Predicting PTSD
The authors of this current study clearly describe the problem of PTSD:
"As the name suggests, posttraumatic stress disorder (PTSD) is a specific anxiety state that occurs in response to a traumatic event. Initially described in combat veterans, it has become abundantly clear that PTSD is a common and disabling consequence of injury. We have previously shown that psychosocial factors limit return to work after injury and that PTSD is a major contributor to this psychosocial morbidity."
The goal of this study was twofold: first, the authors wanted to study the general health problems that patients experienced after injury and how PTSD affects this recovery rate; and second, the authors wanted to test the Michigan Critical Events Perception Scale (MCEPS)—a questionnaire that can be used to measure dissociation at the time of trauma (peritraumatic dissociation), which can be a precursor to PTSD.
The study examined 140 trauma patients and followed them for six months. Here is a summary of what the authors found:
- The trauma patients scored nearly identically to normal individuals on the general health questionnaire at the time of injury, but declined significantly after six months.
- The MCEPS identified 40% of the trauma patients had peritraumatic dissociation.
- At the six-month follow-up, 42% of the patients met the diagnostic criteria for PTSD. "Factors found to be related to PTSD were youth, poor baseline [mental health], injured during an assault, and dissociation."
- Depression and PTSD were found to be strongly linked together after injury.
- And, as the authors suspected, "...PTSD contributes more to the patient’s perceived general health at 6 months than the degree of physical function or injury severity."
- "Within hours of injury, the MCEPS identifies patients who are three times more likely to develop PTSD."
The authors conclude that modern trauma care is effective at treating the physical injury, but not the non-physical aspects:
"We may reduce the costs of trauma, both personal and social, by beginning to address the collateral social and psychological complications of injury with the same intensity we approach the physical."
Michaels AJ, Michael CE, Moon CH, Smith JS, et al. Posttraumatic stress disorder after injury: impact on general health outcome and early risk assessment. The Journal of Trauma: Injury, Infection, and Critical Care 1999;47(3):460-467.
Please note that this article is copyrighted and may not be reproduced without permission. To include our articles and videos on your website, check out our InjuryTV service.