RESUMO
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.
Assuntos
Queimaduras/psicologia , Escalas de Graduação Psiquiátrica/normas , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Doença Aguda , Adulto , Análise de Variância , Nível de Alerta , Aprendizagem da Esquiva , Viés , Queimaduras/complicações , Feminino , Humanos , Pacientes Internados/psicologia , Masculino , Reprodutibilidade dos Testes , Transtornos de Estresse Pós-Traumáticos/classificação , Transtornos de Estresse Pós-Traumáticos/etiologia , Sobreviventes/psicologiaRESUMO
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.
Assuntos
Queimaduras/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etiologia , Doença Aguda , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica , Índice de Gravidade de DoençaAssuntos
Queimaduras/psicologia , Transtornos Autoinduzidos/psicologia , Traumatismos da Mão/psicologia , Automutilação/psicologia , Adulto , Queimaduras/diagnóstico , Transtornos Autoinduzidos/diagnóstico , Seguimentos , Traumatismos da Mão/diagnóstico , Humanos , Masculino , Equipe de Assistência ao Paciente , Readmissão do Paciente , Recidiva , Automutilação/diagnósticoAssuntos
Explosões , Transtornos Mentais/diagnóstico , Violência/psicologia , Doença Aguda , Adaptação Psicológica , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Feminino , Seguimentos , Humanos , Acontecimentos que Mudam a Vida , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados UnidosRESUMO
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.
Assuntos
Adaptação Psicológica , Queimaduras/complicações , Medição da Dor , Adolescente , Adulto , Idoso , Queimaduras/psicologia , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Análise de RegressãoRESUMO
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.
Assuntos
Abuso Sexual na Infância/psicologia , Relações Interpessoais , Estupro/psicologia , Autoimagem , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Sintomas Afetivos/terapia , Idoso , Criança , Abuso Sexual na Infância/terapia , Transtornos Dissociativos/diagnóstico , Transtornos Dissociativos/psicologia , Transtornos Dissociativos/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Determinação da Personalidade , Recidiva , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , Violência/psicologiaRESUMO
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.