This study which, is being submitted in response to PA-99-134 a request for Exploratory/Developmental Grants (R21) for Mental Health Intervention Research, will be conducted at the New York Presbyterian Hospital Regional Burn Center which offers a large heterogeneous population representing both minorities (40 percent) and women (25 percent), where 41 percent of injuries are work-related, and where an alliance between the surgical staff and proposed research team have been well established. Though studies suggest rates of chronic PTSD as high as 45 percent one-year post-burn, there have been no treatment studies of PTSD following burns nor have there been any studies attempting to prevent PTSD in burn patients through early intervention. The principle aim of this study is to adapt, implement, and evaluate a program for the prevention of chronic PTSD in burn survivors. To accomplish these goals, adults consecutively admitted to the Burn Center will be screened for severe PTSD symptoms and Acute Stress Disorder (ASD) within two weeks of their injury. Those with severe PTSD symptoms or a diagnosis of ASD will undergo a comprehensive clinical assessment including the SCID, CAPS, PTSD- SS and a battery of self-report questionnaires that assess social support, coping style, cognitive schemas, ASD and PTSD symptoms. Participants will be randomized to either the prevention program or a supportive counseling control condition (SC). Those in the BP will receive four two-hour prevention sessions. These sessions will be comprised of four techniques psychoeducation, relaxation training, prolonged exposure to traumatic memories, and cognitive restructuring that have proven effective for reducing both severe acute and chronic PTSD symptoms in rape, criminal assault, and motor vehicle accident survivors. To determine the efficacy of the intervention, rates of PTSD and severity of PTSD symptoms in the BP will be compared to rates and severity of symptoms in the SC control condition. Among those burned at work, time to return to work will be compared between the two groups. Results may help fill a gap in the existing literature regarding the efficacy of early intervention for the prevention of PTSD in burn patients. Results will also provide preliminary data on the cost-effectiveness of an early intervention program.
