Early versus delayed imaginal exposure for the treatment of posttraumatic stress disorder following accidental upper extremity injury
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The consequences following work-related injuries are far reaching, which are in part due to unrecognized and untreated posttraumatic stress disorder (PTSD). Imaginal exposure is a frequently used cognitive behavioral approach for the treatment of PTSD. This study examined the impact of early versus delayed treatment with imaginal exposure on amelioration of PTSD symptomatology in individuals who suffered upper extremity injuries.
Sixty individuals who suffered severe work-related injuries received standard, non-randomly assigned psychological treatment for PTSD (e.g., prolonged imaginal exposure) either early (30–60 days) or delayed (greater than 120 days) following severe work-related upper extremity injury. Nine measures of various components of PTSD symptomatology were administered at onset of treatment, end of treatment, and at 6-month follow-up evaluations.
Patients showed significant treatment outcomes at all three measurement intervals in both the early and delayed groups demonstrating that Prolonged Imaginal Exposure is an appropriate treatment for persons diagnosed with PTSD. In addition, there was no difference in return to work status between the early and the delayed treatment groups. However, the early treatment group required significantly fewer treatment sessions than the delayed treatment group.
Results supported the utility of imaginal exposure and the need for early assessment and referral for those diagnosed with PTSD following upper extremity injuries.
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- Amir M, Kaplan Z, Kotler M. Type of trauma, severity of posttraumatic stress disorder core symptoms, and associated features. J Gen Psych. 1996;123:341–51. CrossRef
- Bear-Lehman J. Factors affecting return to work after hand injury. J Occup Therapy. 1983;37(3):189–94. CrossRef
- Beck AT, Steer, R. Beck Depression Inventory. Chicago: The Psychological Corporation, Harcourt Brace Jovanovoch, Inc., 1987.
- Best CL, Ribbe DP. Accidental injury: approaches to assessment and treatment. In: Freedy JR, Hobfoll SE, editors. Traumatic stress: from theory to practice. New York: Plenum Press; 1995. p. 315–37.
- Burgess ES, Hibler R, Keegan D, Everly Jr GS. Symptoms of posttraumatic stress disorder in workers’ compensation patients attending a work rehabilitation program. Int J Rehab Health. 1996;2(1):29–39. CrossRef
- Cheng YH. Explaining disablement in modern times: hand-injured workers’ accounts of their injuries in Hong Kong. Soc Sci Med. 1997;45(5):739–50. CrossRef
- American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
- Foa EB, Kozak MJ. Emotional processing of fear: exposure to corrective information. Psych Bull. 1986;1099(1):20–35. CrossRef
- Foa EB, Meadows EA. Psychosocial treatments for posttraumatic stress disorder: a critical review. Ann Rev Psych. 1997;48:449–80. CrossRef
- Foa EB, Rothbaum BO, Riggs DS, Murdoc TB. Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. J Consult Clin Psych. 1991;59:715–23. CrossRef
- Grunert BK, Devine CA, Matloub HS, et al. Flashbacks after traumatic hand injuries: prognostic indicators. J Hand Surg. 1988;13A(1):125–7.
- Grunert BK, Devine CA, Matloub HS, et al. Psychological adjustment following work-related hand injury: 18 month follow-up. Ann Plast Surg. 1999;29(6):537–42. CrossRef
- Grunert BK, Devine CA, Smith C, et al. Graded work exposure to promote work return after severe hand trauma: a replicated study. Ann Plast Surg. 1992;29(6):532–6. CrossRef
- Grunert BK, Dzwierzynski WW. Prognostic factors for return to work following severe hand injuries. Techniq Hand Upper Extrem Surg. 1997;1(3):213–8. CrossRef
- Grunert BK, Hargarten SW, Matloub HS, et al. Predictive value of psychological screening in acute hand injuries. J Hand Surg. 1992;17A(2):196–9.
- Grunert BK, Matloub HS, Sanger JR, Yousif NJ. Treatment of posttraumatic stress. J Hand Surg. 1990;5A(3):511–5.
- Grunert BK, Smith C, Devine CA, et al. Early psychological aspects of severe hand injuries. J Hand Surg. 1988;13B(2):177–80.
- Grunert BK, Smucker MR, Weis JM. When prolonged exposure fails: adding an imagery-based cognitive restructuring component in the treatment of industrial accident victims suffering from PTSD. Cog Behav Prac. 2003;10(4):333–46. CrossRef
- Grunert BK, Weis JM, Smucker MR, Christianson HF. Imagery rescripting and reprocessing therapy after failed prolonged imaginal exposure for post-traumatic stress disorder following industrial injury. J Behav Ther Exp Psychiat. 2007;38:317–28. CrossRef
- Horowitz MJ, Wilner N, Alvarez W. Impact of event scale: a measure of subjective distress. Psychosomatic Med. 1979;41:209–18.
- Jaycox L, Foa EB, Morral AR. Influence of emotional engagement and habituation of exposure therapy for PTSD. J Consult Clin Psych. 1998;66(1):185–92. CrossRef
- Kaufman AS. Assessing adolescent and adult intelligence. Boston: Allyn and Bacon, Inc.; 1990.
- Keane TM, Fairbank JA, Caddell JM, Zimmering RT. Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans. Behav Ther. 1989;20(2):245–60. CrossRef
- Malt U, Ugland OM. A long-term psychosocial follow-up study of burned adults. Acta Psychiatr Scand. 1989;80(355):94–102. CrossRef
- Pfeffer J. Posttraumatic stress disorder. Brit J Hosp Med. 1988;39:85–6.
- Scotti JR, Beach BK, Northrop LM, et al. The psychological impact of accidental injury: a conceptual model for clinicians and researchers. In: Freedy JR, Hobfol SE, editors. Traumatic stress: from theory to practice. New York: Plenum Press; 1995. p. 181–212.
- Sherman JJ. Effects of psychotherapeutic treatments of PTSD: a meta-analysis of controlled clinical trials. J Traum Stress. 1998;11(3):413–33. CrossRef
- Smith GS, Wellman H, Sorock G, et al. Injuries at work in the US adult population: contributions to the total injury burden. Amer J Pub Health. 2005;95(7):1213–9. CrossRef
- Smucker MR, Dancu C, Foa EB, Niederee JL. Imagery rescripting: a new treatment for survivors of childhood sexual abuse suffering from posttraumatic stress. J Cog Psychother Int Qtr. 1995;9(1):3–17.
- Smucker MR, Niederee J. Treating incest-related PTSD and pathogenic schemas through imaginal exposure and rescripting. Cog Behav Prac. 1995;2:63–93. CrossRef
- Spielberger CD. Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychologists Press, Inc.; 1982.
- Tabachnick BG, Fidell LS. Using multivariate statistics. 3rd ed. New York: Harper Collins; 1996.
- Weis JM, Grunert BK. Posttraumatic stress disorder following traumatic injuries in adults. Wis Med J. 2004;03(6):27–30.
- Weiseth L. The stressors and posttraumatic stress syndrome after an industrial disaster. Acta Psychiatr Scand. 1989;80(355):25–37. CrossRef
- Wolpe J, Lazarus AA. Behavior therapy techniques. New York: Pergamon Press; 1966.
About this Article
- Early versus delayed imaginal exposure for the treatment of posttraumatic stress disorder following accidental upper extremity injury
Volume 7, Issue 2 , pp 127-133
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- Posttraumatic stress disorder
- Upper extremity injuries
- Imaginal exposure
- Time of intervention
- Industry Sectors
- Author Affiliations
- 1. Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8710 W. Watertown Plank Road, Milwaukee, WI, 53226, USA
- 2. Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA