title: Growth curve trajectories of distress in burn patients.
abstract: Psychological adjustment after a major burn injury is a significant concern to providers and patients alike. Although efforts have been made to identify associated risk factors, little is known about heterogeneity in the levels or trajectories of adjustment in this population. This study used a novel application of Growth Mixture Modeling to identify subgroups of patients based on their longitudinal self-reported distress using the Brief Symptom Inventory (BSI). Data were drawn from the database of the Burn Model Systems project, a prospective, multisite, cohort study of major burn injury survivors. The BSI was used to assess symptoms in-hospital and at 6, 12, and 24 months postburn. Participants' T scores on the BSIs Global Severity Index provided a continuous measure of psychological distress. Analyses were conducted using participants' Global Severity Index T scores to discern distinct classes of respondents with similar trajectories across the 2-year follow-up. Results from the Growth Mixture Modeling analysis produced an ordered four-class model of psychological recovery from a major burn. Groups represented the equivalent of high, subthreshold, mild, and minimal symptom severity. Covariates significantly affected the intercept and slope of each class, as well as prediction of group assignment. These analyses demonstrate differences between individual recoveries after a major burn. Psychological distress symptoms remain largely stable over time and highlight the psychological vulnerability of this patient population.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA.
authors.forename: Shawn T
authors.initials: ST
authors.lastname: Mason
authors.forename: Nida
authors.initials: N
authors.lastname: Corry
authors.forename: Neda F
authors.initials: NF
authors.lastname: Gould
authors.forename: Nicole
authors.initials: N
authors.lastname: Amoyal
authors.forename: Vincent
authors.initials: V
authors.lastname: Gabriel
authors.forename: Shelly
authors.initials: S
authors.lastname: Wiechman-Askay
authors.forename: Radha
authors.initials: R
authors.lastname: Holavanahalli
authors.forename: Sean
authors.initials: S
authors.lastname: Banks
authors.forename: Lisa
authors.initials: L
authors.lastname: Arceneaux
authors.forename: James A
authors.initials: JA
authors.lastname: Fauerbach
mesh_terms: D000328:Adult; D002056:Burns / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011581:Psychological Tests; D020127:Recovery of Function; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D017741:Survivors / Q000523:psychology*; D013997:Time Factors