1
|
Kang SG, Kim JW, Kang HJ, Jang H, Kim JC, Lee JY, Kim SW, Shin IS, Kim JM. Differential predictors of early- and delayed-onset post-traumatic stress disorder following physical injury: a two-year longitudinal study. Front Psychiatry 2024; 15:1367661. [PMID: 38751413 PMCID: PMC11094222 DOI: 10.3389/fpsyt.2024.1367661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/28/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives This study aimed to investigate the predictors of both early- and delayed-onset PTSD over a 2-year period following physical injuries. Methods Patients were recruited from a trauma center at a university hospital in South Korea (June 2015 ~ January 2021). At baseline, 1142 patients underwent comprehensive assessments including socio-demographic, pre-trauma, trauma-related, and peri-trauma evaluations. Diagnoses of acute stress disorder (ASD) and subthreshold ASD were also determined using the Clinician-administered PTSD Scale (CAPS). Follow-up assessments at three months included diagnoses of PTSD and subthreshold PTSD using CAPS, and stressful life events (SLEs), with additional evaluations at 6, 12, and 24 months. The analyzed sample comprised 1014 patients followed up at least once after the baseline and 3-month evaluations. PTSD diagnoses were categorized into early-onset (within the first six months after trauma) and delayed-onset (more than six months after trauma). Logistic regression models identified predictors for each group. Results Early-onset and delayed-onset PTSD were diagnosed in 79 and 35 patients, respectively. Early-onset PTSD was predicted by previous psychiatric disorders, previous traumatic events, ASD and subthreshold ASD diagnoses, and higher anxiety levels. In contrast, delayed-onset PTSD was linked to higher education, higher injury severity, and subthreshold PTSD and SLEs at 3-month follow-up. Conclusion Distinct predictors were found for early-onset and delayed-onset PTSD. The findings underscore the heterogeneous factors influencing the temporal development of PTSD post-trauma, and may provide valuable guidance for more targeted interventions and improved patient outcomes.
Collapse
Affiliation(s)
- Sung-Gil Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyunseok Jang
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Jung-Chul Kim
- Division of Trauma, Department of Surgery, Chonnam National University Medical School and Hospital, Gwangju, Republic of Korea
| | - Ju-Yeon Lee
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| |
Collapse
|
2
|
Sabahi Z, Hasani P, Salehi-Pourmehr H, Beheshti R, Sadeghi-Bazargani H. What Are the Predictors of Post-traumatic Stress Disorder Among Road Traffic Accident Survivors: A Systematic Review. J Nerv Ment Dis 2024; 212:104-116. [PMID: 38290103 DOI: 10.1097/nmd.0000000000001739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
ABSTRACT Traffic accidents put tremendous burdens on the psychosocial aspects of communities. Post-traumatic stress disorder (PTSD), after an accident, is one of the most prevalent and incapacitating psychiatric conditions worldwide. In this systematic review, we aimed to investigate the predictors of PTSD in traffic accident victims. Primary search was conducted in November 2021 and updated in 2023. Studies were excluded if they used any analysis except regression for predictors. Cumulatively, primary and update searches retrieved 10,392 articles from databases, and of these, 87 studies were systematically reviewed. The predictors were categorized into sociodemographics, pretrauma, peritrauma, and post-trauma factors. The PTSD assessment time varied between 2 weeks and 3 years. Being a woman, having depression and having a history of road traffic accidents pretraumatically, peritraumatic dissociative experiences, acute stress disorder diagnosis, rumination, higher injury severity, and involvement in litigation or compensation after the trauma were significant predictors of PTSD.
Collapse
Affiliation(s)
- Zahra Sabahi
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parham Hasani
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Rasa Beheshti
- Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|
3
|
Kolozsvári LR, Rekenyi V, Garbóczy S, Hőgye-Nagy Á, Szemán-Nagy A, Sayed-Ahmad M, Héjja-Nagy K. Effects of Health Anxiety, Social Support, and Coping on Dissociation with Mediating Role of Perceived Stress during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5491. [PMID: 37107773 PMCID: PMC10138819 DOI: 10.3390/ijerph20085491] [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: 01/31/2023] [Revised: 03/19/2023] [Accepted: 03/28/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Our study aimed to examine whether health anxiety, social support, and ways of coping relate to dissociation directly or only through the mediation of perceived stress, moderated by the time of measurement (lockdown). We investigated the effect of perceived stress on different forms (sub-scales) of dissociation. METHODS A cross-sectional survey was conducted by an online form at two points in time: the beginning and the later stage of the COVID-19 pandemic. RESULTS We received a total of 1711 responses. Perceived stress moderately correlated with dissociation in both international and Hungarian samples. Health anxiety showed a strong direct and indirect correlation with dissociation. Regarding social support, the support of family significantly decreased the dissociative experiences in the Hungarian sample mediated by perceived and direct stress. In the international sample, goal-oriented coping strategies strongly decreased all dissociation scales in the first measurement, through the mediation of perceived stress. As for the Hungarian sample, positive thinking was found to decrease dissociation by decreasing perceived stress. CONCLUSION health anxiety, coping, and social support appeared to influence dissociation directly and through the mediation of perceived stress. Social support, mainly support of the family and problem-focused coping strategies may decrease the level of stress, this way decreasing dissociative behavior.
Collapse
Affiliation(s)
- László Róbert Kolozsvári
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Viktor Rekenyi
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Szabolcs Garbóczy
- Doctoral School of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary
- Department of Psychiatry, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Ágnes Hőgye-Nagy
- Department of Work and Social Psychology, Institute of Psychology, University of Debrecen, 4032 Debrecen, Hungary
| | - Anita Szemán-Nagy
- Department of Personality and Clinical Psychology, Institute of Psychology, University of Debrecen, 4032 Debrecen, Hungary
| | - Mohamed Sayed-Ahmad
- Department of Radiology and Imaging Science, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Katalin Héjja-Nagy
- Department of Personality and Clinical Psychology, Institute of Psychology, University of Debrecen, 4032 Debrecen, Hungary
| |
Collapse
|
4
|
Daddah D, Glèlè Ahanhanzo Y, Kpozehouen A, Hounkpe Dos Santos B, Ouendo EM, Levêque A. Prevalence and Risk Factors of Post-Traumatic Stress Disorder in Survivors of a Cohort of Road Accident Victims in Benin: Results of a 12-Month Cross-Sectional Study. J Multidiscip Healthc 2022; 15:719-731. [PMID: 35411148 PMCID: PMC8994593 DOI: 10.2147/jmdh.s358395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/25/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Post-traumatic stress disorder (PTSD) is a frequent psychiatric complication in road accident survivors. However, it remains under-explored and is not taken into account in health policies in Benin. The purpose of this study was to determine the prevalence and risk factors of PTSD after a road traffic accident. This will help to improve its diagnosis and management in Benin hospitals. Materials and Methods An institution-based cross-sectional study was conducted from November 2020 to January 2021. Consenting victims of road traffic accidents from three hospitals across Benin, aged 18 years and above, living in the south of the country, were administered various questionnaires at 12-month follow-up. Data on PTSD were collected using a pre-tested, structured and standardized post-traumatic stress disorder questionnaire, the PTSD Checklist (specific version) (PCL-S). A logistic regression model was fitted to identify factors associated with PTSD. An adjusted odds ratio (AOR) followed by a 95% confidence interval was calculated to determine the level of significance with a p-value less than 0.05. Results Out of 865 patients in the cohort eligible for the 12-month follow-up, 734 (85%) participated in the study. The prevalence of PTSD was 26.43% (95% CI: 23.36–29.75). Factors associated with PTSD on multivariate analysis were female gender (adjusted odds ratio (AOR) = 2.14, 95% CI: 1.38–3.33), hospitalization (AOR = 1.87, 95% CI 1.21–2.89), negative impact of the accident on income (AOR = 4.22, 95% CI: 2.16–8.25), and no return to work (AOR = 3.17, 95% CI: 1.99–5.06). Conclusion The prevalence of PTSD is high in road accident survivors in Benin. The results of this study highlight the need for early diagnosis and a multidisciplinary approach to the management of PTSD patients in Benin’s hospitals.
Collapse
Affiliation(s)
- Donatien Daddah
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
- Correspondence: Donatien Daddah, Epidemiology and Biostatistics Department, Regional Institute of Public Health, P.O. Box 384, Ouidah, Benin, Tel +229 97167245, Email
| | - Yolaine Glèlè Ahanhanzo
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alphonse Kpozehouen
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
| | - Bella Hounkpe Dos Santos
- Epidemiology and Biostatistics Department, Regional Institute of Public Health, Ouidah, Benin
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
| | - Edgard-Marius Ouendo
- Health Policies and Systems Department, Regional Institute of Public Health, Ouidah, Benin
| | - Alain Levêque
- Center for Research in Epidemiology, Biostatistics and Clinical Research, Public Health School, (Université Libre de Bruxelles), Brussels, Belgium
| |
Collapse
|
5
|
Almarwani SM, Hijazi LO, Alamer MA, Alnwaiser JM, Aldakheel RA, Alsheikh K, Albabtain I, Alghnam S. The association between family cohesion and disability following blunt trauma: findings from a level-I trauma center in Saudi Arabia. Inj Epidemiol 2020; 7:40. [PMID: 32772920 PMCID: PMC7416389 DOI: 10.1186/s40621-020-00271-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/23/2020] [Indexed: 01/29/2023] Open
Abstract
Background Injuries pose a significant burden on population health of Saudi Arabia. Even in nonfatal injuries, the burden varies from temporary to permanent disabilities. Health outcomes following injuries can vary, and predictors of recovery from disability are not well understood. In the Kingdom, family values and cohesion can differ from other countries due to several factors, including religious beliefs and cultural traditions. Learning about predictors of injury recovery can improve prevention as well as planning for rehabilitation programs. Therefore, the study aims to evaluate the association between family cohesion and recovery following blunt injuries. Methods This prospective study included 249 patients who were hospitalized for at least 1 day following blunt trauma in King Abdulaziz Medical City, Riyadh. Adult patients were interviewed twice: initially during admission, and a second interview via the phone 3 months after discharge. Baseline information included: demographics, injury characteristics, the five dimensions EQ-5D and family support scale. The follow-up interview captured only EQ-5D. Suboptimal family cohesion was defined as any issue with the relationship with parents, spouse, or siblings. Any disability was defined as a reported limitation in one or more domains of the EQ-5D scale. Logistic regression was used to assess the association between family cohesion and recovery at 3 months. Results Of the overall sample, 169 (67.8%) responded to the second interview, and three patients passed away. About 95.2% of patients reported disabilities at baseline, while 88.1% continued to report disabilities after 3 months. Forty patients (16.1%) reported suboptimal family cohesion. Of these patients, 37(94.87%) were in pain, 33(82.5%) reported problems with usual activities, 32(80%) faced problems with self-care, 32 (80%) patients had difficulty in mobility, and 23(57.5%) were depressed. Multivariable regression suggested that patients with suboptimal family cohesion were less likely to recover from disabilities. Conclusion The prevalence of any disability 3 months after discharge is striking. This study suggests that health outcomes after blunt trauma are affected by the strength of the patient’s family cohesion. More research is needed to identify effective ways through which the provision of social support can reduce short term disability after trauma.
Collapse
Affiliation(s)
- Sarah Mohammed Almarwani
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Leen Omar Hijazi
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Modhi Abdullah Alamer
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Jury Muhanad Alnwaiser
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Reem Abdullah Aldakheel
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Khalid Alsheikh
- Department of Orthopedics, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- Department of Surgery-Hospital-NGHA, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health Section- King Abdullah International Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 11426, Saudi Arabia.
| |
Collapse
|
6
|
Coronas R, Gallardo O, Moreno M, Suárez D, García-Parés G, Menchón J. Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors. Eur Psychiatry 2020; 26:508-12. [DOI: 10.1016/j.eurpsy.2010.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2010] [Revised: 06/21/2010] [Accepted: 06/27/2010] [Indexed: 10/19/2022] Open
Abstract
AbstractObjectiveTo determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.MethodsWe included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.ResultsPTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p < 0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p = 0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p = 0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.ConclusionsHR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.
Collapse
|
7
|
"That's what you do for people you love": A qualitative study of social support and recovery from a musculoskeletal injury. PLoS One 2018; 13:e0196337. [PMID: 29694438 PMCID: PMC5919019 DOI: 10.1371/journal.pone.0196337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 04/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background Social support has been identified as a significant factor in facilitating better health outcomes following injury. However, research has primarily focused on the role of social support from the perspective of the person experiencing an injury. Limited research has examined the experiences of the family members and friends of a person with injury. This study aims to explore the perceptions and experiences of social support and recovery following a transport-related musculoskeletal injury (MSI) in a population of injured persons and their family members and friends. Methods This study was conducted using a phenomenological qualitative research design. In-depth semi-structured interviews were conducted with ten persons with MSI, recruited via the Transport Accident Commission (TAC) in Victoria, Australia. Seven family members and friends were also interviewed. The data was analysed using constant comparative method and thematic analysis. Results Several themes were identified including: (1) key sources and types of support received, (2) relationship development and (3) challenges of providing and receiving support. Participants with MSI reported stories about how the social network provided emotional and tangible support. Family members and friends confirmed the supportive acts provided to the participants with MSI. Positive iterative changes in relationships were reported by the participants with MSI. Participants with MSI, their family members and friends described several difficulties including loss of independence, feeling like a burden, and the impact of caring on health and well-being. Conclusions The role of social support is complex given the multitude of people involved in the recovery process. The findings of this study suggest that persons with MSI may benefit from support groups and maintenance of existing support networks. Furthermore, family members and friends engaged in the recovery process may benefit from support in this role.
Collapse
|
8
|
Abstract
BACKGROUND The psychological response of injured people after traffic accidents includes stress and depression. PURPOSE To assess orthopaedic patients' stress, depression, and satisfaction with life after traffic accidents in Greece. METHODS Descriptive, longitudinal, correlational study. Patients' background factors, injury severity, scores on the Impact of Events Scale-Revised (IES-R), the Center for Epidemiologic Studies Depression (CES-D) Scale, and the Satisfaction With Life Quality (SWLQ) Scale were recorded. The principles of the Declaration of Helsinki were applied. RESULTS In total, 60 patients participated in this study during hospitalization following a road traffic accident and 40 patients at 6 months after. Participants were mostly men (75%) with severe injuries (50%). The IES-R score at 6 months was significantly lower than during hospitalization. One out of 3 people had a CES-D score, which is considered of clinical significance. The SWLQ scores were considered high. CONCLUSION As posttraumatic stress and depression seem to affect a considerable percentage of people involved in road traffic accidents in Greece, these individuals should be assessed for posttraumatic stress and depression while still hospitalized.
Collapse
|
9
|
Rosellini AJ, Dussaillant F, Zubizarreta JR, Kessler RC, Rose S. Predicting posttraumatic stress disorder following a natural disaster. J Psychiatr Res 2018; 96:15-22. [PMID: 28950110 PMCID: PMC5726547 DOI: 10.1016/j.jpsychires.2017.09.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 07/23/2017] [Accepted: 09/07/2017] [Indexed: 01/16/2023]
Abstract
Earthquakes are a common and deadly natural disaster, with roughly one-quarter of survivors subsequently developing posttraumatic stress disorder (PTSD). Despite progress identifying risk factors, limited research has examined how to combine variables into an optimized post-earthquake PTSD prediction tool that could be used to triage survivors to mental health services. The current study developed a post-earthquake PTSD risk score using machine learning methods designed to optimize prediction. The data were from a two-wave survey of Chileans exposed to the 8.8 magnitude earthquake that occurred in February 2010. Respondents (n = 23,907) were interviewed roughly three months prior to and again three months after the earthquake. Probable post-earthquake PTSD was assessed using the Davidson Trauma Scale. We applied super learning, an ensembling machine learning method, to develop the PTSD risk score from 67 risk factors that could be assessed within one week of earthquake occurrence. The super learner algorithm had better cross-validated performance than the 39 individual algorithms from which it was developed, including conventional logistic regression. The super learner also had a better area under the receiver operating characteristic curve (0.79) than existing post-disaster PTSD risk tools. Individuals in the top 5%, 10%, and 20% of the predicted risk distribution accounted for 17.5%, 32.2%, and 51.4% of all probable cases of PTSD, respectively. In addition to developing a risk score that could be implemented in the near future, these results more broadly support the utility of super learning to develop optimized prediction functions for mental health outcomes.
Collapse
Affiliation(s)
- Anthony J Rosellini
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA; Center for Anxiety and Related Disorders, Boston University, Boston, MA, USA.
| | | | - José R Zubizarreta
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA; Division of Decision, Risk and Operations, and Department of Statistics, Columbia University, New York, NY, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Sherri Rose
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
10
|
Prang KH, Berecki-Gisolf J, Newnam S. Recovery from musculoskeletal injury: the role of social support following a transport accident. Health Qual Life Outcomes 2015; 13:97. [PMID: 26138816 PMCID: PMC4490643 DOI: 10.1186/s12955-015-0291-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 06/22/2015] [Indexed: 01/25/2023] Open
Abstract
Background Social support can be an important coping resource for persons recovering from injury. In this study, we examined the effects of family structure and sources of social support on physical health, persistent pain and return to work (RTW) outcomes following musculoskeletal injury (MSI) sustained in a transport accident. Methods Secondary analysis of Transport Accident Commission (TAC) cross-sectional surveys held in 2010 and 2011 was conducted. In total 1649 persons with MSI were identified and included. Family structure was determined by marital status and number of children. Sources of social support were measured as perceived help from family, friends, neighbours and employers. Physical health was measured with the Physical Component Summary (PCS) score of the Short-Form-12 Health Survey Version 2. Persistent pain was defined as self-reported persistent pain experienced in the last 3 months, and RTW was defined as being back at work for ≥3 months at time of interview. Multiple linear and logistic regressions were used for the analyses. Results Family and friends’ support was associated with better physical health among persons with >1 day hospital stay. Being married or in a de facto relationship was associated with greater PCS score among non-hospitalised persons. Being widowed/separated/divorced was associated with more self-reported persistent pain (odds ratio 1.62 [95 % confidence intervals 1.11–2.37]). Support from family (0.40 [0.24–0.68]), friends (0.29 [0.17–0.47]) and neighbours (0.59 [0.41–0.84]) was associated with less persistent pain. Among women, support from family (0.09 [0.01–0.78]) was negatively associated with RTW, whereas support from friends (3.03 [1.15–8.02]) was positively associated with RTW. These associations were not observed among men. For both men (5.62 [2.77–11.38]) and women (7.22 [2.58–20.20]), support from employers was positively associated with RTW. Conclusion Family structure and sources of social support had a positive impact on physical health, persistent pain and RTW following MSI. This study highlights the importance of identifying people who have limited access to a social support network. Those with limited access to social support after a transport accident could potentially benefit from the provision of formal sources of practical and psychological support.
Collapse
Affiliation(s)
- Khic-Houy Prang
- Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia.
| | | | - Sharon Newnam
- Monash Injury Research Institute, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Bae SM, Hyun MH, Ra YS. Mediating effects of forgiveness and emotion-focused coping on post-traumatic stress disorder symptoms caused by physical injury and perceived threat. Asia Pac Psychiatry 2015; 7:164-72. [PMID: 24898771 DOI: 10.1111/appy.12142] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 04/24/2014] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The purpose of this study was to develop and test a model (including cognitive appraisal, coping strategy, and forgiveness variables) predicting post-traumatic stress disorder (PTSD) in 127 adults who were involved in traffic accidents. METHODS Participants were recruited from the inpatient and outpatient departments of three urban hospitals in South Korea. We utilized the path analysis to identify the best fitting model to our data. RESULTS Path analysis showed that the baseline model compared with an alternative model was more appropriate for our data. Our results indicated that the severity of physical injury was directly related to the participants' perceived threat. The perceived threat had direct and indirect effects on PTSD symptoms through forgiveness and emotion-focused coping strategies. One of the significant findings was that victims' forgiveness of the person at fault for the accident reduced their PTSD symptoms. The severity of physical injury was not related directly to PTSD symptoms. DISCUSSION Our study demonstrates that victim's forgiveness of the person at fault in a traumatic situation can be useful in helping their recovery after trauma and the forgiveness process may be applied to traffic accident situations as well as other types of interpersonal trauma.
Collapse
Affiliation(s)
- Sung-Man Bae
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea; Department of Psychology, Chung-Ang University, Seoul, South Korea
| | | | | |
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
|
Ghisi M, Novara C, Buodo G, Kimble MO, Scozzari S, Di Natale A, Sanavio E, Palomba D. Psychological distress and post-traumatic symptoms following occupational accidents. Behav Sci (Basel) 2013; 3:587-600. [PMID: 25379258 PMCID: PMC4217600 DOI: 10.3390/bs3040587] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/15/2013] [Accepted: 10/21/2013] [Indexed: 11/16/2022] Open
Abstract
Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening, injury. Therefore, the present study was aimed at assessing the psychological consequences of accidents occurring in several occupational settings (e.g., construction and industry). Thirty-eight victims of occupational accidents (injured workers) and 38 gender-, age-, and years of education-matched workers who never experienced a work accident (control group) were recruited. All participants underwent a semi-structured interview administered by a trained psychologist, and then were requested to fill in the questionnaires. Injured workers reported more severe anxious, post-traumatic and depressive symptoms, and poorer coping skills, as compared to controls. In the injured group low levels of resilience predicted post-traumatic symptomatology, whereas the degree of physical injury and the length of time since the accident did not play a predictive role. The results suggest that occupational accidents may result in a disabling psychopathological condition, and that a brief psychological evaluation should be included in the assessment of seriously injured workers.
Collapse
Affiliation(s)
- Marta Ghisi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-049-827-6037 (ext. 37014); Fax: +39-049-827-6600
| | - Caterina Novara
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| | - Giulia Buodo
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| | - Matthew O. Kimble
- Department of Psychology, Middlebury College, McCardell Bicentennial Hall, 276 Bicentennial Way, Middlebury, VT 05753, USA; E-Mail:
| | - Simona Scozzari
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| | - Arianna Di Natale
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| | - Ezio Sanavio
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| | - Daniela Palomba
- Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy; E-Mails: (C.N.); (G.B.); (S.S.); (A.D.N.); (E.S.); (D.P.)
| |
Collapse
|
14
|
Maselesele VM, Idemudia ES. The role of social support in the relationship between mental health and posttraumatic stress disorder amongst orthopaedic patients. Curationis 2013; 36:E1-7. [PMID: 23718805 DOI: 10.4102/curationis.v36i1.122] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 02/25/2013] [Accepted: 03/23/2013] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Some life-event experiences such as injuries in car accidents, gun shots and the like, can be life changing and traumatic. OBJECTIVES The article investigated the relationship between mental health and posttraumatic stress disorder (PTSD) symptoms after orthopaedic trauma, and attempted to understand whether social support moderates the relationship between mental health and PTSD. METHOD A cross-sectional research model was used. Two hundred participants were selected using simple randomisation within a hospital complex in Gauteng, South Africa. The sample consisted of 110 men and 90 women (x̄=37.8 years, s.d.=12.9 years). Data were collected using the Revised Civilian Mississippi Scale for PTSD, the Multidimensional Scale of Perceived Social Support (MSPSS), and the General Health Questionnaire version 28. RESULTS The findings of the study indicated that there is a statistically significant relationship between mental health and PTSD after orthopaedic trauma, and a positive correlation between poor mental health and PTSD (r=0.52, n=200, p<0.05). However, perceived social support did not moderate mental health or PTSD, indicating that perceived social support did not significantly influence mental health or PTSD, (MSPSS B=0.07, p=0.66). Those with high scores on social support had a lower regression coefficient (B=0.19) for mental health and PTSD than those who reported low social support (B=0.26). CONCLUSION There is a significant relationship between mental health and PTSD of orthopaedic patients, and social support did not moderate the relationship between mental health and PTSD.
Collapse
|
15
|
Iteke O, Bakare MO, Agomoh AO, Uwakwe R, Onwukwe JU. Road traffic accidents and posttraumatic stress disorder in an orthopedic setting in South-Eastern Nigeria: a controlled study. Scand J Trauma Resusc Emerg Med 2011; 19:39. [PMID: 21696614 PMCID: PMC3138453 DOI: 10.1186/1757-7241-19-39] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 06/22/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychiatric liaison services are rare in trauma units of various hospitals in Nigeria and other sub-Saharan African countries. The occurrence of road traffic accidents (RTAs) resulting from low standard of road construction and inadequate maintenance have been on the increase in Nigeria. While the physical consequences of such RTAs are obvious, the psychological consequences are often not apparent. This study assessed the prevalence of posttraumatic stress disorder (PTSD) among victims of RTAs and compared same with controls drawn from a population who have not experienced RTAs. It also assessed the associated socio-demographic variables. METHOD Study population consisted of one hundred and fifty RTA victims and two different control groups drawn from the population consisting of staffs of Federal Neuropsychiatric Hospital, Enugu, Nigeria and that of National Orthopedic Hospital, Enugu, Nigeria, 150 people in each control group were matched for age and sex with the RTA victims and they were interviewed with PTSD module of Mini International Neuropsychiatric Interview (MINI) and their socio-demographic variables obtained with socio-demographic questionnaire. RESULTS The prevalence of PTSD among RTA victims and the two control groups were 26.7%, 8.0% and 8.7% respectively. The difference in prevalence was statistically significant with RTA victims more likely to experience PTSD compared to the two control groups (X² = 27.23, df = 2, p = 0.001). Gender influenced the prevalence of PTSD among victims of RTAs and the controls, with females more likely to experience PTSD when compared to the males. Among victims of RTAs, being gainfully employed prior to the accidents increased the likelihood of developing PTSD and this was statistically significant (X² = 20.09, df = 1, p = 0.000). CONCLUSIONS There is urgent need to pay more attention to developing consultation-liaison psychiatry services in trauma units of Nigerian hospitals, including orthopedic hospitals located in different geographical zones of the country.
Collapse
Affiliation(s)
- Obiora Iteke
- General Adult Psychiatry Unit, Federal Neuropsychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria.
| | | | | | | | | |
Collapse
|
16
|
Allenou C, Olliac B, Bourdet-Loubère S, Brunet A, David AC, Claudet I, Lecoules N, Roullet P, Bui E, Birmes P. Symptoms of traumatic stress in mothers of children victims of a motor vehicle accident. Depress Anxiety 2010; 27:652-7. [PMID: 20013986 DOI: 10.1002/da.20650] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Motor vehicle accidents (MVAs) are the main cause of Posttraumatic stress disorder (PTSD) in industrialized countries. This includes the frequently occurring but understudied situation of parents learning that their children were injured. However, unlike in other types of trauma survivors, little is known about the predictors of PTSD symptoms in mothers whose child has suffered an MVA. METHODS A group of 72 mothers and 28 fathers were prospectively assessed for peritraumatic distress, peritraumatic dissociation, and PTSD symptoms 1 and 5 weeks after their child had suffered an MVA. RESULTS Levels of peritraumatic distress and dissociation were comparable to other trauma victims, 18% of the mothers were considered to be suffering from probable PTSD. In mothers, significant positive correlations were found between PTSD symptoms and peritraumatic distress (r=.34) and dissociation (r=.37), whereas mothers' PTSD symptoms were associated with decreased peritraumatic dissociation in fathers (r=-.37). Even after controlling for covictim/witness status, peritraumatic distress was a predictor of mothers' PTSD symptoms, explaining 14% of the variance. CONCLUSIONS Peritraumatic response and PTSD symptoms should be routinely assessed among parents whose child has experienced a traumatic event.
Collapse
Affiliation(s)
- Charlotte Allenou
- Université de Toulouse et CHU de Toulouse, Hôpital Casselardit, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Baranyi A, Leithgöb O, Kreiner B, Tanzer K, Ehrlich G, Hofer HP, Rothenhäusler HB. Relationship Between Posttraumatic Stress Disorder, Quality of Life, Social Support, and Affective and Dissociative Status in Severely Injured Accident Victims 12 Months After Trauma. PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70691-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
18
|
Victorson DE, Enders CK, Burnett KF, Ouellette EA. The Injury Distress Index: Development and Validation. Arch Phys Med Rehabil 2008; 89:1893-902. [DOI: 10.1016/j.apmr.2008.02.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2007] [Revised: 02/05/2008] [Accepted: 02/11/2008] [Indexed: 10/21/2022]
|