Does Acute Stress Disorder Predict Subsequent Posttraumatic Stress Disorder in Pediatric Burn Survivors?

Rosenberg, Laura; Rosenberg, Marta; Robert, Rhonda; Richardson, Lisa; Sharp, Sherri; Hölzer, Charles E.; Thomas, Christopher; Meyer, Walter J.

doi:10.4088/jcp.14m09365

Cited by 12 publications

(12 citation statements)

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“…Of the 16 studies reviewed, 10 referred to the aggravating factors [12][13][14][15][16][17][18][19][20][21] (table 1) and the remaining 6 were related to the assessment tools (table 2).…”

Section: Resultsmentioning

confidence: 99%

“…This study concluded that clinically elevated PTSD symptom levels were more frequent in children admitted for traumatic injuries (18%) than illness/medical-related causes (4%) and there was a significant relationship (positive) between length of stay and the development of PTSD. Another study 13 examined the prevalence of PTSD in pediatric burn survivors who had been treated for acute stress disorder (ASD) symptoms during their initial hospitalization and compared them with patients who had been asymptomatic for ASD symptoms and found that the prevalence of PTSD was similar in children with ASD symptoms and those without ASD symptoms.…”

Section: Aggravating Factorsmentioning

confidence: 99%

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Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization

Triantafyllou

Matziou

2019

Psychiatriki

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“…Of the 16 studies reviewed, 10 referred to the aggravating factors [12][13][14][15][16][17][18][19][20][21] (table 1) and the remaining 6 were related to the assessment tools (table 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Aggravating Factorsmentioning

confidence: 99%

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization

Triantafyllou

Matziou

2019

Psychiatriki

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“…And opioid tolerance/habituation is a challenge for patients with large severe burns (Bittner et al, 2015), who typically receive the same painful procedures over and over, several times per week, often daily, during several weeks of hospitalization. Excessive pain and/or repeated high opioid doses can pathologically alter the patients pain perception system, disrupting the patient's natural endogenous opioid analgesia system (Schwaller and Fitzgerald, 2014; Ballantyne, 2018; Chambers, 2018), and can increase patient's risk of developing chronic pain, anxiety disorders, and/or Post-Traumatic Stress Disorder (McGhee et al, 2011; Rosenberg et al, 2015, 2018; Pardesi and Fuzaylov, 2017; Peña et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality as an Adjunctive Non-opioid Analgesic for Pre-dominantly Latin American Children With Large Severe Burn Wounds During Burn Wound Cleaning in the Intensive Care Unit: A Pilot Study

Hoffman

Rodriguez

González

et al. 2019

Front. Hum. Neurosci.

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115

144

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Background/Aim: Using a within-subjects, within-wound care design, this pilot study tested for the first time, whether immersive virtual reality (VR) can serve as an adjunctive non-opioid analgesic for children with large severe burn wounds during burn wound cleaning in the ICU, in a regional burn center in the United States, between 2014–2016. Methods: Participants included 48 children from 6 years old to 17 years of age with >10% TBSA burn injuries reporting moderate or higher worst pain during no VR on Day 1. Forty-four of the 48 children were from developing Latin American countries. Patients played adjunctive SnowWorld, an interactive 3D snowy canyon in virtual reality during some portions of wound care, vs. No VR during comparable portions of the same wound care session (initial treatment condition randomized). Using Graphic Rating scales, children's worst pain ratings during “No VR” (treatment as usual pain medications) vs. their worst pain during “Yes VR” was measured during at least 1 day of wound care, and was measured for up to 10 study days the patient used VR. Results: VR significantly reduced children's “worst pain” ratings during burn wound cleaning procedures in the ICU on Day 1. Worst pain during No VR = 8.52 (SD = 1.75) vs. during Yes VR = 5.10 (SD = 3.27), t (47) = 7.11, p < 0.001, SD = 3.33, CI = 2.45–4.38, Cohen's d = 1.03 (indicating large effect size). Patients continued to report the predicted pattern of lower pain and more fun during VR, during multiple sessions. Conclusion: Immersive virtual reality can help reduce the pain of children with large severe burn wounds during burn wound cleaning in the Intensive Care Unit. Additional research and development is recommended.

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“…Recovering from a large severe burn injury involves intense medical treatments such as repeated painful wound cleaning sessions, skin graft surgeries, and physical therapy skin stretching exercises (Hoffman et al, 2011 ). Patients who have sustained a large severe burn are at increased risk of developing psychological disorders such as depression, anxiety, post-traumatic stress disorder, social anxiety, and apprehension about their changed appearance (Meyer et al, 2007 , 2012 ; Stoddard et al, 2011 ; Rosenberg et al, 2015 ). Burn patients often report an increase in negative thoughts and emotions, and a decrease in positive thoughts/emotions (Meyer et al, 2012 ; Murphy et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

“…Patients may experience intense negative emotions such as guilt (e.g., survivor guilt) or shame when thinking about the burn injury. They also may have recurring flashbacks about the accident and this can cause a patient to feel sad, angry, or afraid (Meyer et al, 2007 ; Rosenberg et al, 2015 ). Further, patients with large severe burns are often hospitalized for weeks or months while they recover from their burn injury.…”

Section: Introductionmentioning

confidence: 99%

The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

et al. 2017

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Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury.Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session.Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home.Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions, after VR DBT® mindfulness skills training. Immersive Virtual Reality is becoming widely available to mainstream consumers, and thus has the potential to make this treatment available to a much wider number of patient populations, including severe burn patients. Additional development, and controlled studies are needed.

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Does Acute Stress Disorder Predict Subsequent Posttraumatic Stress Disorder in Pediatric Burn Survivors?

Cited by 12 publications

References 0 publications

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization

Immersive Virtual Reality as an Adjunctive Non-opioid Analgesic for Pre-dominantly Latin American Children With Large Severe Burn Wounds During Burn Wound Cleaning in the Intensive Care Unit: A Pilot Study

The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

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