Abstract
To evaluate whether stresses experienced by physicians during internship are associated with posttraumatic stress disorder (PTSD) symptoms, the authors administered a standardized questionnaire to assess PTSD symptoms, depressive and anxiety symptoms, and social supports to 212 residents. Thirteen percent of residents met diagnostic criteria for PTSD, including 20% of the women and 9% of the men. PTSD symptoms were significantly more frequent in residents who were single or divorced at the time the questionnaire was administered. There were significant positive correlations between PTSD symptoms and symptoms of both current anxiety and depression, and a significant negative correlation existed between social support and PTSD symptoms. PTSD symptoms attributed to stresses associated with internship, which may be deleterious to physician well-being and potentially to patient care, and suggest the importance of making major changes in postgraduate medical training.
This is a preview of subscription content,
to check access.References
Asch DA, Parker RM: The Libby Zion case: one step forward or two steps backward? N Engl J Med 1988; 318:771–775
Gordon GH, Hubbell FA, Wyle FA, et al: Stress during internship. J Gen Intern Med 1986; 1:228–231
Kirsling RA, Kochar MS, Chan CH: An evaluation of mood states among first-year residents. Psychol Rep 1989; 65:355–366
Valko RJ, Clayton PJ: Depression in the internship. Diseases of the Nervous System 1975; 36:26–29
Friedman RC, Bigger TJ, Kornfeld DS: The intern and sleep loss. N Engl J Med 1971; 4:201–203
McCue JD: The distress of internship. N Engl J Med 1985; 312:449–452
Reuben DB: Psychologic effects of residency. South Med J 1983; 76:380–383
Pugno P: Psychologic stresses encountered by resident physicians. Fam Med 1981; 13:9–12
Kirsling RA, Kochar MS: Suicide and the stress of residency training: a case report and review of the literature. Psychol Rep 1989; 64:951–959
Kollar E, Slater G, Palmer J, et al: Stress in subjects undergoing sleep deprivation. Psychosom Med 1966; 28:101–103
Webb W, Agnew H: The effects of a chronic limitation of sleep length. Psychophysiology 1974; 11:265–274
Friedman RC, Kornfeld DS, Bigger TJ: Psychological problems associated with sleep deprivation in interns. Journal of Medical Education 1973; 48:436–441
Sapira J: Dysphoria and impaired mentation in young physicians. South Med J 1977; 70:1305–1307
Small GW: House officer stress syndrome. Psychosomatics 1981; 22:860–869
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised. Washington, DC, American Psychiatric Association, 1987
Andreasen N: Posttraumatic stress disorder, in Comprehensive Textbook of Psychiatry, 4th Edition, edited by Kaplan HI, Sadock BJ. Baltimore, MD, Williams & Wilkins, 1985, pp 918–924
Solomon SD, Gerrity ET, Muff AM: Efficacy of treatments for posttraumatic stress disorder. JAMA 1992; 268:633–638
Heizer JE, Robins LN, McEvoy L: PTSD in the general population. N Engl J Med 1987; 317:1630–1634
Breslau N, Davis GC, Andreski P: Traumatic events and PTSD in an urban population of young adults. Arch Gen Psychiatry 1991; 48:216–222
Norris FH: Epidemiology of trauma: frequency and impact of different potentially traumatic events in different demographic groups. J Consult Clin Psychol 1992; 60:409–418
Hendin H, Pollinger A, Singer P, et al: Meanings of combat and the development of post-traumatic stress disorder. Am J Psychiatry 1981; 138:1490–1493
Bloch AM: Combat neurosis in inner-city schools. Am J Psychiatry 1978; 135:1189–1192
Hocking F: Extreme environmental stress and its significance for psychopathology. Am J Psychother 1970; 24:4–26
Sudman S: Mail surveys of reluctant professionals. Evaluation Review 1985; 9:349–360
Derogatis L: Symptom Checklist-90: administration, scoring, and procedures manual II. Towson, MD, Clinical Psychometric Research, 1983
Flaherty J, Gaviria M, Pathak D: The measurement of social support: the social support network inventory. Compr Psychiatry 1983; 24:521–529
Elliott DL, Girard DE: Gender and the emotional impact of internship. J Am Med Worn Assoc 1986; 41:54–56
Smith MF, Andrasik F, Quinn SJ: Stressors and psychological symptoms of family practice residents and spouses. Journal of Medical Education 1988; 63:397–405
Landau C, Hall S, Wartman SA, et al: Stress in social and family relationships during the medical residency. Journal of Medical Education 1986; 61:654–660
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Washington, DC, American Psychiatric Assocation, 1994
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Klamen, D.L., Grossman, L.S. & Kopacz, D. Posttraumatic Stress Disorder Symptoms in Resident Physicians Related to Their Internship. Acad Psychiatry 19, 142–149 (1995). https://doi.org/10.1007/BF03341425
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03341425