The development of a clinically useful tool for predicting the development of psychological disorder following injury

Authors: Mason, S.¹; Farrow, T. F. D.²; Fawbert, D.³; Smith, R.²; Bath, P. A.⁴; Hunter, M.²; Woodruff, P. W.⁵; Turpin, G.⁶

Source: British Journal of Clinical Psychology, Volume 48, Number 1, March 2009 , pp. 31-45(15)

Publisher: British Psychological Society

Purchase options

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$24.40 plus tax Refund Policy

More about this publication?

More like this?

In this: publication
By this: publisher
In this Subject: Psychology
By this author: Mason, S. ; Farrow, T. F. D. ; Fawbert, D. ; Smith, R. ; Bath, P. A. ; Hunter, M. ; Woodruff, P. W. ; Turpin, G.

Content Key:

- Free

- New

- Open Access

- Subscribed

- Free Trial

Abstract:

Objectives:

To identify factors significantly associated with post-traumatic stress disorder (PTSD), anxiety, and depression at 3 months post-injury; to develop a generic model to predict the occurrence of PTSD, anxiety, and depression at 3 months post-injury; and to validate this model in a test data set of patients.

Design:

Prospective cohort study.

Methods:

Participants were 823 patients attending an emergency department (ED) following accidental injury. Baseline questionnaires were completed, with 1 and 3 months postal follow-ups. Predictor variables demonstrating significant associations with two of the three outcome measures (3-month HAD anxiety and depression scores and PTSD symptoms) were included in multivariate regression models for each outcome. Non-significant predictor variables were removed until all remaining independent variables made the most significant contribution to each of the three models. Models were validated using a test dataset.

Results:

Previous history of mental health problems, neuroticism score and having PTSD symptoms at 1 month predicted adverse outcomes at 3 months. When used on the test datasets, the areas under the receiver operating curve (ROC) curve for the models predicting outcomes at 3 months were: PTSD=0.91 (sensitivity=88.5%); anxiety=0.87 (sensitivity=93.7%); and depression=0.87 (sensitivity=96.7%).

Conclusions:

The final model performed moderately well across the three outcomes and may be useful clinically as a generic rule-out tool to identify those who will not require follow up, watchful waiting or intervention.

Document Type: Research article

DOI: 10.1348/014466508X344799

Affiliations: 1: School of Health and Related Research, University of Sheffield, Sheffield, UK 2: Department of Academic Psychiatry, Longley Centre, Northern General Hospital, University of Sheffield, Sheffield, UK 3: Department of Emergency Medicine, Northern General Hospital, Sheffield, UK 4: Department of Information Studies, University of Sheffield, Sheffield, UK 5: Sheffield Cognition and Neuroimaging Laboratory (SCANLab), Longley Centre, Northern General Hospital, University of Sheffield, Sheffield, UK 6: Department of Clinical Psychology, University of Sheffield, Sheffield, UK