Posttraumatic Stress Disorder and Work-Related Injury

Department of Psychology, University of Winnipeg, Manitoba, Canada.
Journal of Anxiety Disorders (Impact Factor: 2.96). 01/1998; 12(1):57-69. DOI: 10.1016/S0887-6185(97)00049-2
Source: PubMed


The literature indicates a substantial overlap between chronic pain and posttraumatic stress disorder (PTSD) symptoms in individuals who sustain accidental injury. To date, however, there have been no studies of PTSD symptoms in individuals who experience work-related injury. Consequently, we assessed 139 consecutive injured workers using the Modified PTSD Symptom Scale (Falsetti, Resnick, & Kirkpatrick, 1993), as well as a number of general measures of psychopathology. Most participants reported chronic pain and all were receiving workers compensation. Results indicated that 34.7% and 18.2% of the sample reported symptoms consistent with PTSD and partial PTSD, respectively. When PTSD symptom frequency and severity were considered criterion variables in multiple regression analyses, depression was found to be significantly associated with the former and anxiety sensitivity, social fears, and somatic focus with the later. Finally, these measures of general psychopathology correctly classified 78.6% of individuals with PTSD and 81.3% of those with no PTSD. These results suggest that a considerable proportion of injured workers display symptoms consistent with PTSD and that these symptoms are related to general negative affect. Implications, including the suggestion of clinical intake screening of PTSD in this population, are discussed.

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    • "AS is conceptualized as the fear of anxiety-related sensations based on beliefs about their harmful physical, social, or cognitive consequences (Reiss and McNally 1985). Interoceptive cues associated with AS and panic attacks are posited to exacerbate PTSD symptomatology (Hinton et al. 2008), and in fact there is strong evidence for an association between AS and severity of concurrent and prospective PTSD symptoms (Asmundson et al. 1998; Feldner et al. 2006, 2008). Furthermore, PTSD treatment has been shown to reduce AS severity (Gutner et al. 2013). "
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    ABSTRACT: Individuals with posttraumatic stress disorder (PTSD) exhibit deficits in cognitive and emotional processes. PTSD severity is positively associated with anxiety sensitivity (AS) and difficulties in emotion regulation, and difficulties in emotion regulation mediate the relation between AS and PTSD. However, previous research has not examined the interactive nature of these variables. Associations between PTSD, AS, and difficulties in emotion regulation were examined in patients with PTSD in a residential substance use treatment program (N = 120). Conditional process analyses indicated an interactive effect of difficulties in emotion regulation and AS for predicting PTSD symptom severity. For individuals high in emotion regulation difficulties, PTSD symptom severity was high regardless of level of AS; conversely, for individuals high in AS, increased PTSD severity was observed regardless of level of emotion regulation difficulties. Results suggest directions for future research, including examination of whether targeting patient-specific cognitive-affective processes enhances PTSD treatment response among substance-dependent individuals.
    Cognitive Therapy and Research 04/2015; 39:245-252. DOI:10.1007/s10608-014-9648-2 · 1.70 Impact Factor
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    • "Other than PTSD, depression is also commonly observed following injury (Franche and Krause, 2002). Only few studies examined the rates of psychiatric disorders after occupational injuries (Asmundson et al., 1998; MacDonald et al., 2003). In Taiwan, the previous study found that at 3 months after occupational injuries, a significant proportion of workers suffered from psychiatric disorders; however, the diagnosis of psychiatric disorders was obtained by phone interview and not by face-to-face evaluation by a psychiatrist. "
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    ABSTRACT: This study aimed to determine the incidence rates of psychiatric disorders within 1 year after occupational injury and to examine the association between occupational injury and the incidence of psychiatric disorders using National Health Insurance Research Database (NHIRD). We used cohort approach in this investigation. All eligible subjects were from the NHIRD, and aged 18-65 years old. A total of 542,208 patients were enrolled in this study. Among them, 1038 patients sustained occupational injury, 6891 patients sustained non-occupational injury. The reference group in this study was 534,279 patients who ever used the NHI for any medical condition in 2001. The incidence rates of any psychiatric disorders within 1 year after occupational injury (inpatient), occupational injury (outpatient), non-occupational injury (inpatient), non-occupational injury (outpatient), and any disease were 9.5%, 2.5%, 7.4%, 1.5%, and 1.1%, respectively. Occupational injury was found as a significant factor for developing psychiatric disorders within 1 year after the target injury. The incidence rate of any psychiatric disorders was higher in patients after occupational injury than those after non-occupational injury and any medical condition.
    Psychiatry Research 06/2014; 219(3). DOI:10.1016/j.psychres.2014.06.015 · 2.47 Impact Factor
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    • "Contemporary psychological theories of chronic pain have highlighted the role of pain catastrophising and habitual coping strategies in determining a person’s engagement in physical activity. Across a number of fear-avoidance models [12]–[18], it has been suggested that individuals with greater fear of pain, physical movement or reinjury are more likely to display activity avoidance and a lower level of physical activity compared to those who are less fear-avoidant. It has also been suggested that highly fluctuating levels of physical activity may be observed in a subgroup of pain patients who have a tendency to persevere through tasks until pain is unbearable [19], [20]. "
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    ABSTRACT: Promoting physical activity is key to the management of chronic pain, but little is understood about the factors facilitating an individual's engagement in physical activity on a day-to-day basis. This study examined the within-person effect of sleep on next day physical activity in patients with chronic pain and insomnia. 119 chronic pain patients monitored their sleep and physical activity for a week in their usual sleeping and living environment. Physical activity was measured using actigraphy to provide a mean activity score each hour. Sleep was estimated with actigraphy and an electronic diary, providing an objective and subjective index of sleep efficiency (A-SE, SE) and a sleep quality rating (SQ). The individual and relative roles of these sleep parameters, as well as morning ratings of pain and mood, in predicting subsequent physical activity were examined in multilevel models that took into account variations in relationships at the 'Day' and 'Participant' levels. Of the 5 plausible predictors SQ was the only significant within-person predictor of subsequent physical activity, such that nights of higher sleep quality were followed by days of more physical activity, from noon to 11pm. The temporal association was not explained by potential confounders such as morning pain, mood or effects of the circadian rhythm. In the absence of interventions, chronic pain patients spontaneously engaged in more physical activity following a better night of sleep. Improving nighttime sleep may well be a novel avenue for promoting daytime physical activity in patients with chronic pain.
    PLoS ONE 03/2014; 9(3):e92158. DOI:10.1371/journal.pone.0092158 · 3.23 Impact Factor
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