Peritraumatic distress fully mediates the relationship between posttraumatic stress symptoms preoperative and three months postoperative in patients undergoing spine surgery

Abstract

Background: Growing evidence shows the significance of illness and surgical procedures as traumatizing stressors. Risk factors are widely investigated in various settings and samples, using numerous measures of posttraumatic stress and posttraumatic stress disorder (PTSD). While pretrauma psychological distress is acknowledged as an influential factor, peritraumatic experiences are controversially still being discussed as relevant to the development of PTSD. Objective: In a group of patients consecutively undergoing elective spine surgery (N = 89) in a German hospital, this longitudinal study addressed the question of how pretrauma PTSD symptoms and peritrauma distress interact with one another in regard to the amount of posttrauma symptoms of PTSD. Methods: Pre- and posttrauma symptoms of PTSD as well as peritrauma distress were assessed through questionnaires one week before, one week after or three months after surgery. Results: Even though all three variables showed significant correlations with one another, mediation analysis revealed that peritrauma distress fully mediated the relationship between pre- and posttrauma PTSD symptoms. Conclusions: These results add new insights to the controversial discussion on the role peritraumatic experiences play in the development of PTSD, especially in medical settings.

Peritraumatic Distress and Posttraumatic Stress Symptoms During the COVID‐19 Pandemic: The Contributions of Psychosocial Factors and Pandemic‐Related Stressors

“…Regarding PTSS, we identified peritraumatic distress as the strongest predictor of posttraumatic stress during the pandemic, thus replicating earlier findings indicating that peritraumatic psychological processes rather than personality characteristics are the strongest predictors of PTSS (Kessler et al., 2014 ; Ozer et al., 2003 ; Shiban et al., 2018 ). In addition, peritraumatic distress mediated the associations between pandemic‐related stressors and psychological hardiness and PTSS, suggesting that some personal characteristics and experiences can make individuals more prone to developing peritraumatic distress, which, if not handled properly, may later develop into PTSD.…”

“…Taking into account the scale of the pandemic, this is a highly relevant question due to its potential practical impact on planning and organizing the treatment of peritraumatic distress and PTSS in everyday clinical practice. Peritraumatic distress reactions that occur during or immediately following exposure to traumatic events are one of the strongest predictors of PTSD (Kessler et al., 2014 ; Ozer et al., 2003 ; Shiban et al., 2018 ). Thus, we were interested in exploring whether exposure to the COVID‐19 threat would be shown to cause peritraumatic reactions and PTSS as well as whether prominent peritraumatic reactions increase the likelihood of developing PTSS.…”

“…Therefore, peritraumatic responses must be considered within the context of these potential modifiers to fully understand how they increase one's risk of developing PTSD (Gorman et al., 2015 ). According to Shiban et al ( 2018 ), certain peritraumatic variables might influence PTSS directly, whereas others might do so indirectly. In the present study, we aimed to identify the contribution of sociodemographic factors and pandemic‐related stressors in the development of peritraumatic distress and PTSS during the peak of the COVID‐19 pandemic.…”

Validation of the Italian version of the peritraumatic distress inventory: validity, reliability and factor analysis in a sample of healthcare workers

“…The PDI mean score of our sample appears to be in the mid-range of previous studies (Boisclair Demarble, Fortin, D'Antono, & Guay, 2020;Brunet et al, 2001;Bui et al, 2012;Hargrave, Leathem, & Long, 2012;Nishi et al, 2012;Shiban et al, 2018). For instance, survivors to violent crimes or a high magnitude earthquake reported higher scores (Boisclair Demarble et al, 2020;Nishi et al, 2012), while subjects undergoing spine surgery or individuals experienced the sudden death of a close family member showed lower ones (Hargrave et al, 2012;Shiban et al, 2018). Accordingly, our data confirmed the risk of experience relevant trauma in HCWs during the COVID-19 pandemic.…”

“…Nevertheless, only a minority of exposed subjects develops psychopathological reactions such as anxiety, depression and, especially, Post-Traumatic Stress Disorder (PTSD), in response to the potentially traumatizing event (Darves-Bornoz et al, 2008 ; Kessler et al, 2017 ; Olff et al, 2019 ). Among the various factors associated to negative psychopathological outcomes in trauma survivors, peritraumatic distress represents one of the most consistently reported (Brewin, Andrews, & Rose, 2000 ; Hiar et al, 2016 ; Lensvelt-Mulders et al, 2008 ; Letamendia et al, 2012 ; Ozer, Best, Lipsey, & Weiss, 2003 ; Peltonen, Kangaslampi, Saranpää, Qouta, & Punamäki, 2017 ; Shiban et al, 2018 ; Vance, Kovachy, Dong, & Bui, 2018 ).…”