ABSTRACT
OBJECTIVE: The purpose of the present study was to determine if interpersonal counselling (IPC) was effective in reducing psychological morbidity after major physical trauma. METHODS: One hundred and seventeen subjects were recruited from two major trauma centres and randomized to treatment as usual or IPC in the first 3 months following trauma. Measures of depressive, anxiety and post-traumatic symptoms were taken at baseline, 3 months and 6 months. The Structured Clinical Interview for DSM IV diagnoses was conducted at baseline and at 6 months to assess for psychiatric disorder. RESULTS: Fifty-eight patients completed the study. Only half the patients randomized to IPC completed the therapy. At 6 months the level of depressive, anxiety and post-traumatic symptoms and the prevalence of psychiatric disorder did not differ significantly between the intervention and treatment-as-usual groups. Subjects with a past history of major depression who received IPC had significantly higher levels of depressive symptoms at 6 months. CONCLUSION: IPC was not effective as a universal intervention to reduce psychiatric morbidity after major physical trauma and may increase morbidity in vulnerable individuals. Patient dropout is likely to be a major problem in universal multi-session preventative interventions.
Subject(s)
Counseling/methods , Depressive Disorder, Major/prevention & control , Interpersonal Relations , Psychotherapy/methods , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Traumatic/therapy , Wounds and Injuries/epidemiology , Wounds and Injuries/psychology , Adult , Australia/epidemiology , Chronic Disease , Comorbidity , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/psychology , Disability Evaluation , Female , Follow-Up Studies , Humans , Male , Prevalence , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Traumatic/epidemiology , Stress Disorders, Traumatic/prevention & control , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/prevention & control , Trauma Centers/statistics & numerical data , Trauma Severity Indices , Treatment Outcome , Wounds and Injuries/diagnosisABSTRACT
The present study investigated the effect of target stimulus probability on the P3 component of the respiratory-related evoked potential (RREP). A single respiratory stimulus paradigm was employed where normal breaths served as standard stimuli and occluded breaths presented at various probability levels served as target stimuli. EEG was recorded from 29 channels in young adults in two conditions. In Condition 1, occlusions were presented at target probabilities of 0.5, 0.33, 0.25, 0.2, 0.1, and 0.05, that is, every 2nd, 3rd, 4th, 5th, 10th, and 20th breath. Order of target probability presentation varied randomly. Condition 2 used the same target probabilities, but held breathing rate constant by using a paced respiration task. Results indicated that P3 amplitude was significantly affected by stimulus probability, such that the component showed an inverse relationship with probability. This effect was similar between conditions. However, P3 amplitude reduced and latency increased when the secondary task of paced respiration was introduced. These data suggest that models developed to describe the effect of stimulus probability on the amplitude of visual and auditory P3 components are applicable to the respiratory somatosensory modality.
