Posttraumatic Stress Symptoms Among Spinal Cord Injury Patients in Trauma: A Brief Report

Abstract

Background: Attention has recently focused on posttraumatic stress disorder (PTSD) among individuals with traumatic spinal cord injury (SCI). Purpose: To examine characteristics of individuals with and without symptoms of PTSD following acute SCI. Methods: Data were collected on 23 patients (age, 34.5 ± 14.4 years) at a Level I trauma center (14.35 ± 18.48 days following injury). Results: There were 52.2% (n = 12) who experienced symptoms of PTSD post injury, with a significant association in patients with a history of psychological disorders (p = .0094). Conclusion: Findings suggest that patients with SCI who present with PTSD symptoms in the acute trauma care settting should be provided with specific cognitive behavioral interventions.

Posttraumatic stress following spinal cord injury: a systematic review of risk and vulnerability factors

“…Aside from two pilot studies, 11,37 most were also sufficiently powered (N = 26, power at 0.80, α = 0.05, r = 0.50; 62 ). The requirement that included studies utilise robust PTSD tools and primary data sources also minimised measurement error.…”

“…Two studies screened for PTSD in the acute phase of a SCI trauma. 11,61 Effect-size estimates Individual and pooled rs for 18 PTSD risk factors are listed in Table 3 and rank ordered by size. The weighted effect estimates for five factors, all post-injury variables, can be considered clinically important in accordance with the following criteria adopted for this review (that is, r40.10; N fs 4N; CIs≠0, Po0.05): depression comorbidity, posttraumatic cognitions, psychological distress, anxiety, and pain level.…”

“…The experience of psychiatric illness (defined as a single-item question on history of clinically diagnosed affective, anxiety, substance abuse or psychotic disorders) was a positive risk factor for patients reporting distress in the acute trauma setting. 11 In the longer term, those who had experienced an adverse life event 2 prior to injury were at greater risk of developing PTSD (Table 3). However, pooled estimates for these variables did not reach significance.…”

“…15 Other sociomedical indices-alcohol or substance use at the time of injury, age at injury, loss of consciousness and injury type-did not correlate significantly with PTSD, although these findings were based on limited data. 2,11,15,17 Notably, SCI type was associated with a broad range of effect-size estimates: adults with paraplegia reported heightened distress (r = − 0.37 (95% CI, − 0.51 to − 0.21), Po0.01), 8 whereas a higher percentage of individuals with tetraplegia reported a moderate level of acute stress symptoms. 61 In addition, avoidance symptoms were common among children and adolescents with tetraplegic injuries (r = 0.51, (95% CI, 0.10-0.77), P = 0.02), 37 although this finding may be confounded by behavioural changes associated with reduced physical capabilities in the younger cohort.…”

“…This includes lower levels of education and income and being divorced or widowed-although the identified connections between educational attainment, family stability and distress vary in magnitude. 2,[8][9][10][11] The likelihood that an individual with SCI will develop PTSD after injury may also be determined by preexisting mental health problems (for example, depression, anxiety), negative coping styles and prior exposure to trauma. 2,5,8,12,13 There are few data in relation to the role that peritrauma factors, namely SCI characteristics, have in PTSD aetiology and maintenance.…”