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Journal of Occupational Rehabilitation

, Volume 13, Issue 2, pp 63–77 | Cite as

Posttraumatic Stress Disorder (PTSD) in the Workplace: A Descriptive Study of Workers Experiencing PTSD Resulting from Work Injury

  • Heather A. MacDonald
  • Victor Colotla
  • Stephen Flamer
  • Harry Karlinsky
Article

Abstract

In view of the relatively understudied status of work-related posttraumatic stress disorder (PTSD), this study retrospectively examined 44 workers whose claims were accepted for workers' compensation benefits in the absence of significant coexisting physical injuries. The majority of workers (82%) directly experienced the traumatic event while the rest witnessed the event. Over half (54%) of those directly experiencing the event were involved in armed robberies, whereas 38% were physically or verbally assaulted in nonrobbery situations. Almost half of the workers were assigned a coexisting mood or anxiety diagnosis. Psychoactive medication was prescribed to 66% of workers, and 93% of all workers received some form of psychological/psychiatric treatment. Twenty-three percent of the group received vocational rehabilitation assistance and only 43% returned to their previous job with the accident employer. Findings suggest that work-related PTSD is both complex and disabling and merits further investigation.

stress disorders postraumatic/psychology stress disorders posttraumatic/rehabilitation workers' compensation disability injured workers accidents, occupational/psychology 

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REFERENCES

  1. 1.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edn. Washington, DC: American Psychiatric Association, 1994.Google Scholar
  2. 2.
    Lawson BZ. Work-related post-traumatic stress reactions: The hidden dimension. Health Soc Work 1987; 12: 250–258.PubMedGoogle Scholar
  3. 3.
    Silva JA, Leong GB, Ferrari MM. Posttraumatic stress disorder in burn patients. South Med J 1991; 84: 530–531.PubMedGoogle Scholar
  4. 4.
    Page AC, Crino RD. Eye-movement desensitisation: A simple treatment for post-traumatic stress disorder? Aust N Z J Psychiatry 1993; 27: 288–293.PubMedGoogle Scholar
  5. 5.
    Vaughan K, Armstrong MS, Gold R, O'Connor N, Jenneke W, Tarrier N. A trial of eye movement desensitization compared to image habituation training and applied muscle relaxation in post-traumatic stress disorder. J Behav Ther Exp Psychiatry 1994; 25: 283–291.PubMedGoogle Scholar
  6. 6.
    Grunert BK, Devine CA, Matloub HS, Sanger JR, Yousif NJ. Flashbacks after traumatic hand injuries: Prognostic indicators. J Hand Surg 1988; 13a: 125–127.Google Scholar
  7. 7.
    Grunert BK, Devine CA, McCallum-Burke S, Matloub HS, Sanger JR, Yousif NJ. On-site work evaluations: Desensitisation for avoidance reactions following severe hand injuries. J Hand Surg 1989; 14: 239–241.Google Scholar
  8. 8.
    Grunert BK, Matloub HS, Sanger JR, Yousif NJ. Treatment of posttraumatic stress disorder after work-related hand trauma. J Hand Surg 1990; 15a: 511–515.Google Scholar
  9. 9.
    Grunert BK, Devine C, Matloub HS, Sanger JR, Yousif NJ, Anderson RC, Roell SM. Psychological adjustment following work-related hand injury: 18–month follow-up. Ann Plast Surg 1992; 29: 537–542.PubMedGoogle Scholar
  10. 10.
    Grunert BK, Devine CA, Smith CJ, Matloub HS, Sanger JR, Yousif NJ. Graded work exposure to promote work return after severe hand trauma: A replicated study. Ann Plast Surg 1992; 29: 532–536.PubMedGoogle Scholar
  11. 11.
    Cheung E, Alvaro R, Colotla VA. Psychological distress in workers with traumatic upper-or lower-limb amputations following industrial injuries. Rehabil Psychol in press.Google Scholar
  12. 12.
    Mancusi-Ungaro HR, Tarbox AR, Wainwright DJ. Posttraumatic stress disorder in electric burn patients. J Burn Care Rehabil 1989; 7: 521–525.Google Scholar
  13. 13.
    Weisaeth L. The stressors and the post-traumatic stress syndrome after an industrial disaster. Acta Psychiatr Scand 1989; 355: 25–37.Google Scholar
  14. 14.
    Shercliffe R. Post-traumatic stress disorder in industrial accident victims and crime victims: A comparison of symptoms [Thesis]. Burnaby, British Columbia, Canada: Simon Fraser University 1996.Google Scholar
  15. 15.
    Colotla VA, Shercliffe R. MMPI-2 profiles in civilian PTSD: Victims of crime and industrial accidents. A poster presented at the 105th Annual Convention of the American Psychological Association, Chicago, 1997.Google Scholar
  16. 16.
    De Mol J. Post-aggression stress disorders: Psychosocial and work repercussions. Med Sci Monit 1998; 5: 277–282.Google Scholar
  17. 17.
    Burgess ES, Hibler R, Keegan D, Everly GS. Symptoms of posttraumatic stress disorder in worker's compensation patients attending a work rehabilitation program. Int J Rehabil Health 1996; 2: 29–39.Google Scholar
  18. 18.
    Asmundson GJ, Norton GR, Allerdings MD, Norton PJ, Larsen DK. Posttraumatic stress disorder and work-related injury. J Anxiety Disord 1998; 12: 57–69.PubMedGoogle Scholar
  19. 19.
    Flamer S, Buch W. Differential diagnosis of post-traumatic stress disorder in injured workers: Evaluation of the MMPI-2. A paper presented at the 27th Annual Symposium on Recent Development on Research with the MMPI, Minneapolis, MN, 1992.Google Scholar
  20. 20.
    Shercliffe R, Colotla VA, Jacobucci G. The utility of the North Carolina Dissociation Index in a sample of injured workers presenting with PTSD. A poster presented at the 13th Annual Meeting of the International Society for Traumatic Stress Studies, Montreal, Quebec, 1997.Google Scholar
  21. 21.
    Colotla VA, Bowman ML, Shercliffe RJ. Test-retest reliability of injured workers' MMPI-2 profiles. A poster presentation at the 106th Annual convention of the American Psychological Association, San Francisco, 1998.Google Scholar
  22. 22.
    Genest M, Levine J, Ramsden V, Swanson R. The impact of providing help: Emergency workers and cardiopulmonary resuscitation attempts. J Trauma Stress 1990; 3: 305–313.Google Scholar
  23. 23.
    Robinson HM, Sigman MR, Wilson JP. Duty-related stressors and PTSD symptoms in suburban police officers. Psychol Rep 1997; 81: 835–845.PubMedGoogle Scholar
  24. 24.
    Carlier V, Lamberts RD, Gersons BP. Risk factors for posttraumatic stress symptomatology in police officers: A prospective analysis. J Nerv Ment Dis 1997; 185: 498–506.PubMedGoogle Scholar
  25. 25.
    Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol 1999; 2: 131–141.Google Scholar
  26. 26.
    Wagner D, Heinrichs M, Ehlert U. Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. Am J Psychiatry 1998; 155: 1727–1732.PubMedGoogle Scholar
  27. 27.
    Beavan V, Stephens C. The characteristics of traumatic events experienced by nurses on the accident and emergency ward. Nurs Prax N Z 1999; 14: 12–28.PubMedGoogle Scholar
  28. 28.
    Whittington R, Wykes T. Violence in psychiatric hospitals: Are certain staff prone to being assaulted? J Adv Nurs 1994; 19: 219–225.PubMedGoogle Scholar
  29. 29.
    Wykes T, Whittington R. Prevalence and predictors of early traumatic stress reactions in assaulted psychiatric nurses. Am J Forensic Psychiatry 1998; 9: 643–658.Google Scholar
  30. 30.
    Queen Street Mental Health Centre. The prevention and management of aggressive behaviour program. Ontario, Canada: Education Services and Department of Nursing, Toronto, 1991.Google Scholar
  31. 31.
    Fitzpatrick KM, Wilson M. Exposure to violence and posttraumatic stress symptomatology among abortion clinic workers. J Trauma Stress 1999; 12: 227–242.PubMedGoogle Scholar
  32. 32.
    Karlehagen S, Malt UF, Hoff H, Tibell E, Herrstromer U, Hildingson K, Leymann H. The effect of major railway accidents on the psychological health of train drivers–II: A longitudinal study of the one-year outcome after the accident. J Psychosom Res 1993; 37: 807–817.PubMedGoogle Scholar
  33. 33.
    Theorell T, Leymann H, Jodko M, Konarski K, Norbeck HE, Eneroth P. “Person under train” incidents: Medical consequences for subway drivers. Psychosom Med 1992; 54: 480–488.PubMedGoogle Scholar
  34. 34.
    Malt UF, Karlehagen S, Hoff H, Herrstromer U, Hildingson K, Tibell E, Leymann H. The effect of major railway accidents on the psychological health of train drivers–I: Acute psychological responses to accident. J Psychosom Res 1993; 37: 793–805.PubMedGoogle Scholar
  35. 35.
    Kamphuis JH, Emmelkamp PM. Crime-related trauma: Psychological distress in victims of bankrobbery. J Anxiety Disord 1998; 12: 199–208.PubMedGoogle Scholar
  36. 36.
    Miller-Burke J, Attridge M, Fass PM. Impact of traumatic events and organizational response. A study of bank robberies. J Occup Environ Med 1999; 41: 73–83.PubMedGoogle Scholar
  37. 37.
    Mathews L. Road trauma, PTSD and occupational functioning: Implications for policy development, intervention and rehabilitation. Aust N Z J Public Health 1999; 23: 325–327.PubMedGoogle Scholar
  38. 38.
    Fogarty CA, Beck RJ. Work adjustment for individuals with PTSD. Voc Eval Work Adjust Bull 1995; 28: 76–80.Google Scholar
  39. 39.
    MacCluskie KC. A review of eye movement desensitization and reprocessing (EMDR): Research findings and implications for counselors. Can J Counsel 1998; 32: 116–137.Google Scholar
  40. 40.
    Yamey G. Psychologists question “debriefing” for traumatised employees. BMJ 2000; 320: 140.Google Scholar
  41. 41.
    Rose S, Bisson J. Brief early psychological interventions following trauma: A systematic review of the literature. J Trauma Stress 1998; 11: 697–710.PubMedGoogle Scholar
  42. 42.
    Shalev AY. What is posttraumatic stress disorder? J Clin Psychiatry 2001; 62: 4–10.Google Scholar

Copyright information

© Plenum Publishing Corporation 2003

Authors and Affiliations

  • Heather A. MacDonald
    • 1
  • Victor Colotla
    • 2
  • Stephen Flamer
    • 2
  • Harry Karlinsky
    • 3
  1. 1.Department of PsychologyUniversity of CalgaryCalgaryCanada
  2. 2.Department of Psychology, Workers'Compensation Board of British ColumbiaRichmondCanada
  3. 3.Department of PsychiatryUniversity of British ColumbiaVancouverCanada

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