Long-Term Adjustment and Adaptation Mechanisms in Severely Burned Adults

Pain management in severely burned adults: A test of stress inoculation

“…Recent studies have generally supported this view. Of 20 patients evaluated from 1 to 5 years postburn (X = 2.3 years), only 30% were observed to have psychological problems (Andreasen & Norris, 1972;Andreasen et al, 1971). It was noted that these patients were considered to be free of prior psychopathology, and that females were more prone to have difficulty than were males.…”

“…Afterward, when survival seemed more likely, fears of deformity, handicap, disfigurement, and rejection were more common. Although they were frequently based on misunderstanding or lack of information, fears were overwhelming at times (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1972b;Hamburg et al, 1953aHamburg et al, , 1953bKjaer, 1969;Noyes et al, 1971;Weisz, 1967).…”

“…Anxiety reactions have been cited as a common occurrence in almost all burn patients at some time during hospitalization, as well as after discharge (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1971, Hamburg et al, 1953bNoyes et al, 1971;Steiner & Clark, 1977). Symptoms such as insomnia, nightmares, and emotional lability usually diminished over time, but were known to persist for several years in some cases.…”

“…Mild to moderate depression of relatively short duration has been observed in a majority of burn patients, while severe depression, characterized by apathy, insomnia, lethargy and longer duration, has been noted in approximately 20% of burn patients (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1971Andreasen et al, , 1972aAndreasen et al, , 1972bChanges Herzog, 1976;Hamburg et al, 1953b;Noyes et al, 1971).…”

“…In turn, several investigators have noted severe regression and marked dependence occurred frequently enough to be considered a major problem (Andreasen, 1974;Andreasen & Norris, 1972;Andreasen et al, 1972aAndreasen et al, , 1972bDavidson & Noyes, 1973;Hamburg et al, 1953b;Weisz, 1967). …”