Post traumatic distress symptoms following spinal cord injury: a comparative review of European samples

To highlight any cross-cultural differences in the prevalence of post traumatic distress (PTD), and the type of coping strategies implemented following spinal cord injury (SCI).

Cross-sectional questionnaire.

A spinal cord rehabilitation unit in the UK, and six Swiss and German (CH/DE) spinal injury centres.

A total of 85 SCI individuals in the UK, and 71 in CH/DE were evaluated on levels of PTD using the Impact of Event Scale (IES), and depressive symptomatology using the Beck Depression Inventory or the Berne Questionnaire of Well-Being at up to 6 months postinjury. In addition, the coping strategies utilised by the two samples were assessed using the COPE measure.

No significant difference between the two samples was noted with regard to levels of PTD determined by the total score on the IES, although there was a tendency for a higher rate in the UK. Approximately 20 and 10% of both samples scored above the clinical cutoff on the IES subscales of intrusion and avoidance, respectively. No significant difference was found to exist between the rate of PTD in the SCI CH/DE sample and the able-bodied sample in Switzerland. A lower prevalence of depression was noted in the CH/DE sample. The CH/DE sample scored higher on the use of positive reinterpretation and growth, suppression of competing activities, active and restraint coping, whereas the UK sample scored higher on the use of humour as a coping strategy. Overall, denial, focusing on and venting of emotions, mental disengagement and suppression of competing activities were associated with PTD.

No cross-cultural differences in the level of PTD seem apparent between the UK and CH/DE populations. Future research should focus on determining what protects individuals from developing PTD following SCI.