Abstract
BackgroundPeritraumatic psychological- and sensory impressions in victims of civilian accidents are only partly understood. This study scrutinizes the level and duration of perceived psychological threat at scene of injury as well as in hospital (the casualty chain) measured by the Casualty Chain Inventory (CCI). The purpose of the study was to assess and validate the CCI, and to examine the correlations between the new instrument and stress responses measured by the Impact of Event Scale (IES) and the Post-traumatic Stress Scale-10 (PTSS-10)MethodsThree hundred and fifteen injured, conscious, hospitalised patients were assessed with a self-report questionnaire. The CCI consists of eight items including sensory impressions and well-known psychological responses to trauma.ResultsThe internal consistency of the CCI was solid (Cronbach's alpha: .83-.85). A factor analysis revealed two components, "perception" and "dissociation". The instrument correlates significantly with the Impact of Event Scale (r = 0.47 - 0.54) and the Posttraumatic Stress Scale-10 (r = 0.32 - 0.50). The explained variance is high both at the scene of injury (61%) and in the hospital (65%). Dissociation and perception either used as a two-factor solution or as a sum score measured in the hospital, gave the strongest prediction for later psychological distress.ConclusionsThe CCI appears to be a useful screening instrument for, at an early state, identifying patients hospitalized after a physical incident at risk for subsequent psychological distress.
Highlights
Peritraumatic psychological- and sensory impressions in victims of civilian accidents are only partly understood
Ôzer et al concluded that peritraumatic psychological processes might be the strongest predictors of posttraumatic stress disorder (PTSD)
Intrusive memories may often consist of sensory impressions, especially visual, of the moments preceding the traumatic event [12] and trauma-focused cognitive therapy often address the sensory influences on psychological responses during the event
Summary
Peritraumatic psychological- and sensory impressions in victims of civilian accidents are only partly understood. This study scrutinizes the level and duration of perceived psychological threat at scene of injury as well as in hospital (the casualty chain) measured by the Casualty Chain Inventory (CCI). A physical accident can be viewed as a chain of connected moments–the moment one realize that something bad is about to happen, when it happens, waiting for help, transportation to, and treatment in hospital. This process may be defined as the casualty chain. The Casualty Chain Inventory (CCI) was developed, which includes sensory impressions and well-known psychological responses experienced both at the scene of injury and in hospital in order to get a measure of the duration of the responses. By measuring perceived threat at two time points, it is possible to see whether those with a high level of perceived threat both at the scene of injury and in hospital are at greater risk than those who are afraid in one of these situations, i.e. a measure of the duration of experienced threat
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