A psychological exam should be routinely ordered when an injury involves an amputation, either within the injury or following injury.
It is clinically referred to as _body ego_, that concept we have of ourselves and how we adjust to change. The most ready example is how concerned we are when we our hair grays, our skin wrinkles and we gain weight with age. We look back at earlier photos and quite often feel a sense of loss of youth.
For the amputation victim, this is not a gradual process as would be hair loss. It is sudden, traumatic, and permanent. There are no facelifts, hair coloring or diet programs to compensate for this loss. Additionally, they may have _phantom limb_ pain/itching or other sensations that force them to continually focus upon the loss.
But clearly, life has changed for the amputation patient. He/she must accept the loss as permanent. For women, the loss of even the distal end of a finger is a cosmetic problem since nails are often a source of cosmetic importance.
It is extremely important to determine if the amputation patient has begun to incorporate the loss. For many, it is a sense that the injury _could have been worse,_ and the sense of loss is minor. For others, the loss will affect many areas of their lives and their own sense of self.