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

The relationship between acute stress disorder (ASD), posttraumatic stress disorder symptoms (PTSD), and chronic pain was investigated in a longitudinal study of injured accident victims (N = 323, 64.7% men). Assessments took place 5 days (T1), 6 (T2) months, and 12 (T3) months postaccident. Relations between pain and posttraumatic stress symptoms were tested by structural equation modeling. Subjects diagnosed with full or subsyndromal PTSD at T2 and at T3 (14 and 19%) reported significantly higher pain intensity. Cross‐lagged panel analysis yielded a mutual maintenance of pain intensity and ASD or PTSD symptoms across T2. Across the second half year, PTSD symptoms impacted significantly on pain but not vice versa. Clinicians need to pay careful attention to PTSD symptoms in accident survivors suffering from chronic pain.

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“…Posttraumatic morbidity and pain As reported elsewhere (Schnyder et al 2008), rates of full/subsyndromal ASD at T1…”

Section: Tablementioning

confidence: 52%

Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: A longitudinal study

Jenewein

Wittmann

Moergeli

et al. 2009

Journal of Traumatic Stress

107

100

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“…However, previous studies showing dropout to be associated with psychoticism (15) and a lower sense of coherence (20) seem to support this notion.…”

Section: Discussionmentioning

confidence: 84%

“…Recent longitudinal studies of PTSD have included many different groups of subjects, such as exposed disaster workers (1), refugees (2), a community sample (3), survivors of terrorists attacks (4), soldiers hospitalized following serious combat injury (5), patients with myocardial infarction (6), and victims of sexual and physical assault (7). Above all, longitudinal studies of patients following severe injury, especially those involved in motor vehicle accidents (MVAs), comprise one of the largest number of population samples studied (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Objectives Of the Studymentioning

confidence: 99%

Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Nishi

Matsuoka

Nakajima

et al. 2008

Comprehensive Psychiatry

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Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? AbstractIn longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether those who drop out are at high risk of PTSD remains unclear. Over a 25-month period, 188 consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4 to 6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4 to 6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed that those who dropped out were likely to be men, alcohol drinkers, smokers, and unconscious just after MVA and to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Character Inventory. Logistic regression analysis revealed that male sex, unconsciousness during MVA, low cooperativeness, and less severe injuries were significant predictors of dropout. The literature says that male sex and unconsciousness just after MVA might be protective factors against MVA-related PTSD, whereas low cooperativeness is a risk factor for general mental problems. To summarize, it is expected that those who drop from the follow-up are unlikely to have MVA-related PTSD, but might have mental problems independent of injury. In longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether or not those who drop out are at high risk for PTSD remains unclear. Over a 25-month period, 188 TITLE:consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4-6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4-6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed those who dropped out were likely to be men, alcohol drinkers, smokers, unconscious just after MVA, to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Cognitive

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“…The rather low incidence of ASD / PTSD after traffic accidents in Switzerland is known from studies on adult populations (Schnyder, Moergeli, Klaghofer, & Buddeberg, 2001;Schnyder, Wittmann, Friedrich-Perez, Hepp, & Moergeli, 2008). Every third (34.4%) child reported posttraumatic nightmares in the course of half a year postaccident.…”

Section: Nightmares and Psychopathologymentioning

confidence: 99%

Posttraumatic nightmares and psychopathology in children after road traffic accidents

Wittmann

Zehnder

Schredl

et al. 2010

Journal of Traumatic Stress

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Tables: 504 Total: 5'799 2 Abstract Posttraumatic nightmares are considered as a re-experiencing symptom of the DSM-IV posttraumatic stress disorder (PTSD) diagnosis. Different types of posttraumatic nightmares, however, may differ in their relation to psychopathology. Thirty-two children were longitudinally assessed ten days, two, and six months after traffic accidents. Occurrence and characteristics of nightmares were examined and their relation to psychopathology assessed.Thirty-four percent of children reported posttraumatic nightmares during at least one assessment. Exact replicative nightmares at baseline assessment predicted PTSD symptoms two and six months postaccident, but not depressive symptoms. Exact replicative nightmares revealed the strongest cross-sectional association with trauma-specific psychopathology but not with depression. We conclude that posttraumatic nightmares -especially exact replicative ones -may be closely related to psychopathological mechanisms of posttraumatic stress in children. 3Survivors of potentially traumatic events such as accidents, disasters or acts of violence often suffer from psychopathological sequelae. In particular, symptoms of acute or posttraumatic stress disorder (ASD / PTSD; American Psychicatric Association (APA), 1994), such as re-experiencing the traumatic event, avoiding traumatic stimuli, and hyperarousal are frequently reported (Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995).Frequent complaints of individuals suffering from posttraumatic stress are nightmares.Usually, nightmares are defined as frightening dreams from which the dreamer awakes (e.g., . Several representative studies have reported nightmare incidences of 50-70% in adults suffering from PTSD (Kilpatrick, et al., 1998;Leskin, Woodward, Young, & Sheikh, 2002;Neylan, et al., 1998) results. One large scale study including Kurdish children indicated that trauma exposure was related to more realistic dreams lacking in bizarreness and symbolism (Punamäki, Ali, Ismahil, & Nuutinen, 2005). However, a detailed examination of the worst dreams experienced by 13 teenage girls following severe sexual abuse showed a different picture (Garfield, 1987). In this sample, dreams contained no explicit replications but only symbolic references to the traumatic experiences.Several theories propose that posttraumatic nightmares are related to the central pathological mechanism of posttraumatic stress disorder (Kramer, Schoen, & Kinney, 1984;Schreuder, 1995;Stickgold, 2002). For instance, Stickgold (2002) In the first assessment (10 days after the accident) the number of nightmares (introduced as "frightening dreams") since the accident was examined. At the assessments two and six months postaccident, nightmare frequency since the accident was assessed through the nightmare frequency scale of the CAPS item B2. This scale ranges from 0 = never and 1 = 1-2 times a month to 4 = almost every day. In order to keep the nightmare interview as simple as possible, it was not asked how many of the frightening dreams we...

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

Cited by 49 publications

References 82 publications

Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: A longitudinal study

Mutual influence of posttraumatic stress disorder symptoms and chronic pain among injured accident survivors: A longitudinal study

Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Posttraumatic nightmares and psychopathology in children after road traffic accidents

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