Traumatic stress symptoms following a lower limb amputation in diabetic patients: a longitudinal study

Objective: Limited research has focussed on the development of traumatic stress symptoms following an amputation due to a chronic disease such as Diabetes. This study analysed whether coping strategies, anxiety and depression symptoms, sociodemographic and clinical variables were related to traumatic stress symptoms in a sample of patients who had undergone a lower limb amputation.

Design: A longitudinal design with three assessments, one month (T1), six (T2) and ten months after an amputation surgery (T3), included 144 patients.

Main outcome measures: IES-R, WOC and HADS.

Results: Traumatic stress symptoms were prevalent at T1 (M?=?15.65, SD?=?15.40) and probable PTSD was observed in 13.9% patients. Presence of pain, high level of anxiety symptoms and emotion-focused strategies contributed to traumatic stress symptoms, and the period between T1 and T2, was critical. Six to ten months (Λ?=?0.871, F (2,84) =6.245, p=. 003), after surgery, symptoms tended to decrease 0.122 units (SE?=?0.032, p?=?0.002) per assessment.

Conclusions: Findings raise awareness to the need of urgent identification of traumatic stress symptoms in medically ill patients who underwent a lower limb amputation, given the prevalence of traumatic stress symptoms right after surgery and in the following six months.     

Social Comparisons at Work as Related to a Cooperative Social Climate and to Individual Differences in Social Comparison Orientation

Cette étude a porté sur la fréquence des comparaisons sociales dans une situation de travail et sur les sentiments évoqués par ces comparaisons. Ces processus one été rapportés aux différences individuelles qui apparaissent dans l’orientation des comparaisons sociales et à la perception d’un climat de travail coopératif. Les sujets étaient 216 médecins de différents organismes de santé de l’agglomération de Valence en Espagne. En général, les comparaisons vers le haut étaient plus fréquentes et procuraient plus d’impressions positives et moins d’affects négatifs que les comparaisons vers le bas. Ceux qui présentaient un niveau élevé dans l’orientation des comparaisons rapportaient relativement plus de comparaisons vers le haut et vers le bas, plus de sentiments positifs après des comparaisons vers le bas et plus de sentiments negatifs à l’issue de comparaisons vers le haut. Inversement, ceux qui percevaient le climat social au travail comme coopératif rapportaient relativement plus de sentiments positifs après des comparaisons vers le haut. Parmi les 87 sujets participèrent à la partie longitudinale de la recherche, le climat coopératif perçu et l’orientation des comparaisons sociales furent plus stables sur une durée d’un an que le fréquence des comparaisons vers le haut et vers le bas et les conséquences affectives de ces comparaisons. Il faut en conclure que les individus interprètent les comparaisons sociales au travail dans un sens positif quand ils perçoivent le climat social comme coopératif et d’une façon négative quand ils sont à un niveau élevé dans l’orientation des comparaisons sociales. This study examined the frequency of social comparisons in a work setting, and the feelings that these comparisons evoked. These processes were related to individual differences in social comparison orientation, and to the perception of a cooperative social climate at work. The participants were 216 physicians from various health centers in the Community of Valencia in Spain. In general, upward comparisons occurred more often, and elicited more positive and less negative affect than downward comparisons. Those high in social comparison orientation reported relatively more upward as well as downward comparisons, more positive affect after downward comparisons, and more negative affect after upward comparisons. Conversely, those who perceived the social climate at work as cooperative reported relatively more downward comparisons, more negative affect after downward comparison, and more positive affect after upward comparison. Among the 87 participants who participated in the longitudinal part of the study, perceived cooperative climate and social comparison orientation were more stable over a period of one year than the frequency of upward and downward comparison and the affective consequences of upward and downward comparison. It is concluded that individuals interpret social comparisons at work in a positive way when they perceive the social climate as cooperative, and in a negative way when they are high in social comparison orientation.