Predictors of post-traumatic stress disorder after major injury
- SourceAvailable from: Mauricio Gaborit
Article: Desastres y trauma psicológico[Show abstract] [Hide abstract]
ABSTRACT: Los desastres, a través de la historia, han provocado pérdidas humanas y han tenido unsevero impacto económico, social, médico y psicológico en las sociedades. El comprendermejor cómo y a quienes afecta psicológicamente un desastre socio-natural posibilitala intervención psicosocial de manera oportuna y efectiva. En este artículo se señalan lascausas sociales que hicieron que los terremotos de enero y febrero 2001 en El Salvadortuvieran consecuencias tan funestas para personas y comunidades. Se identifican lasdistintas reacciones que tienen las personas en las distintas fases después del eventotraumático, entre las que se destacan la re-experimentación, la evitación, estados disociativos,y algunas reacciones secundarias tales como la depresión, la culpabilidad y labaja autoestima. Se describen, además, aquellos factores que median las relaciones psicológicas de las personas al evento traumático: factores biológicos, evolutivos, socialesy de personalidad. Finalmente, se presenta un pequeño modelo que conceptualiza elestrés traumático en desastres tomando en cuenta variables socio-psicológicas.
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ABSTRACT: The aim of this study was to investigate coping patterns, health status and personality traits in burned adults. Subjects were 161 burn patients treated at the Uppsala University Hospital between 1980 and 1995. Measures were the coping with burns questionnaire (CBQ), the burn specific health scale-brief (BSHS-B) and the Swedish universities scales of personality (SSP). The CBQ was subjected to a K-means cluster analysis and three clusters were derived: extensive, adaptive, and avoidant copers. Extensive copers used the most coping and took an intermediate role regarding health status and the personality trait of neuroticism. Adaptive copers preferred the strategies emotional support and optimism/problem solving, and had the highest health status ratings. Avoidant copers preferred the strategy avoidance and reported the lowest use of emotional support and optimism/problem solving. They had the lowest health status ratings and the highest ratings on neuroticism and aggressiveness. The clusters did not differ in severity of injury or time since injury. In conclusion, coping patterns can be discerned among burn patients, and those individuals preferring avoidance and lacking other coping options displayed more maladaptive traits and poorer health status years after the burn.Burns 10/2002; 28(6):549-54. DOI:10.1016/S0305-4179(02)00064-5 · 1.84 Impact Factor
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ABSTRACT: This article discusses a new personality disorder entity, “traumatic stress personality disorder,” conceptualized as a composite organization with transactional properties that mutually structure post-traumatic stress disorder (PTSD) and personality disorders (PDs). The transactional/synergistic view of PTSD/PD comorbidity derives in part from scientific findings that PTSD's enduring biological effects are discernible in the personality of individuals 30 to 50 years or more after the overwhelming event, and from psychodynamic formulations on the development and structuring of personality defenses. An intertheoretical therapy model is also presented, and consists of multiple therapies actively integrated to meet the patient's complex post-trauma needs. This article argues for the development of theoretical, investigatory, and therapeutic measures to address PTSD/PD configurations in traumatized victims. Basically, the position espoused is that PTSD/PD should be measured as one rather than two entities, with neither component being considered as a confounding but integral factor in measurement. The eight components of traumatic stress personality disorder are discussed, along with a case study to demonstrate the model's clinical applications. The integration of cognitive, behavioral, psychodynamic, and existential treatment approaches is geared to assist the victim to developmental progress to survivor status, and then beyond this level of integration to thriver a person whose adaptational learning in therapy created a “vital psychological immune system” that consistently protects against dissociative regression in response to the daily stresses of life. Transference, countertransference, therapists' self-care and self-monitoring are seen as integral to the treatment of traumatic stress personality disorders.Journal of Contemporary Psychotherapy 01/1997; 27(4):323-367. DOI:10.1023/A:1025618625487