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Randomised controlled trial of psychological debriefing for victims of acute burn trauma

Published online by Cambridge University Press:  03 January 2018

Jonathan I. Bisson*
Affiliation:
University of Wales College of Medicine, Cardiff
Peter L. Jenkins
Affiliation:
St Cadoc's Hospital, Caerleon, Gwent
Julie Alexander
Affiliation:
St Cadoc's Hospital, Caerleon, Gwent
Carol Bannister
Affiliation:
St Cadoc's Hospital, Caerleon, Gwent
*
Dr J. I. Bisson, Gabalfa Clinic, 213 North Road, Cardiff CF4 3AG. Fax: 01222 627954. e-mail: 101454.3011@compuserve.com

Abstract

Background

Psychological debriefing (PD) is widely used following major traumatic events in an attempt to reduce psychological sequelae.

Method

One hundred and thirty-three adult burn trauma victims entered the study. After initial questionnaire completion, participants were randomly allocated to an individual/couple PD group or a control group who received no intervention; 110 (83%) were interviewed by an assessor blind to PD status three and 13 months later.

Results

Sixteen (26%) of the PD group had PTSD at 13-month follow-up, compared with four (9%) of the control group. The PD group had higher initial questionnaire scores and more severe dimensions of burn trauma than the control group, both of which were associated with a poorer outcome.

Conclusions

This study seriously questions the wisdom of advocating one-off interventions post-trauma, and should stimulate research into more effective initiatives.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.Google Scholar
Blake, D. D., Weathers, F. W. & Nagy, L. N. (1990) A clinician rating scale for assessing current and lifetime PTSD: the CAPS–1. Behaviour Therapist, 18, 187188.Google Scholar
Horowitz, M. J., Wilner, N. R. & Alvarez, W. (1979) Impact of event scale: a measure of subjective stress. Psychosomatic Medicine, 41, 768781.Google Scholar
Kilpatrick, A. G., Saunders, B. E., Amick-McMullan, A., et al (1989) Victim and crime factors associated with the development of crime related post-traumatic stress disorder. Behaviour Therapy, 20, 199214.Google Scholar
Lee, C., Slade, P. & Lygo, V. (1996) The influence of psychological debriefing on emotional adaptation in females following early miscarriage. British Journal of Medical Psychology, 69, 4758.CrossRefGoogle ScholarPubMed
Malt, U. F. (1988) The long-term consequences of accidental injuries. British Journal of Psychiatry, 153, 810818.CrossRefGoogle Scholar
Mayou, R., Bryant, B. & Duthie, R. (1993) Psychiatric consequences of road traffic accidents. British Medical Journal, 307, 647651.Google Scholar
Mitchell, J. T. (1903) When disaster strikes … the critical incident debriefing process. Journal of the Emergency Medical Services, 8, 3639.Google Scholar
Peterson, D. R., Carrigan, L., Quested, K. A., et al (1990) Post-traumatic stress disorder in hospitalised patients with burn injuries. Journal of Burn Care and Rehabilitation, 11, 181184.CrossRefGoogle Scholar
Perez-Jimenez, J. P., Graell-Berna, M., Perez-Sales, P., et al (1993) Severe burn injury and post-traumatic stress disorder. American Journal of Psychiatry, 150, 1276.Google Scholar
Perry, S., Difede, J., Musngi, G., et al (1992) Predictors of post-traumatic stress disorder after burn injury. American Journal of Psychiatry, 149, 931935.Google ScholarPubMed
Pitman, R. K., Altman, B., Greenwald, E., et al (1991) Psychiatric complications during flooding therapy for posttraumatic stress disorder. Journal of Clinical Psychiatry, 52, 1720.Google Scholar
Raphael, B., Meldrum, L. & McFmrlane, A. C. (1995) Does debriefing after psychological trauma work? Time for randomised controlled trials. British Medical Journal, 310, 14791480.Google Scholar
Robinson, R. C. & Mitchell, J. T. (1993) Evaluation of psychological debriefings. Journal of Traumatic Stress, 6, 367382.CrossRefGoogle Scholar
Zigmond, A. S. & Snaith, R. P. (1983) The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361370.Google Scholar
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