Skip to main content
Log in

Life-Changing Injuries: Psychological Intervention Throughout the Recovery Process Following Traumatic Amputations

  • Feature
  • Published:
Journal of Health Service Psychology Aims and scope Submit manuscript

Abstract

Trauma amputation triggers intense psychological reactions and causes monumental life changes. Roughly half of amputations are the result of medical complications and half are from traumatic events such as industry and automobile accidents. Shock, dismay, and anger are typical initial emotional reactions. Pain, depression, and adaptation of life changes are longer term challenges. Psychological care should be an integrated component during all stages of recovery and adjustment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Armstrong, D. G., Lavery, L. A., van Houtum, W. H., & Harkless, L. B. (1997). The impact of gender on amputation. Journal of Foot and Ankle Surgery, 36(1), 66–69.

    Article  CAS  Google Scholar 

  • Barmparas, G., Inaba, K., Teixeira, P. G., Dubose, J. J., Criscuoli, M., Talving, P., Plurad, D., Green, D., & Demetriades, D. (2010). Epidemiology of post-traumatic limb amputation: A national trauma databank analysis. American Surgery, 76(11), 1214–1222.

    Google Scholar 

  • Benetato, B. B. (2011). Posttraumatic growth among Operation Enduring Freedom and Operation Iraqi Freedom amputees. Journal of Nursing Scholarship, 43(4), 412–420.

    Article  PubMed  Google Scholar 

  • Bosse, M. J., MacKenzie, E. J., Kellam, J. F., Burgess, A. R., Webb, L. X., Swiontkowski, M. F., Sanders, R. W., Jones, A. L., McAndrew, M. P., Patterson, B. M., McCarthy, M. L., Travison, T. G., & Castillo, R. C. (2002). An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. New England Journal of Medicine, 347, 1924–1931. doi: 10.1056/NEJMoa012604

    Article  PubMed  Google Scholar 

  • Buchheit, T., Van de Ven, T., Hsia, H. L., McDuffe, M., MacLeod, D. B., White, W., Chamessian, A., Keefe, F. J., Buckenmaier, C. T., & Shaw, A. D. (2016). Pain phenotypes and associated clinical risk factors following traumatic amputation: Results from Veterans Integrated Pain Evaluation Research (VIPER). Pain Medicine, 17, 149–161. doi: 10.1111/pme.12848

    PubMed  PubMed Central  Google Scholar 

  • Cater, J. K. (2012). Traumatic amputation: Psychosocial adjustment of six Army women to loss of one or more limbs. Journal of Rehabilitation Research and Development, 49(10), 1443–1456.

    Article  PubMed  Google Scholar 

  • Clasper, J. & Ramasamy, A. (2013). Traumatic amputations. British Journal of Pain, 7, 67–73.

    Article  PubMed  PubMed Central  Google Scholar 

  • Coffey, L., Gallagher, P., Desmond, D., & Ryall, N. (2014). Goal pursuit, goal adjustment, and affective well-being following lower limb amputation. British Journal of Health Psychology, 19, 409–424. doi: 10.1111/bjhp.12051

    Article  PubMed  Google Scholar 

  • Corrigan, J., Selassie, A. W., & Orman, J. A. (2010). The epidemiology of traumatic brain injury. The Journal of Head Trauma Rehabilitation, 25(2), 72–80. doi: 10.1097/HTR.0b013e3181ccc8b4

    Article  PubMed  Google Scholar 

  • Davidson, J. A. (2002). A survey of the satisfaction of upper limb amputees with their prostheses, their lifestyles, and their abilities. Journal of Hand Therapy, 15(1), 62–70.

    Article  PubMed  Google Scholar 

  • Davidson, J. E., Jones, C., & Bienvenu, O. J. (2012). Family response to critical illness: Postintensive care syndrome-family. Critical Care Medicine, 40, 618–624. doi: http://dx.doi.org/10.1097/CCM.0b013e318236ebf9

    Article  PubMed  Google Scholar 

  • Delhey, P., Huber, S., Hanschen, M., Haberle, S., Trentzsch, H., Deller, S., van Griensven, M., Biberthaler, P., Lefering, R., & Huber-Wagner, S. (2015). Significance of traumatic macroamputation in severely injured patients: An analysis of the traumaregister DGU. Shock, 43(3), 233–237. doi: 10.1097/SHK. 0000000000000292.

    Article  PubMed  Google Scholar 

  • Dikmen, S. S., Bombardier, C. H., Machamer, J. E., Fann, J. R., & Temkin, N. R. (2004). Natural history of depression in traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 85(9), 1457–1457.

    Article  PubMed  Google Scholar 

  • Dunn, D. S. (1996). Wellbeing following amputation: Salutary effects of positive meaning, optimism, and control. Rehabilitation Psychology, 41(4), 285–302.

    Article  Google Scholar 

  • Dyster-Aas, J., Willebrand, M., Wikehult, B., Gerdin, B., & Ekselius, L. (2008). Major depression and posttraumatic stress disorder symptoms following severe burn injury in relation to lifetime psychiatric morbidity. Journal of Trauma and Acute Care Surgery, 64(5), 1349–1356. doi: 10.1097/TA.0b013e318047e005

    Article  Google Scholar 

  • Follette, V. Palm, K. M., & Pearson, A. N. (2006). Mindfulness and trauma: Implications for treatment. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 24(1), 45–61.

    Article  Google Scholar 

  • Frierson, R. L. & Lippmann, S. B. (1987). Psychiatric consultation for acute amputees: Report of a tenyear experience. Psychosomatics, 28(4), 183–189.

    Article  CAS  PubMed  Google Scholar 

  • Gallagher, P. & MacLachlan, M. (2001). Adjustment to an artificial limb: A qualitative perspective. Journal of Health Psychology, 6(1), 85–100.

    Article  CAS  PubMed  Google Scholar 

  • Griffith, J. L. & Gaby, L. (2005). Brief psychotherapy at bedside: Countering demoralization from medical illness. Psychosomatics, 46(2), 109–116.

    Article  PubMed  Google Scholar 

  • HCUP Nationwide Inpatient Sample (NIS). (2009). Healthcare cost and utilization project (HCUP). Agency of Healthcare Research and Quality. Rockville: MD.

    Google Scholar 

  • Holzer, L. A., Sevelda, F., Fraberger, G., Bluder, O., Kickinger, W., & Holzer, G. (2014). Body image and self-esteem in lower-limb amputees. Public Library of Science, 9(3), 1–8.

    Google Scholar 

  • Horgan, O. & MacLachlan, M. (2004). Psychosocial adjustment to lower-limb amputation: A review. Disability Rehabilitation, 26(14–15), 837–850.

    Article  PubMed  Google Scholar 

  • Kircanski, K., Lieberman, M. D., & Craske, M. G. (2012). Feelings into words. Psychological Science, 23(10), 1086–1091. doi: https://doi.org/10.1177/0956797612443830

    Article  PubMed  Google Scholar 

  • Kortte, K. B., Stevenson, J. E., Hosey, M. M., Castillo, R., & Wegener, S. T. (2012). Hope predicts positive functional role outcomes in acute rehabilitation populations. Rehabilitation Psychology, 57(3), 248–255. doi: 10.1037/a0029004

    Article  PubMed  Google Scholar 

  • Kuhn, F., Morris, R., Witherspoon, C. D., & Mann, L. (2005). Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiology, 13(6), 209–216. doi: http:/doi.org/10.1080/09286580600665886

    Google Scholar 

  • Langlois, J. A., Rutland-Brown, W., Wald, M., (2006). The epidemiology and impact of traumatic brain injury: A brief overview. The Journal of Head Trauma Rehabilitation, 21(5), 375–378.

    Article  PubMed  Google Scholar 

  • Lieberman, M. D., Eisenberger, N. I., Crockett, M. J., Tom, S. M., Pfeifer, J. H., & Way, B. M. (2007). Putting feelings into words. Psychological Science, 18(5), 421–428. doi: https://doi.org/10.1111/j.1467-9280.2007.01916.x

    Article  PubMed  Google Scholar 

  • McCracken, L. M. & Vowles, K. E. (2014). Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress. American Psychologist, 69(2), 178–187. doi: http://dx.doi.org/10.1037/a0035623

    Article  PubMed  Google Scholar 

  • Milstein, S., Bain, D., & Hunter, G. A. (1985). A review of employment patterns of industrial amputees-Factors influencing rehabilitation. Prosthetics and Orthotics International, 9(2), 69–78.

    Article  Google Scholar 

  • Migliorini, C., Tonge, B., & Taleporos, G. (2008). Spinal cord injury and mental health. Australian and New Zealand Journal of Psychiatry, 42(4), 309–314. doi: 10.1080/00048670801886080

    Article  PubMed  Google Scholar 

  • National Institute of Health (NIH) (no date). Burns and traumatic injuries. Retrieved from: https://report.nih.gov/nihfactsheets/ViewFactSheet.aspx?csid=33

  • Owings, M. & Kozak, L. J. (1998). National Center for the Health S. Ambulatory and Inpatient Procedures in the United States, 1996. Hyattsville, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

    Google Scholar 

  • Perkins, Z. B., De’Ath, H. D., Sharp, G., & Tai, N. R. M. (2012). Factors affecting outcome after traumatic limb amputation. British Journal of Surgery, 99, 75–86.

    Article  PubMed  Google Scholar 

  • Pezzin, L. E., Dillingham, T. R., & MacKenzie, E. J. (2000). Rehabilitation and the long-term outcomes of persons with related amputations. Archives of Physical Medicine and Rehabilitation, 81(3), 292–300. doi: https://doi.org/10.1016/S003-9993(00)90074-1

    Article  CAS  PubMed  Google Scholar 

  • Pezzin, L. E., Dillingham, T. R., MacKenzie, E. J., Ephraim, P., & Rossbach, P. (2004). Use and satisfaction with prosthetic limb devices and related services. Archives of Physical Medicine and Rehabilitation, 85(5), 723–729.

    Article  PubMed  Google Scholar 

  • Ramirez, C. & Menaker, J. (2017). Traumatic amputations. Trauma Reports: Practical, Evidence-Based Reviews in Trauma Care. Retrieved from: https://www.ahcmedia.com/articles/140552-traumaticamputations

    Google Scholar 

  • Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: The Guildford Press.

    Google Scholar 

  • Schwarzbold, M., Diaz, A., Martins, W. T., Rufino, A., Amante, L. N., Thais, M. E., Quevedo, J., Hohl, A., Linhares, M. N., & Walz, R. (2008). Psychiatric disorders and traumatic brain injury. Neuropsychiatric Disorders and Treatment, 4(4), 797–816.

    Google Scholar 

  • Senra, H., Oliveria, R. A., Leal, I., & Vieira, C. (2011). Beyond the body image: A qualitative study on how adults experience lower limb amputations. Clinical Rehabilitation, 26(2), 180–191. doi: 10.1177/0269215511410731

    Article  PubMed  Google Scholar 

  • Sheikh, K. (1985). Return to work following limb injuries. Journal of Social and Occupational Medicine, 35(4), 114–117.

    Article  CAS  Google Scholar 

  • Temple, S. & Stuart, S. (2010). Psychotherapy for the hospitalized medically ill patient. In J. J. Amos & R. G. Robinson (Eds.), Psychosomatic medicine: An introduction to consultation & liaison psychiatry (242–248). New York, NY: Cambridge University Press.

    Google Scholar 

  • Thompson, D. & Fisher, A. (2010). Amputee virtual environment support space—A vision for virtual military amputee support. Journal of Rehabilitation Research & Development, 47(6), vii–xi.

    Article  Google Scholar 

  • Unwin, J., Kacperek, L., & Clarke, C. (2009). A prospective study of positive adjsutment to lower limb amputation. Clinical Rehabilitation, 23, 1044–1050. doi: 10.1177/0269215509339001

    Article  PubMed  Google Scholar 

  • Wan, J. J., Morabito, D. J., Khaw, L., Knudson, M. M., & Dicker, R. A. (2006). Mental illness as an independent risk factor for unintentional injury and injury recidivism. Journal of Trauma, 61, 1299–1304.

    Article  PubMed  Google Scholar 

  • Wald, J. & Alvaro, R. (2004). Psychological factors in work-related amputation: Considerations for rehabilitation counselors. Journal of Rehabilitation, 70(4), 6–15.

    Google Scholar 

  • Ward, H. W., Moss, R. L., Darko, D. F., Berry, C. C., Anderson, J., Kolman, P., Green, A., Nielsen, J., Klauber, M., Wachtel, T. L., & Frank, H. (1987). Prevalence of postburn depression following burn injury. The Journal of Burn Care & Rehabilitation, 8(4), 294–298. doi: https://doi.org/10.1097/00004630-198707000-00011

    Article  CAS  Google Scholar 

  • Warren, A. M., Rainey, E. E., Weddle, R. J., Bennett, M., Foreman, K. R., & Foreman, M. L. (2016). The intensive care unit experience: Psychological impact on family members of patients with and without traumatic brain injury. Rehabilitation Psychology, 61(2), 179–185. doi: https://dx.doi.org/10.1037/rep0000080

    Article  PubMed  Google Scholar 

  • Weishaar, M. E. & Beck, A. T. (1992). Hopelessness and suicide. International Review of Psychiatry, 4(2), 177–184. doi: http://doi.org/10.3109/09540269209066315

    Article  Google Scholar 

  • Wegener, S. T., MacKenzie, E. J., Ephraim, P., Ehde, D., & Williams, R. (2009). Self-management improves outcomes in persons with limb loss. Archives of Physical Medicine and Rehabilitation, 90, 373–380. doi: 10.1016/j.apmr.2008.08.222

    Article  PubMed  Google Scholar 

  • Wright, T. W., Hagen, A. D., & Wood, M. B. (1995). Prosthetic usage in major upper extremity amputations. Journal of Hand Surgery, 20(4), 619–622.

    Article  CAS  PubMed  Google Scholar 

  • Ziegler-Graham, K., MacKenzie, E. J., Ephraim, P. L., Travison, T. G., & Brookmeyer, R. (2008). Estimating the prevalence of limb loss in the United States: 2005 to 2050. Archives of Physical Medicine and Rehabilitation, 89(3), 422–429.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

She has experience in outpatient and inpatient trauma and substance abuse treatment. She completed her doctoral internship at the Syracuse VA Medical Center. Her research and professional interests include acute and post-traumatic stress, ideological bias in psychological science, and law and public policy.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Silander, N.C. Life-Changing Injuries: Psychological Intervention Throughout the Recovery Process Following Traumatic Amputations. J Health Serv Psychol 44, 74–78 (2018). https://doi.org/10.1007/BF03544666

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03544666

Navigation