Low predictive power of peritraumatic dissociation for PTSD symptoms in accident survivors

Wittmann, Lutz; Moergeli, Hanspeter; Schnyder, Ulrich

doi:10.1002/jts.20154

Cited by 33 publications

(21 citation statements)

References 32 publications

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“…This is very much in line with the existing literature [10, 38, 42, 43]. However, given that only 50% of patients with ASD went on to develop PTSD, and only 63% of those with PTSD at 6 months had been diagnosed as having ASD shortly after the accident, it should be kept in mind that ASD, and dissociation in particular, is not necessarily a prerequisite for developing PTSD [26, 42, 44]. There are probably various pathways leading to PTSD.…”

Section: Discussionsupporting

confidence: 76%

Posttraumatic Stress Disorder following Accidental Injury: Rule or Exception in Switzerland?

Schnyder¹,

Wittmann²,

Friedrich-Perez³

et al. 2008

Psychother Psychosom

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Background: There is still marked variability in the findings concerning psychiatric disorders associated with traumatic injury. The aim of this study was to determine the incidence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) following accidental injuries, and to predict the PTSD symptom level at 6 months, taking into particular consideration the role of pre-existing psychiatric morbidity and insufficient command of the local language. Method: A total of 255 accident survivors who were hospitalized for at least 2 consecutive nights at a Swiss university hospital for treatment of recently acquired physical injuries were interviewed within 2 weeks of the trauma and 6 months after the accident. Patients who did not have a good command of German but were fluent in Italian, Spanish, Portuguese, Serbo-Croatian or Albanian were assessed using interpreters. The main outcome measure was the Clinician-Administered PTSD Scale. Results: Ten patients (3.9%) were diagnosed as having ASD. At 6 months, 8 patients (3.1%) had PTSD. A regression model using 12 potential predictor variables explained 40% of the variance of PTSD symptoms; mild traumatic brain injury (p < 0.001), pain (p < 0.05), ASD symptom level (p < 0.001) and emotional coping (p = 0.001) predicted higher PTSD symptom levels, while high Sense of Coherence (p < 0.05) and perceived responsibility for the accident (p < 0.01) were associated with lower PTSD symptom levels at follow-up. Conclusions: ASD and PTSD seem to occur less frequently following accidental injuries than previously reported in the literature. Pre-existing psychiatric morbidity and lack of proficiency in the locally spoken language do not appear to play an important role in the development of PTSD.

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Section: Discussionsupporting

confidence: 76%

Posttraumatic Stress Disorder following Accidental Injury: Rule or Exception in Switzerland?

Schnyder¹,

Wittmann²,

Friedrich-Perez³

et al. 2008

Psychother Psychosom

Self Cite

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“…Two studies utilized an observer-rated version (Wittmann et al, 2006;Zatzick, Kang, Muller, Russo, Rivara, Katon, Jurkovich, & Roy-Byrne, 2002). Assessments of PD occurred within a week of the trauma in 10 studies.…”

Section: General Characteristics Of the Studiesmentioning

confidence: 99%

“…However, bivariate correlations showed that PD was associated with mental health problems at follow-ups. Wittmann et al (2006) assessed both PD and PTSD by means of observer-rated instruments in a large sample of accident survivors (N=214) exhibiting a relatively low degree of post-traumatic psychopathology. When entered before initial PTSD symptoms PD added a significant but small (3%) proportion of explained variance over and above a set of other control variables.…”

Section: Studies With Negative Outcomesmentioning

confidence: 99%

“…However, 2 of the 4 studies that explicitly included subjects suffering from (mild) TBI repeated the reported analyses excluding the TBI-subjects without affecting the results (Marshall & Schell, 2002;Wittmann et al, 2006). Four studies excluded subjects with TBI, the remaining 9 studies did not assess or report on TBI; for 4 of them it can be assumed that no TBIcases were included (Bennett et al, 2002;Kangas et al, 2005;Koopman et al, 1994;Van Loey et al, 2003).…”

Section: As Regards Physical Injury the Issue Of Traumatic Brain Injmentioning

confidence: 99%

“…For example, in 3 recent prospective studies (Simeon, Greenberg, Nelson, Schmeidler, & Hollander, 2005;Van der Velden, Kleber, Christiaanse, Gersons, Marcelissen, Drogendijk, Grievink, Olff, & Meewisse, 2006;Wittmann, Moergeli, & Schnyder, 2006) peritraumatic dissociation had no significant independent predictive value over and above existing mental health problems during the first days or weeks post-event.…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: A systematic review of prospective studies

Velden

Wittmann

2008

Clinical Psychology Review

Self Cite

112

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The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: a systematic review of prospective studies van der Velden, P G; Wittmann, L van der Velden, P G; Wittmann, L (2008). The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: a systematic review of prospective studies. The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: a systematic review of prospective studies AbstractWe conducted a systematic review of prospective studies examining the independent predictive value of peritraumatic dissociation (PD) for posttraumatic stress disorder (PTSD) symptomatology following single traumatic events. Insight into the independent predictive value may help to identify victims at risk for PTSD symptomatology. For this purpose a literature search was carried out using the online databases PsycINFO, Medline/Pubmed, and PILOTS. Studies were included if they were published in peer-reviewed journals (before 2007), focused on more or less single traumatic events (Type I trauma), assessed PD within 1 month, had follow-ups 3 months or later, and which controlled for mental health problems at the time PD was assessed. The majority of the 17 identified studies showed no or only weak indications of an independent predictive value of PD for PTSD symptomatology following type I traumas. Only 3 of the 6 studies with positive results reported a strong independent predictive value of PD. Although bivariately associated with PTSD symptomatology, there is no general consensus across prospective Type I trauma studies that PD qualifies as an important independent predictor of PTSD symptomatology. AbstractWe conducted a systematic review of prospective studies examining the independent predictive value of peritraumatic dissociation (PD) for posttraumatic stress disorder (PTSD) symptomatology following single traumatic events. Insight into the independent predictive value may help to identify victims at risk for PTSD symptomatology. For this purpose a literature search was carried out using the online databases PsycINFO, Medline/Pubmed, and PILOTS.Studies were included if they were published in peer-reviewed journals (before 2007), focused on more or less single traumatic events (Type I trauma), assessed PD within 1 month, had followups 3 months or later, and which controlled for mental health problems at the time PD was assessed. The majority of the 17 identified studies showed no or only weak indications of an independent predictive value of PD for PTSD symptomatology following type I traumas. Only 3 of the 6 studies with positive results reported a strong independent predictive value of PD.Although bivariately associated with PTSD symptomatology, there is no general consensus across prospective Type I trauma studies that PD qualifies as an important independent predictor of PTSD symptomatology. Results indicate that initial mental health problems, among other factors, are better pre...

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The integration of emotions in memories: Cognitive‐emotional distinctiveness and posttraumatic stress disorder

Boals

Rubin

2010

Applied Cognitive Psychology

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The current study examined cognitive-emotional distinctiveness (CED), the extent to which emotions are linked with event information, in memories associated with PTSD. Participants either with PTSD (n=68) or without PTSD (n=40) completed a modified multidimensional scaling technique to measure CED for their most negative and most positive events. The results revealed that participants in the PTSD group evidenced significantly lower levels of CED. This group difference remained significant when we limited the analysis to traumatic events that led to a PTSD diagnosis (n=33) in comparison to control participants who nominated a traumatic event that did not result in PTSD (n=32). Replicating previous findings, CED levels were higher in memories of negative events, in comparison to positive events. These results provide empirical evidence that memories associated with PTSD do contain special organizational features with respect to the links between emotions and memory. Implications for understanding and treating PTSD are discussed.

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Low predictive power of peritraumatic dissociation for PTSD symptoms in accident survivors

Cited by 33 publications

References 32 publications

Posttraumatic Stress Disorder following Accidental Injury: Rule or Exception in Switzerland?

Posttraumatic Stress Disorder following Accidental Injury: Rule or Exception in Switzerland?

The independent predictive value of peritraumatic dissociation for PTSD symptomatology after type I trauma: A systematic review of prospective studies

The integration of emotions in memories: Cognitive‐emotional distinctiveness and posttraumatic stress disorder

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