title: Early versus delayed imaginal exposure for the treatment of posttraumatic stress disorder following accidental upper extremity injury.
abstract: BACKGROUND
  The consequences following work-related injuries are far reaching, which are in part due to unrecognized and untreated posttraumatic stress disorder (PTSD). Imaginal exposure is a frequently used cognitive behavioral approach for the treatment of PTSD. This study examined the impact of early versus delayed treatment with imaginal exposure on amelioration of PTSD symptomatology in individuals who suffered upper extremity injuries.
  
  
  METHODS
  Sixty individuals who suffered severe work-related injuries received standard, non-randomly assigned psychological treatment for PTSD (e.g., prolonged imaginal exposure) either early (30-60 days) or delayed (greater than 120 days) following severe work-related upper extremity injury. Nine measures of various components of PTSD symptomatology were administered at onset of treatment, end of treatment, and at 6-month follow-up evaluations.
  
  
  RESULTS
  Patients showed significant treatment outcomes at all three measurement intervals in both the early and delayed groups demonstrating that Prolonged Imaginal Exposure is an appropriate treatment for persons diagnosed with PTSD. In addition, there was no difference in return to work status between the early and the delayed treatment groups. However, the early treatment group required significantly fewer treatment sessions than the delayed treatment group.
  
  
  CONCLUSIONS
  Results supported the utility of imaginal exposure and the need for early assessment and referral for those diagnosed with PTSD following upper extremity injuries.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8710 W. Watertown Plank Road, Milwaukee, WI 53226 USA.
authors.forename: Jo M
authors.initials: JM
authors.lastname: Weis
authors.forename: Brad K
authors.initials: BK
authors.lastname: Grunert
authors.forename: Heidi Fowell
authors.initials: HF
authors.lastname: Christianson
keywords: Imaginal exposure; Posttraumatic stress disorder; Psychology; Time of intervention; Upper extremity injuries