Prevalence and predictors of posttraumatic stress disorder and depressive symptoms among burn survivors two years after the 2015 Formosa Fun Coast Water Park explosion in Taiwan

Abstract

Background: Posttraumatic stress disorder (PTSD) and depressive symptoms are relatively common in burn survivors. Several previously reported risk factors (e.g. burn severity) have not consistently predicted psychological adjustment post-burn. Empirically-derived risk factors of PTSD from the meta-analysis and theory-derived cognitive variables may be of great predictive value. Objective: This study investigated the prevalence of probable DSM-5 PTSD and major depression (MDD) and the predictors of PTSD and depressive symptoms in burn survivors of the 2015 Formosa Fun Coast Water Park explosion. Three sets of predictors were examined: (a) burn-related variables; (b) empirically-derived risk factors from the meta-analysis; and (c) theory-derived cognitive variables. Method: Participants were 116 burn survivors of the Formosa Fun Coast Water Park explosion. The mean age at the disaster was 22.3 ± 4.2 years; the average total body surface area burned (TBSA) was 49.5%. Results: Of our participants, 12.9 and 20.7% met DSM-5 probable PTSD and MDD two years after the Formosa Fun Coast Water Park explosion. No gender differences were observed. For the prediction of PTSD symptoms post-burn, theory-derived cognitive variables (adjusted R 2 = .562, 95% CI [.423, .638]) performed best and provided significantly better prediction than empirically-derived risk factors from the meta-analysis (adjusted R 2 = .337, 95% CI [.180, .412]) and burn-related variables (adjusted R 2 = .313, 95% CI [.156, .389]). In contrast, the three sets of variables examined provided similar predictions for depressive symptoms post-burn (adjusted R 2 = .267–.295). Random forest regression revealed that theory-derived cognitive variables, particularly negative appraisal of symptoms and maladaptive cognitive coping, were considered the most important predictors of PTSD symptoms post-burn. Conclusion: The prevalence of probable PTSD and MDD were relatively higher in burn survivors. Theory-derived cognitive variables substantially improve predictions for PTSD symptoms post-burn.

Dissociation and disasters: A systematic review

“…Only two of five studies comparing dissociation with depressive pathology in multivariate models reported significant associations[28,30], a significant difference from the bivariate analysis findings (Fisher’s exact test, P = 0.021). Other problems found to be positively associated with dissociation in sporadic studies included anxiety[34,40,41], somatization[42], adult attention-deficit/hyperactivity disorder[27], general mental health problems[43], increased postdisaster use of alcohol[44] or tobacco[38], suicidality[26], hopelessness[26], anger[41], hostility[45], feeling unsafe[44,46], fear during the disaster[24,47], alexithymia[48], trauma memory disorganization[47], trauma-related rumination[47], maladaptive coping strategies[49], lower academic achievement[27], greater injury-related functional impairment[47], lower health-related quality of life[26], and fibromyalgia syndrome[50]. Dissociation was also associated with early traumatic experience[51] and religiosity[28].…”

Machine Learning Demonstrates High Accuracy for Disease Diagnosis and Prognosis in Plastic Surgery

“… 18 , 37 , 39 , 40 , 46 , 51 , 53 , 59 , 63 Further, in conditions in which there are well-established correlations between certain risk markers and an outcome of interest, such as deranged blood tests on admission and AKI in burn patients, ML yielded highly accurate predictive algorithms. 38 , 44 , 55 24 47 However, attempts to include weakly related risk markers resulted in algorithms that had an overall lower predictive accuracy, rendering them unsafe for clinical practice. This review further identified that some plastic surgery subspecialties, such as hand surgery, have yet to incorporate this technology.…”

Οι Επιπτώσεις Του Ναυαγίου "Σάμινα" Στη Ζωή Των Επιζησάντων Και Των Οικογενειών Τους

“…Η θεώρηση της διαδικασίας της ψυχολογικής ανασύνταξης του ατόμου, τόσο μέσα από ένα μοντέλο διάθεσης και στρες, που δίνει έμφαση σε παράγοντες ατομικής ευαλωτότητας, αλλά και μέσα από ένα μοντέλο ελαχιστοποίησης κινδύνου, που δίνει έμφαση στους προστατευτικούς παράγοντες, των οποίων η ύπαρξη θα μειώσει την αρνητική επίδραση της τραυματικής εμπειρίας, αποτελούν εξίσου σημαντικές 'ματιές' στο ψυχικό τραύμα (Rahman, 2017). Σύμφωνα με τους Lazarus & Folkman (1984), τα χαρακτηριστικά της προσωπικότητας επηρεάζουν σημαντικά την αυτό-εκτίμηση του ατόμου, αλλά σε αλληλεπίδραση και με τα ψυχολογικά, γνωστικά και κοινωνικά χαρακτηριστικά, λειτουργούν σαν πηγές καλής διαχείρισης των στρεσογόνων καταστάσεων (Rahman, 2017. Su, 2018.…”

“…Pfeifer & Haeffel, 2014. Άτομα που πίστευαν ότι βιώνουν σοβαρά αρνητικά αποτελέσματα μετά την τραυματική τους εμπειρία, είχαν χειρότερη απόδοση σε κλίμακα ποιότητας ζωής και είχαν περισσότερες πιθανότητες εμφάνισης συμπτωματολογίας μετά-τραυματικού στρες (Leytham & Powell, 2012. Su, 2018.…”

“…Su, 2018. Το άτομο που υιοθετεί ένα τέτοιο τρόπο σκέψης, είναι πιο πιθανό να αναπτύξει καταθλιπτική και αγχώδη συμπτωματολογία έπειτα από μια τραυματική εμπειρία, συγκριτικά με το άτομο που έχει αναπτύξει πιο λειτουργικά μοτίβα σκέψης, ενισχύοντας, καθ' αυτόν τον τρόπο, την αυτοπεποίθηση του στο να ανταπεξέλθει σε δύσκολες συνθήκες (Pfeifer & Haeffel, 2014. Su, 2018.…”