Original articlePosttraumatic Stress Disorder and Spinal Cord Injury
Section snippets
Purpose
Our purpose was to identify the prevalence of PTSD and relative frequency of the 3 types of PTSD symptoms (re-experiencing, arousal, avoidance), confirm the factor structure of the PPTSD-R, and identify the relationship of PTSD symptoms with depression after SCI. We used a larger cohort of participants who were injured for a greater number of years than has been used in previous research. We used a relatively large sample of persons with SCI (N=927) and chose to use the PPTSD-R because it
Participants
All participants are from a 35-year longitudinal study and were first identified from 1 of 3 rehabilitation hospitals. The 3 inclusion criteria were traumatic SCI, minimum of 18 years of age, and minimum of 1 year postinjury (the first cohort required 2 years postinjury). At the time of the previous follow-up in 2002 to 2003, there were a total of 1543 active participants. Of these, 942 participated during the most recent follow-up in 2008 to 2009 (61.0% response rate). There were 237 deaths
Item Responses
Endorsement rates for the first set of items (those related to the event itself) were relatively low (table 1). For instance, less than 5% of the sample endorsed any item as “often,” with the exception of “have difficulty remembering important aspects of event.” Endorsement of the second set of items was much higher (these items related to problems since the event). Item endorsement was significantly related to years postinjury (table 2), with the lowest rates consistently reported among those
Discussion
The results of the current study suggest that PTSD after long-standing SCI, as defined by a minimum of 8 years postinjury, at first assessment, and an average of over 20 years, is similar to the prevalence in the general population.3 First, less than 10% of the sample met the diagnostic criteria. This figure is not substantially different than that observed in nonclinical samples from the general population3 or several studies using participants with SCI.4, 5 Second, the item with the highest
Conclusions
PTSD was relatively rare in the participant sample, which was substantially larger than that reported in previous studies. In particular, re-experiencing the event was rare, less than that reported in a nonclinical sample in the general literature. Because we used the PPTSD-R that explicitly referred back to the event of SCI, it is less likely that the PTSD diagnosis was confounded with disability resulting from the injury. PTSD appears to be comorbid in a substantial portion of cases of
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The factor structure of posttraumatic stress disorder symptoms in patients with traumatic spinal cord injuries
2014, Archives of Psychiatric NursingCitation Excerpt :Furthermore, the current study found that inability to recall the trauma (i.e., C3 symptom) was a poor indicator of emotional numbing. This symptom in traumatic SCI population may be caused be head injury rather than psychogenic amnesia (Krause et al., 2010). Thus, clinicians need to pay special attention to this symptom when they assess PTSD symptoms in this population, and further clarify the exact cause of memory difficulty about the trauma before a clinical judgment is made.
Evaluating a spinal cord injury-specific model of depression and quality of life
2014, Archives of Physical Medicine and RehabilitationPrevalence of Posttraumatic Stress Disorder Symptoms Following Traumatic Spinal Cord Injury: A Systematic Review and Meta-analysis
2022, Harvard Review of Psychiatry
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