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BACKGROUND:Psychological distress is common following a traumatic injury event. The Injured Trauma Survivor Screen (ITSS) was developed at a level 1 trauma center to assess for posttraumatic stress disorder (PTSD) and major depressive episode (MDE) following admission for a traumatic injury. The ITSS sensitivity and specificity were analyzed 1 to 3 and 6 to 9 months postinjury to test the validity across trauma centers. METHOD:Four level 1 trauma centers from the East, Midwest, South, and West in the United States recruited 375 eligible adult inpatients (excluded participants included those with moderate or severe traumatic brain injury, whose injury was self-inflicted, were noncommunicative, or were non-English speaking). Baseline sample (White/Caucasian, 63.2%; male, 62.4%; mean (SD) age, 45 (17.11) years; injured by motor vehicle collision, 42.4%) measurements were conducted during index hospitalization. At first follow-up, 69.6% (n = 261) were retained; at second follow-up, 61.3% (n = 230) were retained. Measurements included the ITSS, PTSD Checklist for DSM-5, Center for Epidemiologic Studies Depression Scale-Revised, and Clinician-Administered PTSD Scaled for DSM 5. RESULTS:At follow-up 1, the ITSS PTSD subscale had a sensitivity of 75% and specificity of 78.8%, and the MDE subscale had a sensitivity of 80.4% and specificity of 65.6%. At follow-up 2, the PTSD subscale had a sensitivity of 72.7% and specificity of 83.1%, and the MDE subscale had a sensitivity of 76.1% and specificity of 68.3%. A combined risk group using two symptom based measures administered at baseline produced increased specificity. CONCLUSION:The nine-item ITSS continues to be an efficient and effective risk screen for PTSD and MDE following traumatic injury requiring hospitalization. This multi-institutional validation study creates a solid foundation for further exploration of the generalizability of this screen's psychometric properties in distinct populations.

Burn injuries can cause significant morbidity and mortality; however, more effective medical interventions have resulted in a large proportion of individuals surviving. Individuals with burn injuries have an increased likelihood of psychological disorders. Burn severity and scar visibility have been tied to stigmatizing social reactions from others and, as a result, can negatively affect the mental health of individuals with burn injuries. Social support has been shown to be a buffer for mental health. The purpose of this study was to investigate the relations between stigma, mental health (anxiety and depression), and social support in individuals with burn injuries. A sample of 97 individuals with burn injuries was recruited from an outpatient burn specialty clinic. Stigma was positively related to depression and anxiety. Social support moderated the relationship between stigma and anxiety such that the statistical effect weakened for individuals with burn injuries who experience medium to high levels of social support. The same buffering effect approached significance for depression. Incorporating a focus on stigma and social support could augment behavioral health interventions that target mental health concerns after a burn injury.

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