The principal aim of this study is to assess acute psychological reactions to burn injury to determine whether our patients develop PTSD, a dissociative syndrome, another psychiatric syndrome, or adapt to the trauma without developing a psychiatric syndrome. A secondary aim is to determine the variables that predict PTSD and dissociative syndrome. To accomplish these goals, a comprehensive assessment of a diverse population of hospitalized adult patients will be conducted. During the first week of hospitalization, a trained clinical interviewer will conduct the SCID, SCID-D, and CAPS to determine the presence or absence of Acute Stress Reaction or any other Axis I disorder. Patients will also complete 5 brief questionnaires that assess social support, general distress, dissociative symptoms, and PTSD symptoms. At one month and six months post-burn, presence or absence of current and lifetime psychopathology will be assessed again using the SCID and the CAPS. Patients will re-answer 3 of the original 5 questionnaires at both assessments. Frequencies of patients who receive a diagnosis of Acute Stress Reaction within one week of hospitalization will be determined. Frequencies of patients who receive a diagnosis of PTSD or a dissociative syndrome one month after injury or six months after injury will also be determined. Prevalence and stability of a diagnosis of dissociative disorder or PTSD will be determined by computing a Kappa score. Among those with PTSD, the prevalence of a co-morbid dissociative disorder will be determined. Results will help fill a gap in the existing literature regarding the nature and frequency of acute psychopathological phenomena after trauma and will thereby provide useful data to guide future diagnostic classification. Results may help clinicians identify adult burn patients at risk for post-traumatic psychiatric syndromes. More generally, with the prospective design, results may help guide future studies of psychological responses to severe trauma.
| Barocas, D; Difede, J; Viederman, M et al. (1998) A case of chronic factitious disorder presenting as repeated, self-inflicted burns. Psychosomatics 39:79-80 |
| Difede, J; Jaffe, A B; Musngi, G et al. (1997) Determinants of pain expression in hospitalized burn patients. Pain 72:245-51 |
