Original scientific paper

https://doi.org/10.24869/psyd.2022.447

STUCK IN A MOMENT: TONIC IMMOBILITY PREDICTS POOR QUALITY OF LIFE IN TREATED PTSD PATIENTS

Juliana Kalaf ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Evandro Silva Freire Coutinho ; Department of Epidemiology, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
Mauro Mendlowicz ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil; 3Department of Psychiatry and Mental Health, (MSM-UFF), Universidade Federal Fluminense, Niterói, RJ, Brazil
Carla Marques Portella ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
William Berger ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Mariana Pires Luz ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Eliane Volchan ; Institute of Biophysics Carlos Chagas Filho, Universidade Federal do Rio de Janeiro (IBCCF-UFRJ), Rio de Janeiro, RJ, Brazil
Paula Rui Ventura ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil; Institute of Psychology, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
Monique Nascimento Júdice ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Sacha Alvarenga Flavio Blanco ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Jéssica Meirelles Paiva ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil
Ivan Figueira ; Institute of Psychiatry, Universidade Federal do Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, RJ, Brazil

Abstract

Background: Posttraumatic stress disorder (PTSD) is a prevalent and disabling multisystem disorder, with significant physical
and psychiatric morbidity and poor quality of life (QOL). Although peritraumatic reactions - tonic immobility and dissociation - are
established predictors of PTSD severity and development, there is a dearth of investigation assessing the impact of peritraumatic
reactions on QOL of PTSD patients. Quality of life has become increasingly important in health care and research as a reliable
outcome measure. It comprises psychological, physical, social and environmental domains, providing important information about
the impact of diseases on patient's life. This study aims to investigate the impact of peritraumatic tonic immobility and peritraumatic
dissociation on QOL of PTSD civilian outpatients.
Subjects and methods: It is a cross-sectional study of 50 victims of urban violence with current PTSD, recruited in a specialized
outpatient clinic. Instruments used were: Structured Clinical Interview IV, Peritraumatic Dissociative Experiences Questionnaire,
Tonic Immobility Scale and WHOQOL-BREF (psychological, physical, social and environmental domains). Linear regression
models were fitted to evaluate the impact of peritraumatic reactions - tonic immobility and dissociation - on WHOQOL-BREF
scores. We controlled for sex as potential confounding.
Results: The severity of peritraumatic tonic immobility negatively impacted on psychological and environment domains of
quality of life. For each additional point on the Tonic Immobility Scale, there was a decreased of 0.8 points on the scores of these
domains of WHOQOL-BREF. Neither the peritraumatic reactions showed effects on physical nor social domains. Possible
limitations of this study include cross-sectional design, relatively small sample size of tertiary center outpatients and recall bias.
Conclusions: Peritraumatic tonic immobility is related to poor quality of life, adding new insights about the relationship between
this immobility reaction and PTSD.

Keywords

peritraumatic reactions; dissociation; tonic immobility; quality of life; post-traumatic stress disorder

Hrčak ID:

290312

URI

https://hrcak.srce.hr/290312

Publication date:

3.11.2022.

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