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Letters to the Editor   |    
Clarifying the Presence of Posttraumatic Stress Symptoms Following Orthopaedic Trauma
Roxane Cohen Silver, PhD1
1 Department of Psychology and SocialBehavior and Department of MedicineUniversity of California, Irvine3340 Social Ecology IIIrvine, CA 92697-7085rsilver@uci.edu
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In support of the research or preparation of this work, the author received grants or outside funding from the National Science Foundation. She did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the author is affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Mar 01;87(3):673-675
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To The Editor:Posttraumatic stress disorder is a serious psychological condition that has received increasing attention over the past decade. Starr et al. should be commended for their attempt, in their article "Symptoms of Posttraumatic Stress Disorder After Orthopaedic Trauma" (2004;86:1115-21), to alert orthopaedic surgeons to the fact that psychological consequences of a severe orthopaedic injury are possible and important. Nonetheless, the percentage of respondents who "met the criteria" for posttraumatic stress disorder (as measured with the Revised Civilian Mississippi Scale for Posttraumatic Stress Disorder) was startlingly high. Because the presence of a serious psychiatric disorder in more than one-half of a traumatized sample is exceedingly rare, it led me to examine the methods and analytic strategy used in this report. There are a number of issues that deserve mention.
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