ABSTRACT
The Clinician Administered Posttraumatic Stress Disorder Scale (CAPS) enables quantification of the severity of each of the 17 posttraumatic stress disorder (PTSD) symptoms. Blanchard and colleagues (1995) have documented variation in rates of PTSD among survivors of motor vehicle accidents depending on the CAPS scoring rule used. This report examines the effects of varying the scoring rules of the CAPS on rates of acute PTSD symptoms in hospitalized burn patients. Changing from the most liberal to the most conservative scoring rule resulted in a change in diagnosis of acute PTSD from 25% of 32% of the sample. The variation documented in this study and others has implications for a range of issues, including rates of PTSD in epidemiological studies, treatment outcome research, and forensic evaluations.
Subject(s)
Burns/psychology , Psychiatric Status Rating Scales/standards , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Acute Disease , Adult , Analysis of Variance , Arousal , Avoidance Learning , Bias , Burns/complications , Female , Humans , Inpatients/psychology , Male , Reproducibility of Results , Stress Disorders, Post-Traumatic/classification , Stress Disorders, Post-Traumatic/etiology , Survivors/psychologyABSTRACT
Several studies have endeavored to learn if acute PTSD symptoms are predictive of chronic PTSD, with equivocal results. In the present study, acute intrusive and avoidant PTSD symptoms were analyzed as possible predictors of chronic PTSD following burn injury. Results showed that baseline IES scores, within one week of injury, were significantly different for those who were later diagnosed with chronic PTSD. Additional analyses, undertaken to assess the relative importance of each symptom group in predicting chronic PTSD, indicated that both the presence, per se, and severity of acute avoidant symptoms predicted chronic PTSD.
Subject(s)
Burns/psychology , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/etiology , Acute Disease , Adult , Chronic Disease , Female , Humans , Male , Predictive Value of Tests , Psychiatric Status Rating Scales , Severity of Illness IndexSubject(s)
Burns/psychology , Factitious Disorders/psychology , Hand Injuries/psychology , Self Mutilation/psychology , Adult , Burns/diagnosis , Factitious Disorders/diagnosis , Follow-Up Studies , Hand Injuries/diagnosis , Humans , Male , Patient Care Team , Patient Readmission , Recurrence , Self Mutilation/diagnosisSubject(s)
Explosions , Mental Disorders/diagnosis , Violence/psychology , Acute Disease , Adaptation, Psychological , Adult , Anxiety Disorders/diagnosis , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , Depressive Disorder/diagnosis , Depressive Disorder/epidemiology , Depressive Disorder/psychology , Female , Follow-Up Studies , Humans , Life Change Events , Male , Mental Disorders/epidemiology , Mental Disorders/psychology , Middle Aged , Psychiatric Status Rating Scales , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , United StatesABSTRACT
This study examines the relationship between extent of injury, degree and type of psychological distress and self-report of pain in burn survivors. One hundred eighty burn patients were interviewed within 2 weeks of their burn trauma. Using a visual analogue scale to assess subjective pain and pain relief, and self-report measures of post-traumatic stress symptoms and general psychological distress, we assessed the relationship between PTSD symptoms, general distress and pain. Subjective pain was unrelated to sex, ethnicity, or total body surface area burned. The most important correlate of subjective pain was general psychological distress. Intrusive PTSD symptoms had no independent power to predict the variance in pain scores. However, among women, more severe avoidant symptoms were associated with greater subjective pain.
Subject(s)
Adaptation, Psychological , Burns/complications , Pain Measurement , Adolescent , Adult , Aged , Burns/psychology , Female , Hospitalization , Humans , Male , Middle Aged , Regression AnalysisABSTRACT
This study assessed self and interpersonal dysfunction as well as posttraumatic stress disorder (PTSD) among three groups of women: women sexually assaulted in both childhood and adulthood, women sexually assaulted only in adulthood and women who were never assaulted. Rates of PTSD were high and equivalent in the two assault groups. However, retraumatized women were more likely to be alexithymic, show dissociation scores indicating risk for dissociative disorders, and to have attempted suicide compared to the other two groups, who did not differ from each other. Additionally, only the retraumatized women experienced clinically significant levels of interpersonal problems. The findings suggest that formulations more inclusive than PTSD are required to capture the psychological difficulties experienced by this population. Treatment implications are discussed.
Subject(s)
Child Abuse, Sexual/psychology , Interpersonal Relations , Rape/psychology , Self Concept , Stress Disorders, Post-Traumatic/psychology , Adult , Affective Symptoms/diagnosis , Affective Symptoms/psychology , Affective Symptoms/therapy , Aged , Child , Child Abuse, Sexual/therapy , Dissociative Disorders/diagnosis , Dissociative Disorders/psychology , Dissociative Disorders/therapy , Female , Humans , Middle Aged , Personality Assessment , Recurrence , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/therapy , Violence/psychologyABSTRACT
OBJECTIVE: The authors' goal was to examine subjective and objective predictors of posttraumatic stress disorder (PTSD). METHOD: Hospitalized burn patients were assessed 1 week after injury with both objective predictors (percent of burned area and facial disfigurement) and subjective predictors (emotional distress and perceived social support). The patients were then assessed 2, 6, and 12 months later for development of PTSD. RESULTS: Among 51 patients, 18 (35.3%) met PTSD criteria at 2 months. High rates of PTSD were also found at 6 months (N = 16, 40.0% of the 40 available patients) and 12 months (N = 14, 45.2% of the 31 available patients). PTSD was predicted by subjective variables assessed at baseline, but patients with more severe burns were not more likely to develop PTSD. CONCLUSIONS: The DSM-III-R diagnosis of PTSD relies on an objective evaluation of the stressor's severity. The prospective data in this study support those who argue that evaluations of the severity of the stressor might also take into account subjective factors.
