The Association Between Daily Posttraumatic Stress Symptoms and Pain Over the First 14 Days After Injury: An Experience Sampling Study

Pacella, Maria L.; Girard, Jeffrey M.; Wright, Aidan G.C.; Suffoletto, Brian; Callaway, Clifton W.

doi:10.1111/acem.13406

Cited by 13 publications

(16 citation statements)

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“…A subset of participants may not complete daily assessments due to technical difficulties or a lack of interest. Studies that used texting, which is less likely to have technical difficulties relative to an application, reported similar findings (Pacella et al, in press). Those who did not complete any mobile assessments did not differ from those who did, however, which suggests there may be few differences in these groups at baseline.…”

Section: Discussionmentioning

confidence: 61%

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Implementing assessments via mobile during the acute posttrauma period: feasibility, acceptability and strategies to improve response rates

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Stolk-Cooke

Legrand

et al. 2018

European Journal of Psychotraumatology

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Background: PTSD is posited to develop in the acute posttrauma period. Few studies have examined psychopathology symptoms within this period due to the demands on individuals in the first month after a trauma. Mobile devices can overcome these barriers. The feasibility of using mobile devices for this purpose, however, is unclear. Objective: The present study evaluated the acceptability of administering PTSD symptom assessments via a mobile application throughout the acute posttrauma period. Method: Participants (N = 90) were recruited from a Level 1 Trauma Center within M = 4.88 days of experiencing a traumatic event. A mobile application was placed on their smartphone that administered a daily self-report assessment of PTSD symptoms for 30 days. Participants were compensated US$1 for each assessment completed. Results: The overall response rate was 61.1% or M = 18.33, SD = 9.12 assessments. Assessments were accessed M = 65.2 minutes after participants were notified to complete them and took M = 2.52 minutes to complete. Participants reported that the daily assessments were not bothersome and were moderately helpful. Conclusion: The present study suggests that using mobile devices to monitor mental health symptoms during the acute posttrauma period is feasible and acceptable. Strategies are needed to determine how to best take advantage of these data once collected.

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Section: Discussionmentioning

confidence: 61%

“…The response rate was 44.93%, which was markedly lower than that of the text messaging studies. A recent study used text messages to track PTSD and pain symptoms for 14 days after an injury (Pacella, Girard, Wright, Suffoletto, & Callaway, in press). The mean response rate was 86%.…”

mentioning

confidence: 99%

Implementing assessments via mobile during the acute posttrauma period: feasibility, acceptability and strategies to improve response rates

Price

Stolk-Cooke

Legrand

et al. 2018

European Journal of Psychotraumatology

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“…Finally, PTSD Coach may be better positioned for use as an adjunct or first tier within a stepped-care model to improve postinjury recovery, 37 with initial ED screening and symptom monitoring after injury to maintain communication with and identify those with high symptoms in the weeks and months to follow. 9,38,59 LIMITATIONS This pilot study had a small sample size, a limited 1month time period of suggested app use, and a limited follow-up period of 3 months postinjury, the earliest time when PTSS is considered persistent. 19 Notably, the validity of our findings, particularly those regarding group differences for black patients, is threatened by the small sample size and a lack of a priori planned analyses or sample size calculation; future research is warranted to replicate these findings using adequately powered preplanned samples.…”

Section: Usability and Acceptabilitymentioning

confidence: 99%

“…8 Even in the acute aftermath of ED care for minor injury, hyperarousal symptoms of PTSD are associated with daily pain. 9 Additionally, PTSD is prevalent and increases risk for recurrent health problems and mortality among patients seeking emergency treatment and evaluation for acute medical events such as acute cardiac syndrome (12%), 10,11 transient ischemic attack, and stroke (25%). 11 Notably, PTSD symptoms (PTSS) contribute to distress-related impairments [12][13][14][15] and poor outcomes 6,8,16 in the absence of full-blown PTSD.…”

mentioning

confidence: 99%

A Pilot Randomized Controlled Trial of the PTSD Coach App Following Motor Vehicle Crash–related Injury

Pacella

Suffoletto

Kuhn

et al. 2020

Academic Emergency Medicine

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Objective: Posttraumatic stress disorder (PTSD) symptoms (PTSS) are common after minor injuries and can impair recovery. We sought to understand whether an evidence-based mobile phone application with self-help tools (PTSD Coach) could be useful to improve recovery after acute trauma among injured emergency department (ED) patients. This pilot study examined the feasibility, acceptability, and potential benefit of using PTSD Coach among acutely injured motor vehicle crash (MVC) patients. Methods: From September 2017 to September 2018, we recruited adult patients within 24 hours post-MVC from the EDs of two Level I trauma centers in the United States. We randomly assigned 64 injured adults to either the PTSD Coach (n = 33) or treatment as usual (TAU; n = 31) condition. We assessed PTSS and associated symptoms at 1 month (83% retained) and 3 months (73% retained) postenrollment. Results: Enrollment was feasible (74% of eligible subjects participated) but usability and engagement were low (67% used PTSD Coach at least once, primarily in week 1); 76% of those who used it rated the app as moderately to extremely helpful. No differences emerged between groups in PTSS outcomes. Exploratory analyses among black subjects (n = 21) indicated that those in the PTSD Coach condition (vs. TAU) reported marginally lower PTSS (95% CI = À0.30 to 37.77) and higher PTSS coping self-efficacy (95% CI = À58.20 to À3.61) at 3 months. Conclusions: We demonstrated feasibility to recruit acutely injured ED patients into an app-based intervention study, yet mixed evidence emerged for the usability and benefit of PTSD Coach. Most patients used the app once and rated it favorably in regard to satisfaction with and helpfulness, but longitudinal engagement was low. This latter finding may explain the lack of overall effects on PTSS. Additional research is warranted regarding whether targeting more symptomatic patients and the addition of engagement and support features can improve efficacy.

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“…Regarding recovery after minor injury, Pacella and colleagues previously found that psychological symptoms are associated with physical symptoms among ED patients discharged home immediately from the ED; specifically, hyperarousal symptoms of PTSD are associated with daily pain during the first 14 days after injury. Similarly, patients with mild–moderate motor vehicle collision (MVC)‐related injuries report reduced health‐related QOL at 2 years post‐MVC and at least one psychiatric diagnosis (50%) at 6‐, 12‐, and 24‐months post‐MVC .…”

Section: Current Studymentioning

confidence: 99%

Early Screening for Posttraumatic Stress Disorder and Depression Among Injured Emergency Department Patients: A Feasibility Study

Jaramillo

Suffoletto

Callaway

et al. 2019

Academic Emergency Medicine

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Background: Despite the risk of developing posttraumatic stress disorder (PTSD) and associated comorbidities after physical injury, few emergency departments (EDs) in the United States screen for the presence of psychological symptoms and conditions. Barriers to systematic screening could be overcome by using a tool that is both comprehensive and brief. This study aimed to determine 1) the feasibility of screening for posttraumatic sequelae among adults with minor injury in the ED and 2) the relationship between ED screening and later psychological symptoms and poor quality of life (QOL) at 6 weeks postinjury.Methods: In the EDs of two Level I trauma centers, we enrolled injured patients (n = 149) who reported serious injury and/or life threat in the past 24 hours. Subjects completed the Posttraumatic Adjustment Scale (PAS) to screen for PTSD and depression in the ED, and 6 weeks later they completed assessments for symptoms of PTSD, depression, and trauma-specific QOL (T-QoL).Results: Our retained sample at 6 weeks was 84 adults (51.2% male; mean AE SD age = 33 AE 11.88 years); 38% screened positive for PTSD, and 76% screened positive for depression in the ED. Controlling for age, hospital admission, and ED pain score, regression analyses revealed that a positive ED screen for both PTSD and depression was significantly associated with 6 weeks PTSD (p = 0.027, 95% confidence interval [CI] = 0.92 to 15.14) and depressive symptoms (p = 0.001, 95% CI = 2.20 to 7.74), respectively. Further, a positive ED screen for depression (p = 0.043, 95% CI = -16.66 to -0.27) and PTSD (p = 0.015, 95% CI = -20.35 to -2.24) was significantly associated with lower T-QoL.Conclusions: These results suggest that it is feasible to identify patients at risk for postinjury sequelae in the ED; screening for mental health risk may identify patients in need of early intervention and further monitoring.T raumatic injury is a leading cause of mortality and morbidity in the United States, 1,2 and approximately 29% of annual emergency department (ED) visits are attributable to physical injury. 3 The majority of these injures are mild, with only 7% requiring hospital admission. 4 However, the stress of From the

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The Association Between Daily Posttraumatic Stress Symptoms and Pain Over the First 14 Days After Injury: An Experience Sampling Study

Cited by 13 publications

References 63 publications

Implementing assessments via mobile during the acute posttrauma period: feasibility, acceptability and strategies to improve response rates

Implementing assessments via mobile during the acute posttrauma period: feasibility, acceptability and strategies to improve response rates

A Pilot Randomized Controlled Trial of the PTSD Coach App Following Motor Vehicle Crash–related Injury

Early Screening for Posttraumatic Stress Disorder and Depression Among Injured Emergency Department Patients: A Feasibility Study

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