Exploring Symptoms of Post-traumatic Stress Disorders and Perceived Social Support among Patients with Burn Injury

The role of specific sources of social support on postinjury psychological symptoms

PURPOSE/OBJECTIVE

The role of perceived social support from specific sources (e.g., families, friends, and significant others) on the development of postinjury posttraumatic stress disorder (PTSD) and associated psychological symptoms (e.g., depression and anxiety) remains relatively unexplored. We examined the predictive role of social support from specific sources on psychological symptoms among emergency department (ED) patients following motor vehicle crash (MVC). Research Methods/Design: Sixty-three injured patients (63.5% female; 37 years old on average) with moderately painful complaints were recruited in the EDs of two Level-1 trauma centers within 24 hr post-MVC. In the ED, participants completed surveys of baseline psychological symptoms and perceived social support; follow-up surveys were completed at 90 days postinjury.

RESULTS

Most of the sample (84.1%) was discharged home from the ED with predominantly mild injuries and did not require hospitalization. After adjusting for race, sex, age, and baseline symptoms, hierarchical regression analyses demonstrated that lower perceived social support in the ED predicted higher PTSD symptoms and depressive symptoms (but not anxiety) at 90 days. This effect seemed to be specific to significant others and friends but not family.

CONCLUSIONS/IMPLICATIONS

MVC-related injuries are robust contributors to psychological sequelae. These findings extend prior work by highlighting that perceived social support, particularly from significant others and friends, provides unique information regarding the development of psychological symptoms following predominantly mild MVC-related injuries. This data may serve to inform recovery expectations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A review of burn symptoms and potential novel neural targets for non-invasive brain stimulation for treatment of burn sequelae

Burn survivors experience myriad associated symptoms such as pain, pruritus, fatigue, impaired motor strength, post-traumatic stress, depression, anxiety, and sleep disturbance. Many of these symptoms are common and remain chronic, despite current standard of care. One potential novel intervention to target these post burn symptoms is transcranial direct current stimulation (tDCS). tDCS is a non-invasive brain stimulation (NIBS) technique that modulates neural excitability of a specific target or neural network. The aim of this work is to review the neural circuits of the aforementioned clinical sequelae associated with burn injuries and to provide a scientific rationale for specific NIBS targets that can potentially treat these conditions. We ran a systematic review, following the PRISMA statement, of tDCS effects on burn symptoms. Only three studies matched our criteria. One was a feasibility study assessing cortical plasticity in chronic neuropathic pain following burn injury, one looked at the effects of tDCS to reduce pain anxiety during burn wound care, and one assessed the effects of tDCS to manage pain and pruritus in burn survivors. Current literature on NIBS in burn remains limited, only a few trials have been conducted. Based on our review and results in other populations suffering from similar symptoms as patients with burn injuries, three main areas were selected: the prefrontal region, the parietal area and the motor cortex. Based on the importance of the prefrontal cortex in the emotional component of pain and its implication in various psychosocial symptoms, targeting this region may represent the most promising target. Our review of the neural circuitry involved in post burn symptoms and suggested targeted areas for stimulation provide a spring board for future study initiatives.

Role of Perceived Social Support on the Association between Physical Disability and Symptoms of Depression in Senior Citizens of Pakistan

An emerging body of literature has implied that perceived social support is known as an upstream element of cognitive health. Various dimensions of perceived social support may have divergent influence on physical and cognitive health in later life. The present study aimed to investigate the mediating role of perceived social support on the relationship between physical disability and symptoms of depression in senior citizens of Pakistan. The data were collected from three metropolitan cities (Lahore, Faisalabad, Multan) in the Punjab province of Pakistan and 100 participants were approached from each city with a total sample size of 300. The results demonstrated that family support, friends' support, and significant others' support mediated the association between physical disability and symptoms of depression, with an indirect effect of 0.024, 0.058, and 0.034, respectively. The total direct and indirect effect was 0.493. Physical disability was directly associated with symptoms of depression and greater physical disability predicted a higher level of symptoms of depression. Perceived social support, including family support, friends' support, and significant others' support, showed an indirect association with symptoms of depression. Furthermore, family support and friends' support were more significantly associated with symptoms of depression as compared to significant others' support. The research discoveries have better implications for health care professionals, hospice care workers, and policy makers. A holistic approach is required to prevent senior citizens from late-life mental disorders.