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Results for “Stress Disorders, Traumatic”

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At least 163 records · Page 9Linked to original sources

PubMed1998

Prospective study of post-traumatic stress disorder in children involved in road traffic accidents.

OBJECTIVE: To determine the prevalence of severe psychological trauma --that is, post-traumatic stress disorder--in children involved in everyday road traffic accidents. DESIGN: 12 month prospective study. SETTING: Accident and emergency department, Royal United Hospital, Bath. SUBJECTS: 119 children aged 5-18 years involved in road traffic accidents and 66 children who sustained sports injuries. MAIN OUTCOME MEASURE: Presence of appreciable psychological distress; fulfillment of diagnostic criteria for post-traumatic stress disorder. RESULTS: Post-traumatic stress disorder was found in 41 (34.5%) children involved in road traffic accidents but only two (3.0%) who sustained sports injuries. The presence of post-traumatic stress disorder was not related to the type of accident, age of the child, or the nature of injuries but was significantly associated with sex, previous experience of trauma, and subjective appraisal of threat to life. None of the children had received any psychological help at the time of assessment. CONCLUSIONS: One in three children involved in road traffic accidents was found to suffer from post-traumatic stress disorder when they were assessed 6 weeks after their accident. The psychological needs of such children after such accidents remain largely unrecognised.

Accidents, Traffic↗

PubMed1999

Psychotic symptoms in post-traumatic stress disorder.

Although many coexisting disorders have been reported with post-traumatic stress disorder (PTSD), little reference has been made to the presence of psychotic symptoms. Psychotic symptoms are not included in the Diagnostic and Statistical Manual of Mental Disorders IV or International Classification of Diseases 10 diagnoses of PTSD. The hallucinations and delusions described here in two cases of PTSD were accompanied by psychotic symptoms. These symptoms clearly differ from flashbacks but have a strong symbolic relationship to the trauma, and they do not respond to antipsychotic drugs. The question is whether there are two separate diagnoses or if psychotic symptoms are an integral part of PTSD. More systematic studies are required to explore the possibility of changing the current classifications of PTSD to include a diagnosis of PTSD with psychotic features.

Adult↗

PubMedDate not supplied

Post-traumatic stress disorder in hospitalized patients with burn injuries.

The degree to which patients hospitalized for a major burn displayed symptoms of post-traumatic stress disorder or met the full criteria for this disorder was assessed during the course of hospitalization. Fifty-four consecutive patients were screened weekly for symptoms of post-traumatic stress disorder. Sixty-three percent showed intrusive recollections of the initial trauma (partial diagnostic criteria) and 16 (29.6%) of the sample met full criteria for post-traumatic stress disorder at some point during the hospitalization. None of the patients met the full diagnostic criteria at discharge from the hospital, although one did at follow-up. Post-traumatic stress disorder was found to be related to patients' total body surface area burn, length of hospital stay, sex (female patients), and lack of responsibility for the injury. The results suggest that although post-traumatic stress disorder in patients with burn injuries generally resolves without interventions other than standard hospital care, it might be preventable if patients who are at risk for developing it receive appropriate psychologic treatment soon after the injury.

Adolescent↗

PubMed2000

Psychological therapies for post-traumatic stress disorder.

BACKGROUND: After exposure to traumatic stressors, a subgroup of survivors (20-30%) will develop post-traumatic stress disorder (PTSD). AIMS: Since the incidence and prevalence rates for PTSD in the community are significant, it is important that general practitioners and psychiatrists be familiar with possible therapeutic options. In this review we shall look at the published evidence about the effectiveness of psychological treatments for PTSD. METHOD: The psychopathological mechanisms involved in PTSD are discussed. Studies of the effectiveness of different psychological therapies are reviewed. RESULTS: The review suggests that persistent fear or shame reactions are key aspects of PTSD. Evidence from systematic reviews suggests that psychotherapeutic treatments are effective in the therapy of reactions based on fear, and may increase the effectiveness of pharmacological therapy. There is less systematic evidence for the efficacy of interventions for symptoms based on shame. CONCLUSIONS: Although a proportion of patients with complex or chronic PTSD may require specialist interventions, most patients can be treated effectively by a general psychiatric service which can offer both pharmacological and psychological interventions.

Affective Symptoms↗

PubMed2002

Serum cholesterol, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning: a relation with post-traumatic stress disorder.

Cholesterol and uric acid, which might correlate with steroidogenesis and monoamine functions, may change under emotionally stressful conditions and in mental disturbances. Among anxiety disorders, an increase of serum cholesterol has been observed in panic disorder. However, the issue has not been adequately investigated in other anxiety disorders, including post-traumatic stress disorder (PTSD). The present study investigated serum cholesterols, uric acid and cholinesterase in victims of the Tokyo subway sarin poisoning, 1995, in a series of 5-year follow-ups. Cholinesterase was studied, in relevance with serum lipid changes and symptoms of PTSD, and also in light of a biological effect of sarin. Out of 34 victims, eight developed PTSD and two were currently diagnosed with PTSD using the Clinician-Administered PTSD Scale (CAPS). No significant relationship was observed between PTSD and serum cholesterols or uric acid. Several factors including co-occurrence of other mental disturbances with PTSD, in addition to the limited sample size, might have affected the result. In contrast, serum cholinesterase level was significantly reduced in the victims with the development of PTSD, compared with the matched controls (P<0.02, t-test). This might partly reflect a long-term remnant effect of sarin intoxication, although an effect of the psychological experience could not be totally excluded.

Adult↗

PubMed1989

Through a glass darkly: the psychoanalytic use of hypnosis with post-traumatic stress disorder.

A severe case of post-traumatic stress disorder stemming from consciousness (with auditory and pain perception) during surgery was treated with 8 sessions of hypnosis. Abreaction and revivification used alone initially retraumatized the patient, and her symptoms worsened. Ego-mastery techniques were then added; emphasis was placed on the role of the therapist as a new object presence to be internalized in restructuring the traumatic memory; memory consolidation and working-through techniques were instituted. The patient's symptoms abated and her condition remitted. The similarities between hypnotic and analytic work are highlighted. In addition, the case material provides a clinical example of the existence and potential traumatic effects of conscious awareness during surgery. It is like through glass, and you see movement and color and stuff--like you see thick glass--and now the glass is real thick and I can see a mass of colors that are not moving or nothing, like a wall. I can't remember anything past that [The Patient]. In the great majority of cases it is not possible to establish the point of origin by a simple interrogation of the patient, however thoroughly it may be carried out. This is in part because what is in question is often some experience which the patient dislikes discussing; but principally because he is genuinely unable to recollect it and often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon. As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its first appearance; when this has been done, it becomes possible to demonstrate the connection in the clearest and most convincing fashion [Breuer & Freud, 1893/1955, p. 3].

Abreaction↗

PubMed1997

Management of post traumatic stress disorder using combat stress treatment principles--a case report.

Combat stress casualties are only generated by war. However, military psychiatrists need to acquire the experience and skills that they would need before they are ever faced with their first combat stress casualty. Non-combat post traumatic stress disorder patients present the best approximation to combat stress casualties. This case study demonstrates how combat stress treatment principles can be successfully applied to a case of non-combat post traumatic stress disorder patient. It is not the intention of this paper to demonstrate whether the combat stress management protocol is superior to other methods or protocols. Recommendations are made on methods to identify post traumatic stress disorder patients and how to seize every available opportunity to practise combat stress treatment principles.

Adult↗

PubMed1989

The implications of life events and social integration in the course of combat-related post-traumatic stress disorder.

This study examined the relationships of life events and social integration with combat-related Post-traumatic stress disorder. The sample consisted of 255 Israeli soldiers who suffered a combat stress reaction episode during the 1982 Lebanon War and were followed one and two years after their participation in combat. Statistical analyses yielded significant effects of positive and negative life events and social integration on the diagnosis of post-traumatic stress disorder. Changes in the diagnosis of post-traumatic stress disorder from time 1 to time 2 were associated with life events and social integration. Theoretical and methodological implications of the findings were discussed.

Adult↗

PubMed2005

Post-traumatic stress disorder, depression, anxiety and quality of life in patients with traffic-related injuries.

AIMS: This paper reports a study to investigate and follow-up relationships between post-traumatic stress disorder, anxiety, depression and quality of life in patients after traffic-related injuries. BACKGROUND: Worldwide, traffic accidents kill 1.2 million people and injure 50 million people per year. Accidental injuries are fourth in the top five causes of death in Taiwan. For survivors, traffic accidents not only cause physical impairments, but also psychological trauma, such as post-traumatic stress disorder, depression and anxiety, all of which affect the quality of life. METHODS: An exploratory, correlational design was used, and participants were recruited consecutively. Data were collected at 1 and 6 weeks post-injury for 64 patients from two major medical centres in Taiwan. Instruments were the New Injury Severity Scale, Post-traumatic Stress Disorder Reaction Index, Beck Depression Inventory, State Anxiety Inventory and Medical Outcomes Study Questionnaire. The data were collected in 2002. RESULTS: Statistically significant improvements occurred in depression, anxiety and the quality of life between week 1 and week 6 (P<0.05); high levels of post-traumatic stress disorder symptoms at week 1 (87.5%) and at week 6 (82.8%) showed no statistically significant improvement. There was a positive correlation between post-traumatic stress disorder and depression (r=0.70, P<0.001) and between post-traumatic stress disorder and anxiety (r=0.57, P<0.001), and a negative correlation between post-traumatic stress disorder and quality of life (r=-0.47, P<0.001). Depression was the most important variable to predict post-traumatic stress disorder at week 6, with depression levels at week 6 being a more powerful predictor than those at week 1. Regression analysis revealed that depression (19%) at week 1, depression at week 6 (45%), anxiety (3.8%) at week 6 and post-traumatic stress disorder (5.8%) explained a statistically significant amount of the variance at week 6. CONCLUSIONS: The findings suggest that traffic accidents have an impact on people's psychosocial wellbeing. Healthcare professionals need to implement interventions to decrease post-traumatic stress disorder, depression and anxiety to increase the quality of life for patients following traffic injuries.

Accidents, Traffic↗

PubMed1994

Psychiatric consultation and post-traumatic stress disorder in burned patients.

We report a prospective study of 65 burned inpatients referred for psychiatric consultation. All of the subjects in the sample were evaluated by a structured questionnaire and clinical interview. Reasons for referral were: suicide attempt by burning (n = 7), substance dependence (n = 8) and behaviour disturbed by coping difficulties (n = 50). The diagnoses were adjustment disorder (n = 40), alcohol dependence (n = 7), opiate dependence (n = 2), dementia (n = 3), depressive disorder (n = 5), schizophrenia (n = 1), delirium (n = 1) and post-traumatic stress disorder (n = 5). Patients with post-traumatic stress disorder (PTSD) were specifically and carefully evaluated. There were no significant differences between patients with PTSD and adjustment disorder for severity and type of burn injuries. We conclude that PTSD is apt to be missed by the medical staff of burn units.

Adolescent↗

PubMed2026

The role of psychological resilience in the relationship between complex post-traumatic stress disorder symptom severity and functioning impairment in mental health support-seeking Australian defence force veterans: A cross-sectional study.

OBJECTIVE: Military veterans have high rates of mental health conditions; complex post-traumatic stress disorder may be the most functionally impaired trauma diagnosis in this patient group. Psychological resilience acts as a protective factor for mental health. Still, it is unclear how this may influence relationships between the two main symptom clusters of complex post-traumatic stress disorder and functioning impairment in veterans. Therefore, we investigated the relationships between psychological resilience, trauma symptom severity, trauma exposure and work/social functional impairment among Australian Defence Force veterans. METHODS: Cross-sectional survey including 148 mental health support-seeking former-serving Australian Defence Force veterans in primary care. Relationships between variables were explored using correlations, mean difference tests and mediation analysis to examine the role of resilience in the relationship between complex post-traumatic stress disorder symptoms and functional impairment. RESULTS: Resilience showed significant negative correlations with functioning impairment. The number of traumas showed weak positive correlations with disturbances in self-organisation symptoms, post-traumatic stress disorder symptoms and functional impairment. The complex post-traumatic stress disorder group had significantly lower resilience and functioning than those with no diagnosis. After controlling for the number of trauma exposures, resilience partially mediated the association between post-traumatic stress disorder symptoms and functioning (indirect effect = 0.141, p < 0.05), and partially mediated the association between disturbances in self-organisation symptoms and functioning (indirect effect = 0.157, p < 0.05). CONCLUSIONS: Psychological resilience was associated with better functioning in veterans regardless of trauma diagnosis. Resilience also partially mediates the relationship between disturbances in self-organisation/post-traumatic stress disorder symptoms and functioning in those with International Classification of Diseases, 11th Revision, complex post-traumatic stress disorder, indicating it is an important intervention target in Australian Defence Force veterans with polytrauma.

Humans↗

PubMed1994

Information processing in post-traumatic stress disorder.

Previous research has established that patients suffering from anxiety disorders, including post-traumatic stress disorder (PTSD), exhibit a cognitive bias that selectively favours the processing of threat material. This information processing bias has frequently been demonstrated by subjects' performance on the Stroop colour-naming task. The current experiment investigated the selective processing of threat information in people with PTSD using a modified Stroop procedure. Subjects were 13 ferry disaster survivors with high PTSD symptomatology, 20 survivors of the same disaster with low PTSD symptomatology, and 12 non-traumatized control subjects. All were asked to colour-name five types of words: ferry disaster words, general threat words, neutral semantically-unrelated words, neutral semantically-related words, and positive words. The disaster survivors with high levels of PTSD symptomatology evidenced a significantly longer response latency for colour-naming disaster-related words than for other word types. The results of the low-PTSD survivors and non-traumatized controls showed no significant difference between response latencies for general threat words and disaster word, although all 3 groups showed increased latencies for threat words compared with neutral words. The mechanisms proposed to underlie this response pattern are discussed, and clinical implications are considered.

Adult↗

PubMed1994

Delayed onset post-traumatic stress disorder in World War II veterans.

Delayed onset post-traumatic stress disorder is an underreported condition in World War II veterans. There is little agreement about the etiology of this syndrome. Two cases of post-traumatic stress disorder in World War II veterans whose individual onset was delayed for over 30 years are described. These veterans developed the symptoms associated with the stresses of late life including bereavement, social isolation and chronic medical illness. Theories regarding the etiology of this syndrome are reviewed and a hypothesis suggesting a heterogeneous condition is presented.

Aged↗

PubMed2000

Health-related quality of life and post-traumatic stress disorder in patients after cardiac surgery and intensive care treatment.

OBJECTIVES: Health-related quality of life and patient satisfaction have become important end points in cardiac surgery. Post-traumatic stress disorder has been described in patients with life-threatening heart disease. In this study, we investigated the occurrence of post-traumatic stress disorder in a sample of patients after cardiac surgery and compared health-related quality of life and patient satisfaction between patients with and without evidence of post-traumatic stress disorder. METHODS: We studied 80 patients serially admitted to the intensive care unit after cardiac surgery (bypass grafting, n = 51; aortic valve replacement, n = 29). Health-related quality of life was assessed with the use of the SF-36 Health Status Questionnaire. Post-traumatic stress disorder was measured with a previously validated instrument (the Post-Traumatic Stress Syndrome 10-Questions Inventory), and 20 different aspects of life satisfaction were quantified on a scale ranging from 0 to 10. For measurements of health-related quality of life and post-traumatic stress disorder, age- and gender-comparable healthy individuals, as well as patients with cardiovascular diseases, served as control groups. RESULTS: Patients who had cardiac surgery described high life satisfaction summary scores (156 of a maximum of 200 points) and only small impairments in physical and mental SF-36 summary scores when compared with healthy control groups (median reduction 7.15, P <.05). Patients with evidence of post-traumatic stress disorder (n = 15) reported the lowest SF-36 mental health summary scores when compared with patients without stress disorder (38.3 vs 48.4, P =.004) and rated their life satisfaction lower (121.5 vs 162.0, P =.002). CONCLUSIONS: Patients who have had cardiac surgery demonstrate a high life satisfaction with an acceptable degree of physical and mental health-related quality of life. Impairments in psychosocial function and life satisfaction were found in a subgroup of patients with evidence of post-traumatic stress disorder.

Aged↗

PubMed1993

Road to recovery. Post-traumatic stress disorder: the hidden victim.

1. Post-traumatic stress disorder (PTSD) is characterized by the development of a set of specific symptoms following a psychologically distressing event that is outside the range of usual human experience. 2. Recovery does not seem to feel as difficult or overwhelming if it is approached "one day at a time." 3. The psychologic damage that occurs in PTSD is due primarily to holding the experiences inside, "stuffing" them down through various psychodynamics, or keeping the experiences subdued through addictive behaviors. 4. PTSD among Vietnam veterans is not a mental illness; it is a reaction to extreme stress and a reaction to keeping memories stuffed down and not allowed to surface.

Adult↗

PubMed1993

Use of art therapy with post-traumatic stress disordered veteran clients.

1. The post-traumatic stress disordered veteran client may exhibit a cluster of problematic behaviors that are integral to current maladaptive coping patterns. 2. These coping patterns can be successfully addressed through a multidisciplinary therapeutic approach that emphasizes client-controlled expression of emotions and client-focused step-by-step behavior modification. 3. Art therapy and nursing, in a collaborative approach, can facilitate individual and group interventions that promote expression of feelings, congruency between experience and self-concept, and feelings of effectiveness in behavioral change.

Adaptation, Psychological↗

PubMed2000

Premature treatment termination by angry patients with combat-related post-traumatic stress disorder.

Angry patients with conjoined post-traumatic stress disorder often direct their anger at health care providers during the course of treatment. Such misplaced anger can interfere with treatment. Emerging treatments for trauma-related anger are effective. However, even in the course of psychotherapy for trauma-related anger, these patients direct anger at their therapists, compromising the treatment alliance and increasing the likelihood of premature termination. A case example is presented to illustrate the effect of anger on the treatment alliance. A therapeutic strategy is proposed to reduce the likelihood of premature treatment termination in these high-risk patients. This strategy may also be helpful in primary care contexts.

Adult↗

PubMed2000

[Post-traumatic stress disorder. After the flood in Saguenay].

OBJECTIVE: To measure the prevalence of posttraumatic stress disorder and emotional distress among victims of the Saguenay flood compared with those who were not affected by the flood. DESIGN: Cross-sectional study using a telephone survey of victims and a control group. SETTING: Chicoutimi, Que. PARTICIPANTS: Sixty-two adults in a flooded area and a control group of 79 volunteers chosen randomly from an adjacent area. MAIN OUTCOME MEASURES: Diagnostic criteria for posttraumatic stress disorder measured using the Post-traumatic Stress Disorder Reaction Index and high scores on the Self-Reporting Questionnaire on emotional distress. RESULTS: Socially and demographically, study group and control group were comparable. Prevalence of posttraumatic stress disorder in the study group was close to 20% (odds ratio [OR] 6.08; 95% confidence interval [CI] 1.63 to 22.64). Prevalence of emotional distress in the study group was 29% (OR 2.42; 95% CI 1.04 to 5.61). CONCLUSION: The Saguenay flood caused psychological distress that was measurable 4 months later. Health care professionals should be aware of the psychological effects of natural disasters.

Adolescent↗