Abstract Details

Title Psychological attachment orientations and long-term post-traumatic stress symptoms among family members of neurointensive care unit patients

Topic Pain

Presentation(s) Pain and Palliative Care Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 005

Objective To determine whether anxious psychological attachment orientation among family members of neurointensive care unit (NICU) patients predicts long-term post-traumatic stress disorder (PTSD) symptoms among families following ICU discharge.

Background Rates of PTSD symptoms are high amongst families of ICU patients following hospital discharge. Adult attachment theory describes how people respond when separated from loved ones; those who have an “anxious” attachment orientation are preoccupied with being psychologically close with their partners. There is growing evidence that a person’s attachment orientation correlates with development of PTSD in multiple populations; however, this has not yet been investigated among ICU families.

Design/Methods We enrolled a consecutive sample of family members of patients admitted to a single Neuro ICU from 7/2018-4/2019 and 8/2019-3/2020. Near time of ICU discharge, in addition to collecting demographics, we identified each participant’s attachment orientation via a standardized Relationship Questionnaire. Six months after discharge, participants completed the Impact of Events Scale-Revised (IES-R) to measure PTSD symptoms. We conducted a univariate analysis and an adjusted multivariate analysis to determine if anxious attachment orientation predicts 6-month PTSD. For this study, an IES-R score of >24 was indicative of PTSD.

Results

158/417 (37.9%) eligible respondents participated. 27 (16.7%) had an anxious orientation, while 135 (83.3%) were non-anxious. In a univariate analysis, 10/27 (37.0%) of anxious participants developed PTSD, compared to 24/135 (17.8%) of non-anxious participants (p=0.04). In a multivariate model adjusting for subjects’ ethnicity, previous experience with caring for patients with severe cognitive/physical disabilities, and number of family meetings, anxious attachment significantly predicted PTSD (OR 3.64, 95% CI 1.35-9.77, p=0.01).

Conclusions

Anxious attachment orientation predicts PTSD symptoms among families of neuro ICU patients 6 months following patient discharge. Future ICU interventions designed to decrease rates of PTSD among families may be higher yield if focused on this high-risk population.

Authors/Disclosures
Qiang Zhang PRESENTER	Mrs. Zhang has nothing to disclose.
	No disclosure on file
	No disclosure on file
Tara A. Kimbrough, MD (Ochsner Medical Center)	Dr. Kimbrough has nothing to disclose.
	No disclosure on file
Prerak Juthani (Yale School of Medicine)	Mr. Juthani has nothing to disclose.
	No disclosure on file
	No disclosure on file
David Y. Hwang, MD, FAAN (University of North Carolina School of Medicine)	The institution of Dr. Hwang has received research support from NIH. The institution of Dr. Hwang has received research support from Neurocritical Care Foundation. Dr. Hwang has received publishing royalties from a publication relating to health care. Dr. Hwang has received personal compensation in the range of $10,000-$49,999 for serving as a Associate Medical Director with New England Donor Services.

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