Article

OBJECTIVES: To identify the prevalence of posttraumatic stress disorder (PTSD)
after spinal cord injury (SCI) in a sample averaging over 2 decades postinjury at
assessment. Related objectives are to confirm the factor structure, compare
subscales with those reported in a nonclinical sample, and identify the
relationship of PTSD with depression. DESIGN: Survey. SETTING: A medical
university in the Southeastern United States. PARTICIPANTS: Participants were
initially identified through specialty hospitals in the Midwest and Southeastern
United States. A cohort of adults (N=927) with traumatic SCI of at least 1 year
duration at enrollment in 2002 to 2003 and a minimum of 7 years at the time of
assessment completed the study materials. INTERVENTIONS: Not applicable. MAIN
OUTCOMES MEASURES: PTSD was measured by the Purdue Posttraumatic Stress Disorder
Scale-Revised, and depression was measured by the Patient Health Questionnaire
9-item. RESULTS: PTSD was reported by less than 10% of the participants. Item
endorsement decreased as a function of years postinjury, primarily because of low
rates of endorsement among those 21 or more years postinjury. Confirmatory factor
analysis did not result in an acceptable fit for subscales, item sets, or factors
previously reported in the literature. Participants scored higher than a
nonclinical sample (reported in the literature) on the arousal and avoidance
subscales but lower on the re-experiencing subscale. Item endorsement were lower
for the first set of items that relate directly to the SCI itself, with the
highest item endorsement for "have difficulty remembering important aspects of
event." PTSD rarely occurred in the absence of a depressive disorder.
CONCLUSIONS: PTSD does not appear to be highly prevalent in long-term SCI
survivors, and endorsement of items related to re-experiencing and even recalling
the injury are rare. Because SCI often is accompanied by mild traumatic brain
injury, difficulty recalling the event may have an organic rather than
psychologic component.

Langue : ANGLAIS