Posttraumatic stress disorder after spinal cord injury


Cao, Y., Li, C., Newman, S., Lucas, J., Charlifue, S., & Krause, J. S. (2017). Posttraumatic stress disorder after spinal cord injury. Rehabilitation Psychology, 62(2), 178-185. doi:


The purpose of the present study was twofold: (1) To identify the prevalence of posttraumatic stress disorder (PTSD) after spinal cord injury (SCI) among multiple racial ethnic groups with SCI, and (2) assess the relationship between PTSD and demographic characteristics, injury-related factors, employment, depressive symptoms, and health events. The 1,063 participants utilized in this study were from three different regions of the United States (Southeastern, Mountain, and Western). Inclusion criteria were as follows: (1) traumatic SCI with residual deficits, (2) age 18 years or older, and (3) experienced their injury a minimum of 1 year prior. All participants completed the Purdue PTSD Scale-Revised to measure PTSD symptomatology, with instructions that indicated “these questions are about your reaction to the event of your spinal cord injury.” Depression was measured by the Older Adult Health and Mood Questionnaire, while self-perceived general health was assessed with the Behavioral Risk Factor Surveillance System. Of significance, the authors found that approximately one fourth of SCI participants met the DSM-IV PTSD criteria and were above the cutoff score on the Purdue PTSD Scale-Revised, which is substantially higher than that of the general population (6.8%; Kessler et al., 2005). Interestingly, when controlling for all other factors, all minority groups (Hispanic=31.3%, Black=24.7%, and Other=30.9%) had higher odds of having PTSD compared with non-Hispanic Whites (19.4%). This finding is in contrast to the weak or nonsignificant relationship between PTSD and race/ethnicity in the general population. Consistent with the current body of literature, a strong relationship was found between PTSD and depression. Lastly, the authors found that the number of episodes of medical care due to post-SCI injury in the past year was significantly associated with PTSD. This study highlights the need for healthcare providers to remain cognizant of the mental health inequality problem, and to understand additional complications a person from an ethnic minority may have experienced. Meaning, it is important to assess the life stress of being an ethnic minority for that particular SCI survivor.

I CHOSE THIS ARTICLE because it brings us a step closer to understanding how, psychologically, individuals of different racial ethnic groups experience a similar traumatic medical occurrence. Likewise, I believe this article acts as a reminder of the strong relationship between PTSD and depression, and importance of assessing for both disorders when one of the diagnoses appears to be present.

THIS MONTH’S REHABILITATION SCIENCE SPOTLIGHT was chosen by Lucas D. Driskell, M.S., Rehabilitation and Neuropsychology Intern for Baylor College of Medicine at TIRR Memorial Hermann Rehabilitation Hospital; Member of Division 22 Science Committee.