1
|
Yang YS, Bae SM. Association between resilience, social support, and institutional trust and post-traumatic stress disorder after natural disasters. Arch Psychiatr Nurs 2022; 37:39-44. [PMID: 35337437 DOI: 10.1016/j.apnu.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/04/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
Disasters can cause significant personal and social distress and adversely affect mental health. Compared with research on the risk factors of post-disaster post-traumatic stress disorder (PTSD), limited studies have reported protective factors against PTSD. We investigated whether resilience, social support, and trust in government were associated with PTSD in disaster survivors, after adjustment for the perceived damage and demographic variables including sex, age, and economic status. We investigated 2311 disaster survivors, using data from the "Long-term survey on the change of life of Disaster victim" performed by NDMI(National Disaster Management Research Institute). Hierarchical regression analysis was used in this study. A high level of trust in institutions was associated with few PTSD symptoms after adjustment for resilience and social support. Among the subfactors of institutional trust, psychological counseling and environmental and facility restoration were associated with PTSD. Psychological counseling and environmental and facility restoration support for disaster survivors were associated with reduced PTSD symptoms. Post-disaster policy support, including psychological counseling and environmental and facility restoration services, is important. Our findings highlight the protective factors against PTSD symptoms and may serve as guidelines for specific interventions for the management of post-disaster PTSD.
Collapse
Affiliation(s)
- Ye-Seul Yang
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea
| | - Sung-Man Bae
- Department of Psychology, Graduate School, Dankook University, Cheonan, Republic of Korea; Department of Psychology and Psychotherapy, College of Health Science, Dankook University, Cheonan, Republic of Korea.
| |
Collapse
|
2
|
Truszczyńska-Baszak A, Guszkowska M, Dadura E, Tarnowski A. Prognostic factors of post-traumatic stress disorder risk in patients with surgical treatment of hip acetabular fracture. Original study. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01488-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AbstractThe aim of the study was to assess the risk of developing post-traumatic stress disorder in patients after hip acetabular fracture surgery. The study involved 42 patients fulfilling inclusion criteria. Physical ability levels of the patients were determined with the Harris Hip Score, and modified Merle d’Aubigné scale. High risk of post-traumatic stress disorder was assessed with the PTSD-C questionnaire. Patients had in PTSD-C questionnaire 42.86 ± 28,10 points. In Harris Hip Score 63.64 ± 16.06, in Merle scale 11.10 ± 2.82, that was poor results in both scales. Positive correlation with age reached the level of tendency (ρ = 0.294; p = 0.059). Patients at risk of PTSD were in worse functional state measured by HHS (U = 136.0; p = 0.034) and Merle scale (U = 132.0; p = 0.026) and they were older (U = 147.5; p = 0.068). The groups differed significantly in gender ratio (χ2 = 4.01; p = 0.045). Women (8/10) were more often than men (14/32) at risk of PTSD. Patients after surgical fixation of the acetabulum experience significant functional disability. Increased level of disability after fracture and surgery, older age and female sex make patients vulnerable to PTSD. It is advisable to make medical staff who treat accident victims aware towards aspects which may be related to disorders of the patients’ psychological health.
Collapse
|
3
|
Psychological Distress of Patients Experiencing Different Types of Road Traffic Injuries in Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103429. [PMID: 32423067 PMCID: PMC7277653 DOI: 10.3390/ijerph17103429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/07/2020] [Accepted: 05/12/2020] [Indexed: 12/02/2022]
Abstract
Road-related injuries are often catastrophic, and the eighth leading cause of all-aged mortality. While psychological problems, including anxiety, driving phobia, and post-traumatic stress have been found to be common among injured survivors, the literature in this area is still limited. This study aimed to evaluate the prevalence of distress between different types of road injuries among 413 patients in Thai Binh hospitals from October to December 2018. The Kessler Psychological Distress Scale (K6) was used to assess mental health status. Sociodemographic and clinical characteristics were also collected. The results of Multiple Logistic and Tobit regression models were utilized. Psychological issues were found in 13.8% of the participants. In terms of K6 profile, nervous, restless/fidgety, and “everything was an effort” were the three most frequently endorsed aspects. Having soft-tissue injuries had a 0.32-time lower likelihood of psychological distress compared to those having other injuries. Additionally, patients who were diagnosed with fractures were 4.5-times more likely to report psychological distress. Our finding highlights the need for psychological screening to reduce disabilities associated with non-fatal injury related to road traffic crashes.
Collapse
|
4
|
Global Research on Quality of Life of Patients with HIV/AIDS: Is It Socio-Culturally Addressed? (GAP RESEARCH). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062127. [PMID: 32210042 PMCID: PMC7143369 DOI: 10.3390/ijerph17062127] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/18/2023]
Abstract
Quality of life (QOL) has been considered as an important outcome indicator in holistic care for HIV-infected people, especially as HIV/AIDS transforms from a fatal illness to a chronic condition. This study aimed to identify trends and emerging topics among research concerning the QOL of people living with HIV/AIDS (PLWHA). The analyzed data were English papers published from 1996 to 2017, searched and extracted from the Web of Science Core Collection. Collaborations between countries and the correlation between the keywords were visualized by VOSviewer while the abstracts’ content was analyzed using exploratory factor analysis and Jaccard’s’ similarity index. There has been an increase in both the number of publications and citations. The United Nations of America leads in terms of paper volume. The cross-nation collaborations are mainly regional. Despite a rather comprehensive coverage of topics relating to QOL in PLWHA, there has evidently been a lack of studies focusing on socio-cultural factors and their impacts on the QOL of those who are HIV-infected. Further studies should consider investigating the role of socio-cultural factors, especially where long-term treatment is involved. Policy-level decisions are recommended to be made based on the consideration of cultural factors, while collaborations between developed and developing nations, in particular in HIV/AIDS-ridden countries, are strongly recommended.
Collapse
|
5
|
Giummarra MJ, Lau G, Grant G, Gabbe BJ. A systematic review of the association between fault or blame-related attributions and procedures after transport injury and health and work-related outcomes. ACCIDENT; ANALYSIS AND PREVENTION 2020; 135:105333. [PMID: 31863937 DOI: 10.1016/j.aap.2019.105333] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/07/2019] [Accepted: 10/15/2019] [Indexed: 06/10/2023]
Abstract
Attributions of fault are often associated with worse injury outcomes; however, the consistency and magnitude of these impacts is not known. This review examined the prognostic role of fault on health, mental health, pain and work outcomes after transport injury. A systematic search of five electronic databases (Medline, Embase, CINAHL, PsycINFO, Cochrane Library) yielded 16,324 records published between 2000 and January 2018. Eligibility criteria were: adult transport injury survivors; prospective design; multivariable analysis; fault-related factor analysed; pain, mental health, general health or work-related outcome. Citations (n = 10,558, excluding duplicates) and full text articles (n = 555) were screened manually (Reviewer 1), and using concurrent machine learning and text mining (Reviewer 2; using Abstrackr, WordStat and QDA miner). Data from 55 papers that met all inclusion criteria were extracted, papers were evaluated for risk of bias using the QUIPS tool, and overall level of evidence was assessed using the GRADE tool. There were six main fault-related factors classified as: fault or responsibility, fault-based compensation, lawyer involvement or litigation, blame or guilt, road user or position in vehicle, and impact direction. Overall there were inconsistent associations between fault and transport injury outcomes, and 60% of papers had high risk of bias. There was moderate evidence that fault-based compensation claims were associated with poorer health-related outcomes, and that lawyer involvement was associated with poorer work outcomes beyond 12 months post-injury. However, the evidence of negative associations between fault-based compensation claims and work-related outcomes was limited. Lawyer involvement and fault-based compensation claims were associated with adverse mental health outcomes six months post-injury, but not beyond 12 months. The most consistent associations between fault and negative outcomes were not for fault attributions, per se, but were related to fault-related procedures (e.g., lawyer engagement, fault-based compensation claims).
Collapse
Affiliation(s)
- Melita J Giummarra
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.
| | - Georgina Lau
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Genevieve Grant
- Australian Centre for Justice Innovation and Faculty of Law, Monash University, Clayton, VIC, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Health Data Research UK, Swansea University Medical School, Swansea University, Wales, UK
| |
Collapse
|
6
|
Papadakaki M, Tsalkanis A, Sarris M, Pierrakos G, Eleonora Ferraro O, Stamouli MA, Orsi C, Otte D, Tzamalouka G, Lajunen T, Özkan T, Morandi A, Gnardellis C, Chliaoutakis J. Physical, psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries. JOURNAL OF SAFETY RESEARCH 2018; 67:155-163. [PMID: 30553418 DOI: 10.1016/j.jsr.2018.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/04/2018] [Accepted: 10/10/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. METHODS A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), "Impact of Event Scale" (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of 'Direct' and 'Indirect' costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. RESULTS A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50-64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65+ and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50-64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. CONCLUSIONS There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. PRACTICAL IMPLICATIONS A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.
Collapse
Affiliation(s)
- Maria Papadakaki
- Laboratory of Health and Road Safety, Department of Social Work, School of Health and Social Welfare, Technological Educational Institute of Crete, Estavromenos, P.C. 71004 Heraklion, Greece.
| | - Angelos Tsalkanis
- Department of Social Work, School of Health and Social Welfare, University of West Attica, Athens, Greece.
| | - Markos Sarris
- Department of Health Care Units and Business Administration, University of West Attica, Athens, Greece.
| | - George Pierrakos
- Department of Health Care Units and Business Administration, University of West Attica, Athens, Greece.
| | - Ottavia Eleonora Ferraro
- Centre of Study and Research on Road Safety, Medical School, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy.
| | - Maria-Angeliki Stamouli
- Department of Health Care Units and Business Administration, University of West Attica, Athens, Greece
| | - Chiara Orsi
- Centre of Study and Research on Road Safety, Medical School, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy
| | - Dietmar Otte
- Hannover Medical University, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | - Georgia Tzamalouka
- Laboratory of Health and Road Safety, Department of Social Work, School of Health and Social Welfare, Technological Educational Institute of Crete, Estavromenos, P.C. 71004 Heraklion, Greece
| | - Timo Lajunen
- Suomalainen liikennetutkimuskeskus, Traffic Research Centre of Finland, Helsinki, Finland.
| | - Türker Özkan
- Suomalainen liikennetutkimuskeskus, Traffic Research Centre of Finland, Helsinki, Finland.
| | - Anna Morandi
- Centre of Study and Research on Road Safety, Medical School, University of Pavia, Via Forlanini 2, 27100 Pavia, Italy.
| | | | - Joannes Chliaoutakis
- Laboratory of Health and Road Safety, Department of Social Work, School of Health and Social Welfare, Technological Educational Institute of Crete, Estavromenos, P.C. 71004 Heraklion, Greece.
| |
Collapse
|
7
|
Knight C. Trauma-informed supervision: Historical antecedents, current practice, and future directions. CLINICAL SUPERVISOR 2018. [DOI: 10.1080/07325223.2017.1413607] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Carolyn Knight
- School of Social Work, University of Maryland, Baltimore County, Baltimore, Maryland, United States
| |
Collapse
|
8
|
Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries. Injury 2017; 48:297-306. [PMID: 27889110 DOI: 10.1016/j.injury.2016.11.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/05/2016] [Accepted: 11/17/2016] [Indexed: 02/02/2023]
Abstract
The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013-2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, "Impact of Event Scale" (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98-2.27] at the first follow up and 3.43 times higher [CI 1.43-9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury in a timely manner.
Collapse
|
9
|
Nöthling J, Lammers K, Martin L, Seedat S. Traumatic dissociation as a predictor of posttraumatic stress disorder in South African female rape survivors. Medicine (Baltimore) 2015; 94:e744. [PMID: 25906104 PMCID: PMC4602697 DOI: 10.1097/md.0000000000000744] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Women survivors of rape are at an increased risk for posttraumatic stress disorder (PTSD). Traumatic dissociation has been identified as a precursor of PTSD. This study assessed the predictive potential of traumatic dissociation in PTSD and depression development.The study followed a longitudinal, prospective design. Ninety-seven female rape survivors were recruited from 2 clinics in Cape Town, South Africa. Clinical interviews and symptom status assessments of the participants were completed to measure dissociation, childhood traumas, resilience, depression, and PTSD.Traumatic dissociation was a significant predictor of PTSD and depression. The linear combination of prior dissociation, current dissociation, and resilience significantly explained 20.7% of the variance in PTSD. Dissociation mediated the relationship between resilience and PTSD.As traumatic dissociation significantly predicts PTSD, its early identification and management may reduce the risk of developing PTSD. Interventions focused on promoting resilience may also be successful in reducing the risk of dissociation following rape.
Collapse
Affiliation(s)
- Jani Nöthling
- From the Department of Psychiatry (JN, KL, LM, SS), Stellenbosch University, Cape Town, South Africa and PsyQ (KL), ParnassiaGroep, The Hague, Netherlands
| | | | | | | |
Collapse
|
10
|
Staff perception of aggressive behaviour in community services for adults with intellectual disabilities. Community Ment Health J 2014; 50:743-51. [PMID: 23949541 DOI: 10.1007/s10597-013-9636-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 07/29/2013] [Indexed: 10/26/2022]
Abstract
Experiencing aggressive behaviour has been associated with increased stress and turnover among staff who support adults with intellectual disabilities. Incident perception is a strong predictor of psychological outcomes after trauma but has not been studied in this staff group. This study clustered exposure to aggression and endorsement of emotional difficulties among 386 community residential group home staff and evaluated the contribution of four behavioural topographies to staff-rated perceived severity. Staff exposure varied considerably. Perceived severity correlated with subjective emotional difficulties. High perceived severity was associated with daily exposure, aggression towards others causing injury, and property aggression causing injury or damage. Therefore, the role the staff plays, whether a witness or target, may impact their experience.
Collapse
|
11
|
Nhac-Vu HT, Hours M, Chossegros L, Charnay P, Tardy H, Martin JL, Mazaux JM, Laumon B. Prognosis of outcome in adult survivors of road accidents in France: one-year follow-Up in the ESPARR cohort. TRAFFIC INJURY PREVENTION 2014; 15:138-147. [PMID: 24345015 DOI: 10.1080/15389588.2013.804180] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE The consequences of road crashes are various, and few studies have dealt with the multidimensionality of outcomes. The aim of the present study was to assess the multidimensional nature of outcomes one year after a crash and to determine predictive factors that could help in adapting medical and social care to prevent such consequences to improve road crash victims' prognosis. METHODS The study population was the 886 respondents to the one-year follow-up from the ESPARR (Etude et Suivi d'une Population d'Accidentés de la Route du Rhône) cohort, aged ≥ 16 years; the analysis was carried out only on the 616 subjects who fully completed a self-report questionnaire on health, social, emotional, and financial status one year after a crash. Multiple correspondence analysis and hierarchical clustering was implemented to produce homogeneous groups according to differences in outcome. Groups were compared using the World Health Organization Quality of Life Assessment (WHOQOL-BREF, a standard instrument of quality of life, assessing physical health, psychological health, social relationships, and environment) and the Injury Impairment Scale (IIS), a tool to predict road crash sequelae. Baseline predictive factors for group attribution were analyzed by weighted multinomial logistic regression models. RESULTS Three hundred seventeen of the 616 subjects (60.1%) were men. Mean age was 36.9 years (SD = 16.5). Five victim groups were identified in terms of consequences at one year: one group (206 subjects, 33.4%) with few problems, one with essentially physical sequelae, one with problems that were essentially both physical and social, and 2 groups with a wider range of problems (one including psychological problems but fewer environmental problems; the last one reported negative physical, psychological, social, and environmental impact; notably, all had post-concussion syndrome [PCS]). There were significant differences between groups in terms of family status, injury severity, and certain types of injury (thorax, spine, lower limbs). Comparison on the WHOQOL-BREF confirmed that groups reporting more adverse outcomes had a lower quality of life. Description of the 5 groups by IIS indicators showed that IIS underestimated physical consequences one year after the crash. In addition to the known prognostic factors such as age, initial injury severity, and injury type, socioeconomic fragility and having a relative involved in the accident emerged as predictive of poor outcome at one year. CONCLUSIONS One year after the crash, victims may still be experiencing multiple problems in terms of not only physical health but also of mental health, social life, and environment. Poor outcome may be predicted from both accident-related factors and socioeconomic fragility. Our results are useful in catching the attention of both clinicians and the public administration regarding victims at risk of suffering from important consequences after an accident. If those suffering head injuries are recognized, it would be very important to better consider and treat posttraumatic stress disorder (PTSD) or PCS. Furthermore, subjects from lower socioeconomic backgrounds, with or without lower limb injuries, have numerous difficulties after an accident, notably for returning to work. An objective would be to provide them with more specific support. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.
Collapse
|
12
|
Heron-Delaney M, Kenardy J, Charlton E, Matsuoka Y. A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors. Injury 2013; 44:1413-22. [PMID: 23916902 DOI: 10.1016/j.injury.2013.07.011] [Citation(s) in RCA: 115] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 07/09/2013] [Accepted: 07/09/2013] [Indexed: 02/02/2023]
Abstract
Posttraumatic stress disorder (PTSD) is one of the most common psychological consequences for adult road traffic crash (RTC) survivors and can have serious and long-lasting consequences for recovery if left untreated. Prevalence rates of PTSD following a RTC vary from 6% to 45% (based on 51 prevalence estimates across 35 studies). Explanations for this wide variance are explored. A systematic review of published studies found 49 papers (44 unique studies) investigating predictors of later PTSD in RTC survivors. Consistent predictors of PTSD include rumination about the trauma, perceived threat to life, a lack of social support, higher Acute Stress Disorder symptom severity, persistent physical problems, previous emotional problems, previous anxiety disorder and involvement in litigation/compensation. Moderate predictors of PTSD are discussed, as well as factors, which consistently do not predict PTSD in RTC survivors. The results inform future models of post-RTC traumatic stress aetiology.
Collapse
Affiliation(s)
- Michelle Heron-Delaney
- School of Medicine, Centre of National Research on Disability and Rehabilitation Medicine (CONROD), University of Queensland, Royal Brisbane and Women's Hospital, Level 1 Edith Cavell Building, Herston, QLD 4029, Australia.
| | | | | | | |
Collapse
|
13
|
Prehospital Echocardiography — A New Diagnostic Tool for Pulselessness and Resuscitation Management. Prehosp Disaster Med 2012. [DOI: 10.1017/s1049023x00010335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
14
|
A Phenomenological Analysis of Disaster-Related Experiences in Fire and Emergency Medical Services Personnel. Prehosp Disaster Med 2012; 27:115-22. [DOI: 10.1017/s1049023x12000507] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis article explores the experiences of fire and Emergency Medical Services (EMS) personnel during and immediately after a technological event using a phenomenological approach. Personnel engaged in the rescue operations during and immediately after the Ghislenghien gas explosion reflected upon their experiences in their responses to a specially designed, self-reporting questionnaire that included open-ended questions. Firefighters reported more perceived threat and direct exposure to death than did EMS personnel. Qualitative analysis indicates that the central characteristics of this potentially traumatizing event were the suddenness and massiveness of the impact, and the fact that it involved young victims and/or multiple deaths. With regard to emotions, powerlessness, horror, fear, a sense of apocalypse, and grief were experienced by both firefighters and EMS personnel. Firefighters noted that the death of colleagues, the involvement of friends and family, the massive impact, and exposure to the burned victims were most shocking. Emergency Medical Services personnel and in-hospital staff reported the impact, the confrontation with death, the involvement of friends and family, and the pain, suffering, and screaming of burned victims as the most shocking aspects of this event. Qualitative differences in the lived experiences of firefighters, EMS personnel, and in-hospital staff might be explained by differences in life threat, contact with death, and various degrees of training.De Soir E, Knarren M, Zech E, Mylle J, Kleber R, Van der Hart O. A phenomenological analysis of disaster-related experiences in fire and Emergency Medical Services personnel. Prehosp Disaster Med. 2012;27(2):1-8.
Collapse
|
15
|
Hodgson RC, Webster RA. Mediating role of peritraumatic dissociation and depression on post-MVA distress: path analysis. Depress Anxiety 2011; 28:218-26. [PMID: 21328635 DOI: 10.1002/da.20774] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 09/09/2010] [Accepted: 10/23/2010] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the role of pre-trauma, traumatic event, and peri-traumatic psychological characteristics on post-motor vehicle accident (MVA) Posttraumatic Stress Disorder (PTSD) and depression. METHODS The sample comprised 333 (54% female) hospital accident and emergency attendees who completed a self-report postal screening survey approximately 1-month post-accident and 128 (62% female) participants who completed a follow-up survey at 3-months. RESULTS Path analysis (Model 1) showed that dissociation partially mediated the relationship between past emotional problems and initial post-MVA distress, as well as between fear of dying and levels of distress. Level of alertness and perceived accident severity had no direct effects on post-MVA distress. However, higher levels of exposure contributed to distress predominantly in the presence of high levels of fear and subsequent dissociative experiences. When ongoing PTSD and depression symptoms were included (Model 2), feeling depressed/sad at 1-month was the strongest predictor of both PTSD and depression symptom severity at 3-months post-MVA, explaining 53% and 40% of the variance, respectively. Dissociation remained an important mediating variable at both time points. CONCLUSIONS These models show the influence of previous emotional vulnerability factors and the important mediating role of peri-traumatic experiences (in the presence of fear due to increased levels of accident severity) on post-MVA morbidity. Additionally, MVA survivors who report feeling depressed/sad 1-month after their accident are at greater risk of developing both PTSD and depression.
Collapse
Affiliation(s)
- Robert C Hodgson
- School of Psychology, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | | |
Collapse
|
16
|
Israeli civilians under heavy bombardment: prediction of the severity of post-traumatic symptoms. Prehosp Disaster Med 2010; 24:389-94. [PMID: 20066639 DOI: 10.1017/s1049023x00007196] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
CONTEXT The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage. OBJECTIVE Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peri-traumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity. DESIGN, SETTING, AND PARTICIPANTS Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment. INTERVENTION(S) None MAIN OUTCOME MEASURE(S) Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation. RESULTS The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p <0.01); more prior trauma, (p <0.01); more life threat, (p <0.01); and greater PTSD symptomatology (12 % of KY participants and 38% of KS participants had probable PTSD), compared to residents in the comparison town (Kfar Yona; KY). Both groups reported a similar degree of peri-event dissociation (KS: M = 7.2 +/-3.7; KY: M = 7.3 +/-3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD. CONCLUSIONS The terror of bombardment is a risk factor for PTSD among civilians. Although there is considerable resilience in chronically threatened communities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.
Collapse
|
17
|
|
18
|
|
19
|
Willebrand M, Andersson G, Ekselius L. Prediction of Psychological Health After an Accidental Burn. ACTA ACUST UNITED AC 2004; 57:367-74. [PMID: 15345987 DOI: 10.1097/01.ta.0000078697.69530.0e] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Burn victims often display psychological symptoms that can impede recovery, but knowledge about risk factors for psychopathology is limited. This study aimed to predict psychological health 3 months after burn injury from coping and trauma-related factors assessed early in hospitalization. METHODS For this study, 34 burn patients were interviewed during hospitalization about their accident and coping. Questionnaires were administered during hospitalization and 3 months after the burn including the Impact of Event Scale-Revised for posttraumatic stress symptoms (intrusion, avoidance, arousal) and the Hospital Anxiety and Depression Scale for mood. RESULTS Anxiety, depressive, and avoidant symptoms at 3 months were highly predicted by baseline levels of these symptoms and avoidant coping. The life threat at the burn event predicted intrusive and arousal symptoms, and coping by self-control predicted less intrusive symptoms. Burn severity was not predictive of psychological health. CONCLUSIONS Coping style, life threat during the accident, and early symptoms are strong predictors of psychopathology after a burn.
Collapse
Affiliation(s)
- Mimmie Willebrand
- Department of Neuroscience Psychiatry, Uppsala University Hospital, Uppsala, Sweden.
| | | | | |
Collapse
|
20
|
Söderquist J, Wijma K, Wijma B. Traumatic stress in late pregnancy. J Anxiety Disord 2004; 18:127-42. [PMID: 15033212 DOI: 10.1016/s0887-6185(02)00242-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2001] [Revised: 03/08/2002] [Accepted: 04/29/2002] [Indexed: 11/28/2022]
Abstract
Traumatic stress has traditionally been studied in the aftermath of traumatic events. In contrast, this study aimed to explore if traumatic stress can occur before an event that is perceived as threatening or feared. Traumatic stress, as related to the forthcoming delivery, was studied in 1224 women. Background data and psychological characteristics were assessed in early pregnancy and traumatic stress and fear of childbirth in late pregnancy. Of all subjects, 2.3% met all DSM-IV criteria for posttraumatic stress disorder (PTSD) and 5.8% fulfilled criteria B, C, and D in late pregnancy. Traumatic stress and fear of childbirth correlated significantly. High trait anxiety, depressive symptomatology, psychological/psychiatric counseling related to childbirth, and self-reported psychological problems, measured in early pregnancy, were risk factors for traumatic stress and fear of childbirth in late pregnancy. Results suggest the occurrence of "pre"traumatic stress (i.e., a threatening forthcoming event provoking symptoms similar to those after a traumatic event).
Collapse
Affiliation(s)
- Johan Söderquist
- Department of Molecular and Clinical Medicine, Division of Obstetrics and Gynaecology, Linköping University, S-58183 Linköping, Sweden.
| | | | | |
Collapse
|
21
|
Abstract
OBJECTIVE To validate an Italian version of the Impact of Event Scale (IES) in patients addressing the emotional impact of a recent road accident. METHODS Seventy-nine subjects were examined within 1-34 weeks after an accident by means of (1). an Italian version of the IES, (2). a free description of the accident, and (3). a questionnaire assessing subjects' behaviour and feelings. RESULTS IES data were analysed by means of the principal component analysis (PCA) method, followed by a quartimax rotation, obtaining a two-factor solution interpreted as intrusion (Factor 1) and avoidance (Factor 2). Furthermore, the scores to the two subscales were considered in order to assess their predictive value on some variables linked to the traumatic event. Intrusion significantly discriminated the emotional intensity and fear level of subjects as a consequence of the accident. CONCLUSIONS The IES is a two-dimensional test capable of evaluating posttraumatic stress. The intrusion and avoidance factors explained 40% of the total variance. The two-factor solution has a psychological counterpart and is similar to the findings of earlier studies conducted on a larger number of subjects in other countries.
Collapse
Affiliation(s)
- Filomena Pietrantonio
- Dipartimento di Psicologia, Università degli Studi di Roma "La Sapienza," via dei Marsi 78, 00185 Rome, Italy
| | | | | | | |
Collapse
|
22
|
Silove D, Blaszczynski A, Manicavasager V, Tyndall K, Petridis A, Hillman K. Capacity of screening questionnaires to predict psychiatric morbidity 18 months after motor vehicle accidents. J Nerv Ment Dis 2003; 191:604-10. [PMID: 14504570 DOI: 10.1097/01.nmd.0000087187.13408.e1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Motor vehicle accidents are one of the most common causes of trauma-related psychiatric morbidity. Previous studies have suggested that symptom screening instruments may be useful in predicting risk of longer-term psychiatric morbidity, but results have varied. The present study is based on 83 of an eligible 102 consecutive hospital-admitted survivors of road trauma who completed a structured clinical interview at baseline and 18-month follow-up. A subsample returned symptom questionnaires within 2 weeks of the accident, with between 60 and 66 completing the questionnaire. Receiver Operator Characteristic curve analyses were applied to obtain optimal predictive scores on each screening measure. Combining the derived cutoff scores on the Impact of Event Scale (measuring posttraumatic stress disorder symptoms) and the Beck Depression Inventory yielded an odds ratio of 82.9 in predicting any psychiatric morbidity at 18 months, with a specificity of 95%, and high positive (89%) and negative (91%) predictive indices. If these exploratory findings are confirmed by future studies, the case will be strengthened for routine screening of motor vehicle accident survivors to allow ongoing monitoring and selective early interventions for the high-risk subgroup. Compliance with completing and returning questionnaires remains a major challenge in this population, however, as indicated by the level of attrition in our study.
Collapse
Affiliation(s)
- Derrick Silove
- Psychiatry Research and Teaching Unit, School of Psychiatry, University of New South Wales, Liverpool Hospital, Liverpool, Australia
| | | | | | | | | | | |
Collapse
|
23
|
Clum GA, Nishith P, Calhoun KS. A preliminary investigation of alcohol use during trauma and peritraumatic reactions in female sexual assault victims. J Trauma Stress 2002; 15:321-8. [PMID: 12224804 DOI: 10.1023/a:1016255929315] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of these analyses was to investigate the association between reported alcohol use during a sexual assault and perceptions of assault severity and physical and emotional peritraumatic reactions. Self-report data were collected on 57 sexually assaulted college women. Multivariate regression analyses revealed that perception of assault severity mediated the relationship between alcohol use and peritraumatic physical reactions.
Collapse
Affiliation(s)
- Gretchen A Clum
- Center for Trauma Recovery, University of Missouri, St Louis, 63121-4499, USA.
| | | | | |
Collapse
|