Posttraumatic Stress Disorder (PTSD) After Critical Illness: A Conceptual Review of Distinct Clinical Issues and Their Implications

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Abstract

Purpose/Objective: Posttraumatic stress disorder (PTSD) that develops after critical care may be marked by a unique constellation of symptoms that differ, for example, from the symptoms that develop in response to more traditional traumas such as combat or assault. Research Method/Design: We describe ways in which symptoms of PTSD after critical illness can be clinically engaged, drawing from literature pointing to “best treatment” practices in other settings. And, we discuss the relevance of intensive care unit (ICU) related PTSD to rehabilitation psychologists and explain why rehabilitation psychologists are well suited to identify and treat ICU-related PTSD. Results: In this conceptual review, drawing from both empirical findings and theoretical models, we surmise that traumatized survivors of critical illness demonstrate 2 central clinical features—avoidance and reexperiencing. Conclusions/Implications: The potentially unique clinical profile of ICU-related PTSD likely requires unique assessment and treatment practices. These services may be best provided by providers with expertise in providing coordinated care, such as rehabilitation psychologists. Next steps should include empirical study to determine whether practices that are empirically supported in other settings may be translated to the ICU and post-ICU hospitalization for critical illness survivors.

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