Evaluation of post traumatic distress in the first 6 months following SCI

Abstract

Study design: Cross-sectional questionnaire. Objectives: To assess the degree of post traumatic stress symptomatology and its correlates amongst a group of new spinal cord injured patients. Setting: The National Spinal Injuries Centre, Stoke Mandeville Hospital NHS Trust. Method: Eighty-®ve participants with an average age of 32.6 years were assessed between 6 and 24 weeks post injury. Seventeen participants were female. Seventy per cent had complete lesions. Forty per cent had paraplegia and 60% had tetraplegia. Road tra c accidents were the most common cause of injury followed by falls and then sporting accidents. The Impact of Event Scale was used to measure the experience of intrusive thoughts about the trauma and avoidance of trauma related stimuli. Anxiety (SAI), depression (BDI) and dependency (FIM) were also measured. Results: High levels of distress were evident in 14% of the sample. Trauma-related distress was signi®cantly higher in female patients or patients with high levels of anxiety or depression. Conclusion: In this sample, the rates of trauma-related distress following spinal cord injury were comparable to those found following other traumas and are of clinical signi®cance. Spinal Cord (2001) 39, 381 ± 386

Psychosocial issues in spinal cord injury: a review

“…23,43,46,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] These estimates are affected by the type of instruments, choice of cutoff point (for example, possible, probable and major) and sample characteristics (gender, age and time after SCI). Craig (2009) 5 found five studies that applied a structured diagnostic interview during the rehabilitation or hospitalization phase, reporting 20-43% having minor or major depression disorder.…”

Event centrality as a unique predictor of posttraumatic stress symptoms and perceived disability following spinal cord injury

“…This wide disparity in prevalence rates mostly stems from variation in the amount of time-since-injury of the participant sample. Studies of participants with more recent SCIs (3-24 months post-injury) report prevalence rates between 14% -44% [3][4][5] , whereas studies involving participants with more distant SCIs (> 2 years) report prevalence rates of 1% -13% [6][7][8] . However, it should be noted that one study did find a prevalence rate of only 1% in a sample of participants with a recent SCI 9 .…”

“…Such a finding demonstrates that some individuals continue to experience clinical levels of posttraumatic stress symptoms for decades following the SCI. Although clinical levels of PTSS are less prevalent than clinical levels of depression following SCI, rates of PTSS following SCI are comparable to other types of trauma and constitute a clinical concern 5,10 . PTSS typically reflect persistent re-experience of the trauma event, avoidance of trauma-relevant stimuli, general numbing of responsiveness, and increased arousal 11 .…”

“…Research on posttraumatic stress following SCI finds prevalence rates of 1% -44% for posttraumatic symptoms [3][4][5][6][7][8][9][10] . This wide disparity in prevalence rates mostly stems from variation in the amount of time-since-injury of the participant sample.…”

Post-traumatic stress disorder and emotional distress in persons with spinal cord lesion

“…One such study found strong associations between post-traumatic distress symptoms and depression in 85 in-patients with SCL. 17 The aim of the present study was to determine the prevalence of PTSD in patients with new SCL. The hypotheses to be tested were as follows: (1) Patients with traumatic SCL suffer more from PTSD compared with those with nontraumatic SCL; (2) Patients with SCL suffering from PTSD have higher levels of depression and emotional distress compared with those without PTSD; (3) There exist positive associations between PTSD and depression, and between PTSD and emotional distress; (4) Injury severity (paraplegia/tetraplegia and neurological level) influences PTSD severity for patients with nontraumatic and traumatic lesions.…”