scholarly journals Pain and Posttraumatic Stress Symptom Clusters: A Cross-Lagged Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Vivian de Vries ◽  
Alette E. E. de Jong ◽  
Helma W. C. Hofland ◽  
Nancy E. Van Loey

Pain and posttraumatic stress disorder (PTSD) frequently co-occur but underlying mechanisms are not clear. This study aimed to test the development and maintenance of pain and PTSD symptom clusters, i.e., intrusions, avoidance, and hyperarousal. The longitudinal study included 216 adults with burns. PTSD symptom clusters, indexed by the Impact of Event Scale-Revised (IES-R), and pain, using a graphic numerical rating scale (GNRS), were measured during hospitalization, 3 and 6 months post-burn. Cross-lagged panel analysis was used to test the relationships between pain and PTSD symptom clusters. Cross-lagged results showed that in-hospital intrusions predicted pain and avoidance 3 months post-burn. In-hospital pain predicted intrusions and avoidance 3 months post-burn and a trend was found for hyperarousal (90% CI). In the second wave, intrusions predicted pain and hyperarousal. Pain predicted hyperarousal. This study provides support for an entangled relationship between pain and PTSD symptoms, and particularly subscribes the role of intrusions in this bidirectional relationship. To a lesser extent, hyperarousal was unidirectionally related to pain. These results may subscribe the driving role of PTSD, particularly intrusions, which partly supports the Perpetual Avoidance Model.

2006 ◽  
Vol 22 (4) ◽  
pp. 259-267 ◽  
Author(s):  
Eelco Olde ◽  
Rolf J. Kleber ◽  
Onno van der Hart ◽  
Victor J.M. Pop

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.


2008 ◽  
Vol 17 (6) ◽  
pp. 534-543 ◽  
Author(s):  
Karen Wallen ◽  
Wendy Chaboyer ◽  
Lukman Thalib ◽  
Debra K. Creedy

Background Admission to intensive care is often a sudden and unexpected event precipitated by a life-threatening condition, 2 determinants thought to influence the development of posttraumatic stress disorder. Objectives To identify the frequency of acute symptoms of posttraumatic stress disorder and to describe factors predictive of these symptoms in patients 1 month after discharge from intensive care. Methods In this prospective cohort study, all patients meeting the inclusion criteria during the study period were invited to participate. Participants completed the Impact of Event Scale-Revised, and demographic and clinical data were accessed from an intensive care unit database. Results During a 9-month period, 114 of 137 patients who met the inclusion criteria consented to participate in the study, and 100 (88%) completed it. The mean total score on the Impact of Event Scale-Revised was 17.8 (SD, 13.4; possible range, 0–88). A total of 13 participants (13%) scored higher than the cutoff score for clinical posttraumatic stress disorder. Neither sex nor length of stay was predictive of acute symptoms of post-traumatic stress disorder. In multivariate analysis, the only independent predictor of symptoms was age. Patients younger than 65 years were 5.6 times (95% confidence interval, 1.17–26.89) more likely than those 65 years and older to report symptoms. Conclusion The rate of symptoms of posttraumatic stress disorder 1 month after discharge from intensive care was relatively low. Consistent with findings of previous research, being younger than 65 years was the only independent predictor of symptoms.


2017 ◽  
Vol 41 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Maria Panagioti ◽  
Ioannis Angelakis ◽  
Nicholas Tarrier ◽  
Patricia Gooding

AbstractInconsistent findings have been reported by previous cross-sectional studies regarding the association between specific posttraumatic stress disorder (PTSD) symptom clusters and suicidality. To advance the understanding of the role of specific PTSD symptoms in the development of suicidality, the primary aim of this study was to investigate the predictive effects of the three specific PTSD symptom clusters on suicidal ideation prospectively. Fifty-six individuals diagnosed with PTSD completed a two-stage research design, at baseline and 13–15 months follow-up. The clinician administered PTSD scale (CAPS) was used to assess the severity of the PTSD symptom clusters and validated self-report measures were used to assess suicidal ideation, severity of depressive symptoms and perceptions of defeat entrapment. The results showed that only the hyperarousal symptom cluster significantly predicted suicidal ideation at follow-up after controlling for baseline suicidal ideation, severity of depressive symptoms and perceptions of defeat and entrapment. These findings suggest that both disorder-specific and transdiagnostic factors are implicated in the development of suicidal ideation in PTSD. Important clinical implications are discussed in terms of predicting and treating suicidality in those with PTSD.


2005 ◽  
Vol 33 (4) ◽  
pp. 443-457 ◽  
Author(s):  
Atle Dyregrov ◽  
Magne Raundalen

A total of 1695 Norwegian adolescents answered a questionnaire concerning how they perceived and reacted to the threat of war during the 1999 Kosovo war and the 2003 Iraq war. Based on previous research and clinical experience the following hypotheses were formed: a) The Kosovo war, being in closer proximity to Norway, will result in more reactions than the Iraq war; b) There will be more communication between adolescents and adults following the Iraq war than following the Kosovo war, due to education by psychologists via the media in the intervening period; c) Girls will evidence more reactions than boys, in line with previous work; d) Adolescents who score above cut-off on the Impact of Event Scale will report less communication with friends and parents, in line with psychosocial theories of posttraumatic stress and previous empirical findings. The first three hypotheses were generally supported, but findings regarding hypothesis (d) were mixed. It is believed that a more open communicative climate has developed in families and schools following increased attention by professionals and media to the coverage of wars and disasters in the media. Mild reactions to the two wars suggest adolescent resilience. Professionals can play an important role in disseminating information on how such events can be handled by parents, professionals and society at large.


2021 ◽  
Author(s):  
Jiin Jeong ◽  
Ah-Ram Kim ◽  
Claudia Hilton ◽  
Ickpyo Hong

Abstract Background: Post-traumatic stress disorder (PTSD) is a mental illness caused by traumatic events, such as the COVID-19 pandemic. Accurate diagnosis of this disorder is critical to establish effective intervention approaches. The Impact of Event Scale-6 (IES-6) is widely used for PTSD screening, but there has been no research on its psychometric properties with individuals who experienced the COVID-19 pandemic.Methods: A random sample of 600 participants were randomly selected from a COVID-19 survey database (n = 6,391). Rasch analysis was conducted to examine item fit, rating scale structure, construct validity, differential item functioning (DIF), and precision of the IES-6. Results: The principal component analysis of Rasch residuals (54.1% of the raw variance explained) and the average of residual correlations (average r = .19) supported the unidimensionality structure in the IES-6. The rating scale was suitable, and the item difficulty hierarchy was logical. The item fit and the DIF contrast were acceptable, except for item 5. The IES-6’s person reliability was .76, which was also an acceptable level.Conclusions: This study showed that the IES-6 has acceptable item-level psychometrics for screening PTSD in adults in the United States for individuals who have experienced the COVID-19 pandemic. The findings suggested that the IES-6 would be useful for the rapid identification of PTSD and allow clinicians to quickly provide interventions for people with the disorder and their families.


2011 ◽  
Vol 5 (4) ◽  
pp. 156-165 ◽  
Author(s):  
Ignacio Jarero ◽  
Susana Uribe

This ongoing field study was conducted subsequent to the discovery of clandestine graves with 218 bodies recovered in the Mexican state of Durango in April 2011. A preliminary psychometric assessment was conducted with the 60 State Attorney General employees who were working with the corpses to establish a triage criterion and provide baseline measures. The Impact of Event Scale (IES) and the short posttraumatic stress disorder (PTSD) rating interview were administered, and the 32 individuals whose scores indicated moderate-to-severe posttraumatic stress and PTSD symptoms were treated with the eye movement desensitization and reprocessing (EMDR) Protocol for Recent Critical Incidents (EMDR-PRECI). Participants were assigned to two groups: immediate treatment (severe scores) and waitlist/delayed treatment (moderate scores). Each individual client session lasted between 90 and 120 minutes. Results showed that one session of EMDR-PRECI produced significant improvement on self-report measures of posttraumatic stress and PTSD symptoms for both the immediate treatment and waitlist/delayed treatment groups. This study provides preliminary evidence in support of the protocol’s efficacy in a natural setting of a human massacre situation to a group of traumatized adults working under extreme stressors. More controlled research is recommended to evaluate further the protocol’s efficacy.


Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Megan M. Hosey ◽  
Jeannie-Marie S. Leoutsakos ◽  
Ximin Li ◽  
Victor D. Dinglas ◽  
O. Joseph Bienvenu ◽  
...  

2006 ◽  
Vol 99 (2) ◽  
pp. 569-580 ◽  
Author(s):  
E. V. Aidman ◽  
L. Kollaras-Mitsinikos

The study examined the relationship of extraversion, neuroticism, and impulsiveness with posttraumatic stress reactions of avoidance and intrusion. 36 outpatients from a Trauma Unit at a major metropolitan hospital in Melbourne (Victoria), and 24 age-matched controls completed the Impact of Event Scale, the Eysenck Personality Questionnaire Revised, and the Impulsivity Questionnaire. Intrusion symptoms were predicted both by Extraversion and Neuroticism, after controlling for age and gender, with Neuroticism making a stronger contribution to the prediction. The only predictor of Avoidance symptoms was Neuroticism. Impulsivity correlated with Intrusion symptoms but predicted them only in the trauma group. This finding, along with the observed positive associations of Extroversion with both posttraumatic symptoms, lends support to Gray's model of dispositions influencing responses to trauma, suggesting that impulsive (extroverted) neurotics are more vulnerable to posttraumatic stress than introverted ones.


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