This longitudinal, cohort study examined the effect of personality traits on the emergence of posttraumatic stress disorder (PTSD) in a recently traumatized, civilian, mixed-gender sample with significant injuries. Burn survivors (N = 70) were administered the NEO-Personality Inventory (NEO-PI) and the Structured Clinical Interview for DSM III-R (SCID) at hospital discharge and readministered the SCID 4 and 12 months later. Overall, the sample of burn survivors scored significantly higher on neuroticism and extraversion and lower on openness, agreeableness, and conscientiousness relative to a normative national sample. Furthermore, multivariate analysis of variance revealed that PTSD symptom severity groups (i.e., single symptom, multiple symptoms, subthreshold PTSD, PTSD) were differentially related to neuroticism and extraversion. Planned comparisons indicated that neuroticism was higher and extraversion was lower in those who developed PTSD compared with those who did not develop PTSD.

SWAP) is a 14-item questionnaire, assessing both the subjective appraisal and social-behavioral components of body image among bum survivors. Burn survivors requiring hospitalization (n = 165} completed a packet of psychometric instruments, including the SWAP at 1-week postdischarge. The SWAP demonstrated a high level of internal consistency (Cronbach's alpha, r. = .87; the mean interitem correlation, r,, = .32, the mean itemtotal correlation, rit = .53). Eighty-four participants were retested approximately 2 months after the initial assessment to evaluate test-retest reliability (rlt, = .59). A principal-components analysis with a varimax rotation yielded 4 easily interpretable factors accounting for 66% of the total variance. The correlations of die SWAP total score with other selected psychometric measures provided evidence for both convergent and discriminant validity. This initial evaluation of the SWAP suggests that it is both a reliable and valid measure of body image for a burn-injured population.Enduring a severe burn presents a burn survivor with numerous challenges, not the least of which is adjusting to scarring and related changes in his or her appearance (Patterson et al., 1993). To date, most research on the psychological effect of scarring and disfigurement following a severe bum injury has focused on the relationship between burn characteristics (e.g., size and location of burn), demographic characteristics of the burn survivors (e.g., sex and age), and subsequent emotional distress. For example, a number of researchers have emphasized the importance of the distinction between hidden (e.g., back, stomach) or visible (e.g., face) scars. Abdullah et al. (1994) found that children with visible scars from burn injuries reported more body-image disparagement than did children with hidden scars. Similarly, in adult populations, visible scarring has been shown to relate to decreased interaction with nonfamily members (Browne et al., 1985) and to increased withdrawal from activities that emphasize physical appearance (Andreasen & Norris, 1972). Other studies have suggested that alterations in

Normal human polymorphonuclear neutrophils (PMN) undergo rapid apoptosis during in vitro culture. In contrast, apoptosis is inhibited in PMN from patients with severe burns. This inhibition is not an inherent property of the cells but is caused by thermolabile factors present in the plasma. Endotoxin and the proinflammatory cytokines interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) do not appear to be directly responsible. The ability of burn plasma to inhibit apoptosis was reduced by neutralizing antibodies to human granulocyte macrophage colony-stimulating factor (GM-CSF). GM-CSF levels could not be detected in the burn plasma. However, the incubation of burn-derived or normal leukocyte populations consisting primarily of PMN in burn plasma induced the production of GM-CSF. The results suggest that activation of GM-CSF synthesis by factor(s) in burn plasma may play a role in regulating inflammation by the inhibition of apoptosis.

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