N.23 - Reflections on the adolescent group with particular reference to trauma and accidents

Adolescents in the Hospital:accidents and pre-traumatic psychological dynamics

Abstract

Objective: To explore the psychological characteristics and relationship factors pertaining to adolescents admitted to surgical and orthopaedic hospital wards for accidents of various kinds, in order to increase knowledge of the dynamics which contribute to accident risk among adolescents.

Method: A sample of 205 subjects (between 14 and 24 years of age) compared with a control group of 205 subjects was studied. Clinical semi-structured interviews were conducted by six psychotherapists specializing in adolescent psychotherapy. A modified Defence Mechanism Inventory was employed. Categorical data from the interviews were analysed by x square tests and DMI scales scores were analysed by two-factor analyses of variance. A cluster analysis of the entire sample based on DMI scores and all categorical variables, except the case/control variable, was done using SPAD.

Results: Young people who have had accidents, and in particular those who have had more than one, appear to have more problems than controls. These problems cover various areas of their present and past. In addition to these difficulties, there are two important psychodynamic elements: quality of self- esteem and how they are attempting to deal with the process of separation and individuation.

Conclusions: Many elements have emerged which confirm the necessity of not undervaluing the psychological context in which an accident occurs, especially for multiple accidents cases. The accident can be interpreted as the expression of a tendency to “act out” problems and suffering which cannot be dealt with on a psychological level.

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