Life‐events and psychiatric symptoms in a general psychiatry clinic: The role of intrusion and avoidance

Abstract

Recent literature has been concerned with the relationship between life-events and psychological symptoms, and more particularly studies of communities subsequent to disasters have suggested the presence of intrusive cognitions to be a mediating variable. In this investigation new patients presenting to a general community psychiatric clinic over a four-month period completed a brief life-event scale, the Impact of Event Scale (IES) and the 28-item General Health Questionnaire (GHQ). Appropriate statistical methods were employed to model the intervening role of IES scores between numbers of life-events and subsequent psychiatric symptomatology. Data was collected on 48 subjects, for whom it was shown that IES score accounted for the reporting of psychiatric symptoms following adversity. It appeared to be the dimension of cognitive intrusion that mediated this effect, with cognitive avoidance occupying a subsidiary, reactive role. There was also evidence of specific relationships between intrusion and anxiety and somatic subscales of the GHQ, and between avoidance and depression. Despite small numbers and simple measures, the findings supported the post-disaster studies, and raises further questions about the emotional processing of adversity.

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

“…The mean level of trauma-related distress found amongst acute patients at an emergency community psychiatric service is more comparable with the level found in the present sample. 32 The mean intrusion and avoidance scores for that group were 11.4 (SD 7.5) and 11.5 (SD 6.9) respectively. The traumas experienced ranged from bereavement or severe illness to relationship, employment or ®nancial problems' (p 335).…”

“…The traumas experienced ranged from bereavement or severe illness to relationship, employment or ®nancial problems' (p 335). 32 Information about prior traumatic experiences and/ or the stressor would enhance hypothesis generation and comparisons with other studies. Assessments of people's appraisals and attributions regarding the accident and its sequalae are likely to have been particularly informative.…”

Psychometric testing of the Impact of Event Scale-Chinese Version (IES-C) in oral cancer patients in Taiwan

“…This theoretical relationship between the IES, anxiety, and depression was also supported by previous empirical reports. A moderate correlation was found between the intrusion and avoidance subscales [12,35], both of which were found to be positively associated with anxiety and depression [7,20,34]. The relationship between the IES, its subscales, and demographic-and disease-related factors has been examined, but the findings are inconsistent.…”

Die posttraumatische Verbitterungsstörung (PTED)

“…B. tiefgreifende Konflikte am Arbeitsplatz ("Mobbing"), Arbeitslosigkeit, der Tod eines Angehörigen,Scheidung,schwere Krankheit oder Trennungs-und Verlusterlebnisse sein. Obwohl es eine umfangreiche Literatur zu psychischen Reaktionen auf solche nicht direkt lebensbedrohlichen Ereignisse gibt mit Evidenz für eine hohe Prävalenz [22,25,4,13,20,9], so wird doch die Diagnose einer Anpassungsstörung eher selten gestellt.Auch in epidemiologischen Studien zu psychischen Störungen werden diese Erkrankungen regelhaft nicht berücksichtigt [17]. Ein Grund hierfür ist das Fehlen eines prä-zisen Diagnosealgorithmus und auch das Konzept, dass Belastungsreaktionen sich spätestens nach einem halben Jahr zurückgebildet haben sollten und bei fortbestehender Symptomatik von einer sonstigen Störung auszugehen ist.…”