asthma populations are mediated in part by self-efficacy. Safeguarding and improving self-efficacy in this population is an important area for future research and intervention.
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Affiliation(s)
- Ernest H Wagner
- a School of Health in Social Science, University of Edinburgh, Medical School , Edinburgh , UK.,b Department of Clinical Psychology , NHS Grampian, Royal Cornhill Hospital , Aberdeen , UK
| | - Mark Hoelterhoff
- c Department of Psychology , University of Cumbria , Carlisle , UK , and
| | - Man Cheung Chung
- d Department of Educational Psychology , The Chinese University of Hong Kong , Hong Kong , Hong Kong
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Rojhani S, Stiens SA, Recio AC. Independent sailing with high tetraplegia using sip and puff controls: integration into a community sailing center. J Spinal Cord Med 2017; 40:471-480. [PMID: 27415644 PMCID: PMC5537965 DOI: 10.1080/10790268.2016.1198548] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients' lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology. METHODS We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process. Our sailor is a 27-year-old man with a history of traumatic SCI resulting in C4 complete tetraplegia. RESULTS The participant completed an adapted introductory sailing course, and instruction on the sip-and-puff sail and tiller control mechanism. With practice, he navigated an on-water course in moderate winds of 5 to 15 knots. DISCUSSION Despite trends toward shorter rehabilitation stays, aggressive transdisciplinary collaboration with recreation therapy can provide community and natural environment experiences while inpatient and continuing post discharge. Such peak physical and psychological experiences provide a positive perspective for the future that can be shared on the inpatient unit, with families and support systems like sailing clubs in the community. CONCLUSION Rehabilitation theory directs a team process to achieve patient self-awareness and initiate self-actualization in spite of disablement. Utilization of local community sailing centers that have provided accessible assisted options provides person-centered self-realization of goals as assisted by family and natural supports. Such successful patients become native guides for others seeking the same experience.
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Affiliation(s)
- Solomon Rojhani
- Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD, USA,Correspondence to: Solomon Rojhani, Chief Resident 2016-2017, The Johns Hopkins University School of Medicine, Department of Physical Medicine & Rehabilitation, 600 North Wolfe Street Phipps 160, Baltimore, MD, USA, 21287. E-mail:
| | - Steven A. Stiens
- Department of Rehabilitation Medicine, University of Washington, VA Puget Sound Health Care System, Seattle, WA, USA
| | - Albert C. Recio
- International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger & Department of Physical Medicine & Rehabilitation, The Johns Hopkins School of Medicine, Baltimore, MD, USA
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Event centrality as a unique predictor of posttraumatic stress symptoms and perceived disability following spinal cord injury. Spinal Cord 2017; 55:1023-1027. [PMID: 28555662 DOI: 10.1038/sc.2017.57] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 12/11/2022]
Abstract
STUDY DESIGN We conducted a cross-sectional study involving completion of self-report measures. OBJECTIVES Individuals who acquire a spinal cord injury (SCI) face numerous physical and psychological challenges, with the former receiving considerable less attention during the rehabilitation process. In this article, we examined event centrality as a unique predictor of psychological outcomes in a sample of individuals receiving rehabilitation for SCI. Event centrality refers to the extent to which individuals construe a stressful experience as a core part of their identity. In samples of individuals exposed to psychological traumas (for example, sexual assault or military combat), event centrality has emerged as a consistent and powerful predictor of posttraumatic stress symptoms (PTSSs). This is the first study to examine event centrality in an SCI sample. SETTING Inpatient rehabilitation program in a large urban city in the Southwestern United States. METHODS A sample of 55 participants in rehabilitation for a recent SCI completed measures of event centrality, PTSS, depressed mood and perceived disability. RESULTS Event centrality was significantly related to perceived disability (r=0.48) and PTSS (r=0.31) and accounted for unique variance in these two outcomes after controlling for demographics and depressed mood. CONCLUSION Event centrality is common among individuals with SCI and may be a unique contributor to worse psychological and functional outcomes. We hope our findings will alert health-care professionals to the importance of event centrality. SPONSORSHIP This study was supported by a grant from the Danish National Research Foundation (DNRF89).
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Pollock K, Dorstyn D, Butt L, Prentice S. Posttraumatic stress following spinal cord injury: a systematic review of risk and vulnerability factors. Spinal Cord 2017; 55:800-811. [PMID: 28485385 DOI: 10.1038/sc.2017.45] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/22/2017] [Accepted: 03/23/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To summarise quantitatively the available evidence relating to pretraumatic, peritraumatic and posttraumatic characteristics that may increase or decrease the risk of developing posttraumatic stress disorder (PTSD) following spinal cord injury (SCI). STUDY DESIGN Systematic review. METHODS Seventeen studies were identified from the PubMed, PsycInfo, Embase, Scopus, CINAHL, Web of Science and PILOTS databases. Effect size estimates (r) with associated 95% confidence intervals (CIs), P-values and fail-safe Ns were calculated. RESULTS Individual studies reported medium-to-large associations between factors that occurred before (psychiatric history r=0.48 (95% CI, 0.23-0.79) P=0.01) or at the time of injury (tetraplegia r=-0.36 (95% CI, -0.50 to -0.19) P<0.01). Postinjury factors had the strongest pooled effects: depressed mood (rw=0.64, (95% CI, 0.54-0.72)), negative appraisals (rw=0.63 (95% CI, 0.52-0.72)), distress (rw=0.57 (95% CI, 0.50-0.62)), anxiety (rw=0.56 (95% CI, 0.49-0.61)) and pain severity (rw=0.35 (95% CI, 0.27-0.43)) were consistently related to worsening PTSD symptoms (P<0.01). Level of injury significantly correlated with current PTSD severity for veteran populations (QB (1)=18.25, P<0.001), although this was based on limited data. CONCLUSION Combinations of peri- and post-injury factors appear to be influential in the development of PTSD among persons with SCI. Further studies are needed to extrapolate these findings to the broader spinal cord-injured population. More longitudinal research, driven by multicausal models of causation such as the diathesis-stress model, is also needed to determine the temporality of PTSD risk factors.
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Affiliation(s)
- K Pollock
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - D Dorstyn
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - L Butt
- Craig Hospital, Englewood, CO, USA
| | - S Prentice
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Metikaridis TD, Hadjipavlou A, Artemiadis A, Chrousos G, Darviri C. Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial. J Back Musculoskelet Rehabil 2016; 30:BMR709. [PMID: 27232086 DOI: 10.3233/bmr-160709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Studies have shown that stress is implicated in the cause of neck pain (NP). OBJECTIVES The purpose of this study is to examine the effect of a simple, zero cost stress management program on patients suffering from NP. METHODS This study is a parallel-type randomized clinical study. People suffering from chronic non-specific NP were chosen randomly to participate in an eight week duration program of stress management (N= 28) (including diaphragmatic breathing, progressive muscle relaxation) or in a no intervention control condition (N= 25). Self-report measures were used for the evaluation of various variables at the beginning and at the end of the eight-week monitoring period. Descriptive and inferential statistic methods were used for the statistical analysis. RESULTS At the end of the monitoring period, the intervention group showed a statistically significant reduction of stress and anxiety (p= 0.03, p= 0.01), report of stress related symptoms (p= 0.003), percentage of disability due to NP (p= 0.000) and NP intensity (p= 0.002). At the same time, daily routine satisfaction levels were elevated (p= 0.019). No statistically significant difference was observed in cortisol measurements. CONCLUSIONS Stress management has positive effects on NP patients.
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Affiliation(s)
- T Damianos Metikaridis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
| | - Alexander Hadjipavlou
- Department of Orthopaedic Surgery and Traumatology, School of Health Sciences, University of Crete, Crete, Greece
| | - Artemios Artemiadis
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
| | - George Chrousos
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
- First Department of Pediatrics, Children's Hospital Aghia Sofia, School of Medicine, University of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Course Stress Management and Health Promotion, School of Medicine, University of Athens, Athens, Greece
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Kisala PA, Victorson D, Pace N, Heinemann AW, Choi SW, Tulsky DS. Measuring psychological trauma after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Psychological Trauma item bank and short form. J Spinal Cord Med 2015; 38:326-34. [PMID: 26010967 PMCID: PMC4445023 DOI: 10.1179/2045772315y.0000000022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To describe the development and psychometric properties of the SCI-QOL Psychological Trauma item bank and short form. DESIGN Using a mixed-methods design, we developed and tested a Psychological Trauma item bank with patient and provider focus groups, cognitive interviews, and item response theory based analytic approaches, including tests of model fit, differential item functioning (DIF) and precision. SETTING We tested a 31-item pool at several medical institutions across the United States, including the University of Michigan, Kessler Foundation, Rehabilitation Institute of Chicago, the University of Washington, Craig Hospital and the James J. Peters/Bronx Veterans Administration hospital. PARTICIPANTS A total of 716 individuals with SCI completed the trauma items RESULTS The 31 items fit a unidimensional model (CFI=0.952; RMSEA=0.061) and demonstrated good precision (theta range between 0.6 and 2.5). Nine items demonstrated negligible DIF with little impact on score estimates. The final calibrated item bank contains 19 items CONCLUSION The SCI-QOL Psychological Trauma item bank is a psychometrically robust measurement tool from which a short form and a computer adaptive test (CAT) version are available.
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Affiliation(s)
- Pamela A. Kisala
- Department of Physical Therapy, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Natalie Pace
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | | | - David S. Tulsky
- Correspondence to: David Tulsky, Professor and Director of the Center on Assessment Research and Translation, STAR Campus, University of Delaware, 540 S. College Ave, Newark, DE 19713, USA.
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Liu S, Wang L, Cao C, Zhang J. The factor structure of posttraumatic stress disorder symptoms in patients with traumatic spinal cord injuries. Arch Psychiatr Nurs 2014; 28:301-4. [PMID: 25439970 DOI: 10.1016/j.apnu.2014.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 05/17/2014] [Accepted: 05/30/2014] [Indexed: 10/25/2022]
Abstract
The current study investigated the factor structure of posttraumatic stress disorder (PTSD) symptoms in a sample of 256 patients with traumatic spinal cord injuries (SCI) in China. The confirmatory factor analysis results showed that a five-factor model composed of intrusion, avoidance, emotional numbing, dysphoric arousal, and anxious arousal fits the data significantly better than the tripartite DSM-IV model and the two well-supported four-factor models, and the C3 symptom (inability to recall important aspect of the trauma) loaded weakly on its corresponding factor. Implications and limitations for the results are discussed.
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Affiliation(s)
- Songhuai Liu
- Faculty of Rehabilitation Medicine, Capital Medical University, China; Department of Psychology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, China; Department of Clinical Psychology, Capital Medical University, China.
| | - Li Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
| | - Chengqi Cao
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China.
| | - Jianxin Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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Ratzer M, Brink O, Knudsen L, Elklit A. Posttraumatic stress in intensive care unit survivors - a prospective study. Health Psychol Behav Med 2014; 2:882-898. [PMID: 25750824 PMCID: PMC4346029 DOI: 10.1080/21642850.2014.943760] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 07/02/2014] [Indexed: 11/15/2022] Open
Abstract
Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21%) had symptom levels indicating subclinical PTSD. Female, five illness factors: coma time, mechanical ventilation, sedation, benzodiazepine, pain relieving medication, and four psychological factors: symptoms of acute stress (T1), fear of death and/or feeling completely helpless and powerless in relation to the accident and/or ICU (T1), SOC (T1) and more external locus of control (T1) correlated significantly with PTSD symptoms at T2. In the linear regression analysis, female, length of sedation, dissociation (T1), hypervigilance (T1), and external locus of control predicted 58% of the variation of PTSD. Conclusions: High levels of PTSD symptoms occurred in 19.2% of respondents in six months following traumatic injury requiring ICU admission. Screening for the variables gender, length of sedation, dissociation, hypervigilance, and locus of control after ICU admission following traumatic injuries may help to predict who will develop PTSD.
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Affiliation(s)
- Mette Ratzer
- Pedagogic Psychological Counseling, Aarhus Municipality , Aarhus , Denmark
| | - Ole Brink
- Trauma Center, Aarhus University Hospital , Aarhus , Denmark
| | - Linda Knudsen
- Trauma Center, Aarhus University Hospital , Aarhus , Denmark
| | - Ask Elklit
- Department of Psychology, National Centre for Psychotraumatology, University of Southern Denmark , Odense , Denmark ; School of Psychology, University of Ulster Coleraine , Northern Ireland
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Relationship of locus of control, psychological distress, and trauma exposure in groups impacted by intense political conflict in Egypt. Prehosp Disaster Med 2013; 28:423-7. [PMID: 23719509 DOI: 10.1017/s1049023x13008601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Social and political instability have become common situations in many parts of the world. Exposure to different types of traumatic circumstances may differentially affect psychological status. OBJECTIVE The aim of this study was to compare the relationship between personal perceptions of control over the events happening in one's life and psychological distress in two groups who experienced physical trauma but differed as to whether the trauma was a result of political upheaval and violence. Views on the extent to which the state was interested in the individual were also assessed. METHODS The sample consisted of 120 patients who were injured in the Cairo epicenter and 120 matched controls from the greater Cairo area whose injuries were from other causes. The Brown Locus of Control Scale and the Symptom Checklist-90-Revised (SCL 90-R) were administered approximately three months after the January 2011 start of the demonstrations and subsequent overthrow of the government. RESULTS The groups did not differ on locus of control. For both groups, externality was associated with greater distress, suggesting a relationship between perceived helplessness in controlling one's life and distress. The Cairo group scored significantly higher than the control group on the SCL 90-R Global Severity Index (GSI) and Positive Symptom Total (PST). Perceptions of state interest in the population were low; overall, 78% viewed the state as having little or no interest in them. Discussion The relationship between exposure intensity and psychological distress is examined. In addition, differences in findings in populations experiencing political chaos compared with other types of disasters are considered. CONCLUSION Beliefs regarding personal control over one's life circumstances are more closely associated with psychological distress than the circumstances in which the trauma occurred.
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Wegener ST, Adams LL, Rohe D. Promoting optimal functioning in spinal cord injury: the role of rehabilitation psychology. HANDBOOK OF CLINICAL NEUROLOGY 2012; 109:297-314. [PMID: 23098721 DOI: 10.1016/b978-0-444-52137-8.00019-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Comprehensive treatment and rehabilitation includes attention to the psychological needs of individuals with SCI and their families. This chapter is designed to familiarize neurologists and other practitioners with psychological issues and care in SCI. While psychologists play a key role, attention to psychosocial health is a responsibility shared by all members of the rehabilitation team, beginning with the patient and family, and including clinicians who are not formally identified as mental health providers. Treatment planning for a person with SCI begins with a thorough assessment of the cognitive, emotional, personality, and social factors that influence functioning and rehabilitation. Rehabilitation psychologists use a mixture of assessment tools, including clinical interviews, behavioral observations, and a wide range of standardized test instruments. Psychological interventions can involve direct intervention with the patient, in individual, family or group-based therapies. Other psychological strategies involve assistance through less direct methods - consultation and training to other rehabilitation team members or facilitating peer role-modeling and support groups. The chapter provides an overview of core clinical issues (emotional responses, substance use, pain, cognitive deficits, sexuality and vocational rehabilitation), delineates the process of psychological assessment and intervention, and provides guidance on incorporation of rehabilitation psychology into SCI rehabilitation.
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Affiliation(s)
- Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Abstract
OBJECTIVE The overall objective of this study was to illustrate a systematic approach for capturing the psychologic-personal perspective in International Classification of Functioning, Disability and Health-based comprehensive research on spinal cord injury (SCI) in terms of what and how to measure. The specific aims were to identify (1) relevant areas of research for capturing the psychologic-personal factors in a study that is planned and conceptualized according to the comprehensive context of the International Classification of Functioning, Disability and Health, using SCI as a case in point; (2) a set of domains relevant for SCI research from a psychologic-personal perspective; and (3) suitable measurement instruments that can be considered for the assessment of those identified domains based on a set of predefined guiding principles. DESIGN The psychologic-personal factor structure was developed based on an item pool of 1246 entries from secondary analyses of available data from SCI studies. The domain set for psychologic-personal factors was identified through reviewing the scientific literature in PubMed and PsycInfo. The set of measurement instruments was collected using available measurement reviews, searches in the literature, instrument databases, and further sources and was selected using guiding principles. RESULTS Forty specific psychologic-personal factors, subdivided into seven areas of research, were identified: (1) sociodemographic personal characteristics, (2) the position in the immediate social and physical context, (3) personal history and biography, (4) feelings, (5) thoughts and beliefs, (6) motives, and (7) patterns of experience and behavior. The psychologic-personal factors domain set contains both cross-cutting outcome domains, namely quality-of-life, life satisfaction, subjective well-being, and sociodemographic personal characteristics, life events, positive and negative affect, perceived stress, locus of control, self-efficacy, purpose in life, coping, lifestyle, and personality. For each of the identified domains, a pool of measurement instruments was listed, and the application of predefined guiding principles for measurement instrument selection was exemplified for self-efficacy. It resulted in the selection of the General Self-Efficacy Scale by Schwarzer and Jerusalem (Measures in Health Psychology: A User's Portfolio. Causal and Control Beliefs. pp. 35-37; 1995). CONCLUSIONS The results of the current article contributed to creating a transparent protocol for the Swiss Spinal Cord Injury Cohort study, coordinated by the Swiss Paraplegic Research in Nottwil, Switzerland. This article also stresses the relevance of the comprehensive approach to SCI and the consideration of the psychologic-personal perspective in this approach. The study, therefore, hopes to encourage scientists to use the International Classification of Functioning, Disability and Health and the psychologic-personal perspective as a frame of reference for their research. Furthermore, the research reported in this article can inform the World Health Organization's future development of the personal factors classification in the International Classification of Functioning, Disability and Health.
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Green SE. Depression Before and After 9/11: The Interactive Relationship of Internal and Chance Health Locus of Control Beliefs. JOURNAL OF LOSS & TRAUMA 2011. [DOI: 10.1080/15325024.2011.572031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sara E. Green
- a Department of Sociology , University of South Florida , Tampa, Florida, USA
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Posttraumatic stress disorder and spinal cord injury. Arch Phys Med Rehabil 2010; 91:1182-7. [PMID: 20684898 DOI: 10.1016/j.apmr.2010.05.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 05/20/2010] [Accepted: 05/27/2010] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To identify the prevalence of posttraumatic stress disorder (PTSD) after spinal cord injury (SCI) in a sample averaging over 2 decades postinjury at assessment. Related objectives are to confirm the factor structure, compare subscales with those reported in a nonclinical sample, and identify the relationship of PTSD with depression. DESIGN Survey. SETTING A medical university in the Southeastern United States. PARTICIPANTS Participants were initially identified through specialty hospitals in the Midwest and Southeastern United States. A cohort of adults (N=927) with traumatic SCI of at least 1 year duration at enrollment in 2002 to 2003 and a minimum of 7 years at the time of assessment completed the study materials. INTERVENTIONS Not applicable. MAIN OUTCOMES MEASURES PTSD was measured by the Purdue Posttraumatic Stress Disorder Scale-Revised, and depression was measured by the Patient Health Questionnaire 9-item. RESULTS PTSD was reported by less than 10% of the participants. Item endorsement decreased as a function of years postinjury, primarily because of low rates of endorsement among those 21 or more years postinjury. Confirmatory factor analysis did not result in an acceptable fit for subscales, item sets, or factors previously reported in the literature. Participants scored higher than a nonclinical sample (reported in the literature) on the arousal and avoidance subscales but lower on the re-experiencing subscale. Item endorsement were lower for the first set of items that relate directly to the SCI itself, with the highest item endorsement for "have difficulty remembering important aspects of event." PTSD rarely occurred in the absence of a depressive disorder. CONCLUSIONS PTSD does not appear to be highly prevalent in long-term SCI survivors, and endorsement of items related to re-experiencing and even recalling the injury are rare. Because SCI often is accompanied by mild traumatic brain injury, difficulty recalling the event may have an organic rather than psychologic component.
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Mellon RC, Papanikolau V, Prodromitis G. Locus of control and psychopathology in relation to levels of trauma and loss: self-reports of Peloponnesian wildfire survivors. J Trauma Stress 2009; 22:189-96. [PMID: 19452533 DOI: 10.1002/jts.20411] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study investigated whether relations between beliefs about the personal controllability of reinforcing events and levels of psychopathology were differentiated with respect to levels of trauma and loss experienced in a series of devastating wildfires. In contrast with studies of combat veterans and professional firefighters, in wildfire survivors external locus of control beliefs and psychopathology were correlated only in respondents who experienced higher levels of trauma and loss; specifically, for residents of designated disaster areas (N = 409), but not for a demographically matched sample of residents of adjacent, non-fire-damaged areas (N = 391). The conflicting findings across studies are interpreted with respect to probable differences in contingencies of reinforcement for causal attributions in professionals and in novices in disaster management.
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Affiliation(s)
- Robert C Mellon
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece.
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Hatcher MB, Whitaker C, Karl A. What predicts post-traumatic stress following spinal cord injury? Br J Health Psychol 2008; 14:541-61. [PMID: 18983727 DOI: 10.1348/135910708x373445] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES Spinal cord injury (SCI) is a severe, traumatic event and recently research into the role of post-traumatic stress disorder (PTSD) subsequent to the injury has become of increasing interest. This study has been conducted in order to investigate potential risk factors for the development of post-traumatic stress disorder symptoms in those with SCI. DESIGN This cross-sectional study used multiple regression analysis to look for associations between post-traumatic stress symptom severity, SCI-related factors and previously identified risk factors for PTSD such as dysfunctional cognitions, demographic factors and personality predispositions (neuroticism, alexithymia). METHOD A total of 102 participants with SCI completed measures of post-traumatic stress severity, acceptance of injury, post-traumatic cognitions, social support, neuroticism and alexithymia. In addition, information about type, level and cause of the SCI was assessed. RESULTS High levels of post-traumatic stress symptoms were found. Potential risk factors for the development of PTSD were negative cognitions of self and neuroticism. Variables that added to the variance explained by the models included time since injury and difficulty identifying feelings. Acceptance of injury was mediated by negative cognitions of the self and neuroticism. CONCLUSIONS The study highlights the need for services to be aware of the psychological difficulties experienced by this client group. An important finding is that the acceptance of the injury is mediated by negative cognitions of the self which need to be identified as potential risk factors in order to prevent the development of post-traumatic symptoms in this population.
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Affiliation(s)
- Mal B Hatcher
- Clinical Health Psychology Services, Royal Hampshire County Hospital, Winchester and Eastleigh NHS Trust, Hampshire, UK
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