Biomedical subjects

Sara Freedman

Publications and source records attributed to Sara Freedman.

4 recordsLinked to original sources

PubMed2006

Posttraumatic stress disorder among hospital surgical physicians exposed to victims of terror: a prospective, controlled questionnaire survey.

BACKGROUND AND OBJECTIVE: Surgical physicians often treat victims of terror-related multiple-casualty incidents. This may cause secondary posttraumatic stress disorder (PTSD), impairing their ability to care for patients. The objective of this study was to determine whether professional exposure to victims of terror caused PTSD in Israeli physicians from surgical disciplines. METHOD: This was a validated questionnaire survey of physicians (November 2002 through March 2003) from 2 Jerusalem hospitals (a tertiary trauma center and a secondary regional hospital) divided into study (physicians from surgical disciplines regularly exposed to victims of terror) and control (physicians not regularly exposed) groups. Questionnaires included the PTSD Symptom Scale-Self-Report to diagnose PTSD (DSM-IV criteria) and allowed exclusion of other causes of similar symptoms. The main outcome measure was the difference in the prevalence of PTSD between groups. RESULTS: Included were 212 (102 study, 110 control) participants. The study group experienced a significantly higher level of exposure to terror victims at work, validating prospective group definitions. The prevalence of PTSD was similar in both groups (study group = 16%, control group = 15%; p = 1.00). The study and control groups were similar in all predicting variables except for number of years in medical practice, occupational status, and workplace. The groups had similar levels of exposure to terror outside work (p = .24). The probability that a physician would have PTSD was related to use of nonadaptive coping strategies (OR = 5.1; p = .009) and a higher level of exposure to terror out of work (OR = 3.5; p = .013). CONCLUSION: Hospital physicians from surgical disciplines who were professionally exposed to victims of terror did not demonstrate a higher incidence of PTSD than their less exposed counterparts.

Adaptation, Psychological↗

PubMed2005

PTSD following terrorist attacks: a prospective evaluation.

OBJECTIVE: This study evaluated the prevalence of posttraumatic stress disorder (PTSD) and the longitudinal course of early PTSD symptoms in survivors of terrorist attacks. It additionally assessed the effect of continuous terrorism on the course of early symptoms of PTSD. METHOD: Thirty-nine survivors of terrorist attacks and 354 survivors of motor vehicle accidents were evaluated upon admission to a general hospital emergency room and 1 week and 4 months later. Heart rate was measured upon admission to the emergency room. Peritraumatic dissociation was assessed at 1 week. PTSD symptoms, anxiety, and depression were measured at 1 week and 4 months. The Clinician-Administered PTSD Scale conferred a diagnosis of PTSD at 4 months. Additionally, the course of early PTSD symptoms during an era of frequent terrorist attacks (N=137) was compared with that seen during years of relative calm (N=256). RESULTS: Survivors of terrorist attacks had higher rates of PTSD than motor vehicle accident survivors (37.8% versus 18.7%). The type of traumatic event, however, did not add to the prediction of PTSD from the emergency room heart rate, peritraumatic dissociation symptoms, and early PTSD symptoms. The longitudinal course of early PTSD symptoms was not affected by the greater frequency of terrorist attacks. CONCLUSIONS: Early symptoms are reliable risk indicators of PTSD across events and circumstances. Converging effects of terror-induced fear, adjustment, and resiliency might explain the lack of effect of intense terrorism on the course of PTSD symptoms.

Accidents, Traffic↗

PubMed2004

Coping with trauma: narrative and cognitive perspectives.

The immediate period following a traumatic event is a crucial time in the survivors' process of recovery. During this time, a narrative of the trauma is generated and constructed, alongside a process of cognitive processing of the traumatic events. In the first part of the article we present the outlines of the narrative and cognitive attitudes to trauma; the second part will illustrate the developmental process through which the trauma narrative is shaped, in the stories of five survivors of a terror attack. We suggest that by analyzing three main components of the trauma narrative (coherence, finding meaning and self-evaluation), together with the equivalent cognitive attitudes, it is possible to evaluate the process of recovery, identify foci of difficulties in this process and pinpoint possible therapeutic interventions in the early stages after the trauma.

Adaptation, Psychological↗

PubMed2002

PTSD symptoms and cognitive performance in recent trauma survivors.

Chronic post-traumatic stress disorder (PTSD) has been associated with cognitive impairments involving memory and attention. The association between cognitive impairment and early PTSD symptoms is unknown, yet such association may lead to poorer processing of traumatic memories and thereby contribute to subsequent PTSD. This study evaluated the relationship between PTSD symptoms and cognitive functioning within 10 days of traumatic events. Forty-eight survivors were assessed for symptoms of PTSD, anxiety, depression and dissociation and for immediate and delayed verbal and figural memory, attention, learning and IQ. Survivors with high levels of PTSD symptoms showed impaired attention and immediate recall for figural information and lower IQ. They did not show, however, an impairment of verbal recall and learning. The observed difference was not explained by anxiety or dissociation. It disappeared, however, when the effect of depressive symptoms was controlled for. Lower IQ and impaired attention are associated with early PTSD and depressive symptoms. Poorer attention may have a role in shaping traumatic memories.

Adult↗