Article

Accident cognitions and subsequent psychological trauma

May 2000
Journal of Traumatic Stress 13(2):359-65

May 2000
13(2):359-65

DOI:10.1023/A:1007797904536

Source
PubMed

Authors:

Susan Jeavons

Ken Greenwood

University of the Sunshine Coast

This study used a sample of 72 consecutive attendees to hospital following motor vehicle accidents. It aimed to assess the relationship between demographic variables, details of the accident and cognitions about the accident recorded soon afterward, and degree of psychological trauma 3 and 6 months later. Psychological trauma was assessed using the General Health Questionnaire, Impact of Event Scale, and Posttraumatic Stress Disorder Interview. A structured interview was used to gain information about demographic, accident, and accident cognition variables. Results showed that initial cognitions such as perceived threat to life, rather than demographic or accident variables, had the strongest relationships to subsequent trauma.

Posttraumatic Stress Disorder After a Car Accident in the Czech Population: Prevalence and Risk Factors For Its Development

Article

Full-text available

Oct 2023

Prognostic factors of post-traumatic stress disorder risk in patients with surgical treatment of hip acetabular fracture. Original study

Article

Full-text available

Feb 2021
CURR PSYCHOL

The aim of the study was to assess the risk of developing post-traumatic stress disorder in patients after hip acetabular fracture surgery. The study involved 42 patients fulfilling inclusion criteria. Physical ability levels of the patients were determined with the Harris Hip Score, and modified Merle d’Aubigné scale. High risk of post-traumatic stress disorder was assessed with the PTSD-C questionnaire. Patients had in PTSD-C questionnaire 42.86 ± 28,10 points. In Harris Hip Score 63.64 ± 16.06, in Merle scale 11.10 ± 2.82, that was poor results in both scales. Positive correlation with age reached the level of tendency (ρ = 0.294; p = 0.059). Patients at risk of PTSD were in worse functional state measured by HHS (U = 136.0; p = 0.034) and Merle scale (U = 132.0; p = 0.026) and they were older (U = 147.5; p = 0.068). The groups differed significantly in gender ratio (χ ² = 4.01; p = 0.045). Women (8/10) were more often than men (14/32) at risk of PTSD. Patients after surgical fixation of the acetabulum experience significant functional disability. Increased level of disability after fracture and surgery, older age and female sex make patients vulnerable to PTSD. It is advisable to make medical staff who treat accident victims aware towards aspects which may be related to disorders of the patients’ psychological health.

Contribution to better understanding of outcome for road traffic injury victims : assessment of the consequences of one year in the cohort ESPARR

Article

Dec 2012

Hoang T N V

Background: it is possible that victims can suffer from multiple problems after an accident, and this canbe seen in the people with the most serious consequences. However, few studies allow us to know theprofile and prognostic factors of severity of consequences after the accident in this population of victims.Moreover, there are few tools to predict 1-year post-traumatic sequelae in road crash victims.The thesis aims to determine subgroups of victims with similar outcomes 1 year after the crash andpredictive factors for attribution to these subgroups and validate sequelae prediction by the InjuryImpairment Score (IIS), in comparison with the one year outcomes.Methods: the thesis is a part of the broader ESPARR study based on the Rhône Registry of Road TrafficCasualties. The ESPARR cohort comprised 1,372 subjects, including 1,168 aged 16 years. Among 886adult subjects who responded to a follow-up questionnaire one year later, the main analysis was carriedout on 616 participants, who completed a self-report questionnaire on health, social, emotional andfinancial status 1 year after a crash. The multiple correspondence analysis and hierarchical clusteringmethod was implemented to produce homogeneous road-crash victim subgroups according to differencesin outcome. Baseline (time of accident) predictive factors for subgroup attribution were analysed onweighted multinomial logistic regression models. We used outcomes data at 1-year follow-up of roadinjury to validate the ability of IIS to predict sequelae.Results: five different victim groups were identified in terms of consequences one year after the crash:one group (206 subjects, 33.4%) presented few problems, one group with essentially physical sequelae,one group with essentially physical and social problems, and two groups presented many problems (oneincluded more victims with psychological problem and less environment problem). As well as the knownprognostic factors of age, initial injury severity and lesion type, socioeconomic fragility and the fact of arelative being involved in the accident emerged as being predictive of poor outcome one year later. IIS, inthis injured population, failed to predict sequelae one year later as measured by real data.Conclusion: one year after a road accident, victims may still experience multiple problems in terms notonly of physical health but also of mental health, social life and environment. Poor outcome may bepredicted both from accident-related factors and from victims' socioeconomic fragility. These findings areuseful in guiding prevention in terms not only of recovery of health status but also of recovery of sociallife in the best possible environment.

A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors

Article

Aug 2013

Traumatic Dissociation as a Predictor of Posttraumatic Stress Disorder in South African Female Rape Survivors

Article

Apr 2015
MEDICINE

Women survivors of rape are at an increased risk for posttraumatic stress disorder (PTSD). Traumatic dissociation has been identified as a precursor of PTSD. This study assessed the predictive potential of traumatic dissociation in PTSD and depression development. The study followed a longitudinal, prospective design. Ninety-seven female rape survivors were recruited from 2 clinics in Cape Town, South Africa. Clinical interviews and symptom status assessments of the participants were completed to measure dissociation, childhood traumas, resilience, depression, and PTSD. Traumatic dissociation was a significant predictor of PTSD and depression. The linear combination of prior dissociation, current dissociation, and resilience significantly explained 20.7% of the variance in PTSD. Dissociation mediated the relationship between resilience and PTSD. As traumatic dissociation significantly predicts PTSD, its early identification and management may reduce the risk of developing PTSD. Interventions focused on promoting resilience may also be successful in reducing the risk of dissociation following rape.

Masters Thesis: BECOMING DISPOSSESSED: SURVIVORS’ EXPERIENCES OF MATERIAL LOSS DURING HURRICANE HARVEY

Article

May 2020

Losing material possessions during flood events is emotionally distressing and may contribute to the etiology of mental illness in flood survivors. Disaster research has investigated the tangible and intangible value of material possessions lost to flooding and the psychological impact of that forced removal. While these studies treat loss as a secondary disaster stressor, there is evidence that survivors’ cognitions and behaviors towards their possessions during primary exposure to flooding may impact their wellbeing. This exploratory qualitative study aims to describe essential features of flood survivors’ lived experience of material loss caused by flooding during Hurricane Harvey. Thirty open-ended interviews with Hurricane Harvey survivors were collected from minority households in areas of Houston that saw severe residential flooding. Phenomenological and narrative approaches to qualitative inquiry were chosen to inductively reveal core emotional, sensory, and relational characteristics constituting their narrative of living through loss during Harvey. Participants’ narratives followed a three-part structure: projections about agency and the losing control, the realization of material losses, and the interpretation of that loss in the aftermath. Participants characterized their experience of loss as unfolding over time and under various material circumstances and settings. Analysis revealed a typology reflecting substantial variation in the phenomena surrounding ir experience of material loss related within narratives. Participants who evacuated experienced the reality of their loss in the abstract until returning home to recognize the extent and emotional weight of their loss. Participants who did not evacuate gave vivid descriptions of the sensory experience and emotional distress of witnessing their dispossession firsthand and of trying and failing to prevent losses as they were occurring. This qualitative inquiry into participants’ lived experiences during hurricane Harvey offers the first empirical evidence towards characterizing the impact of primary exposure to material loss on subjective wellbeing.

Psychological Distress of Patients Experiencing Different Types of Road Traffic Injuries in Vietnam

Article

Full-text available

May 2020
Int J Environ Res Publ Health

Road-related injuries are often catastrophic, and the eighth leading cause of all-aged mortality. While psychological problems, including anxiety, driving phobia, and post-traumatic stress have been found to be common among injured survivors, the literature in this area is still limited. This study aimed to evaluate the prevalence of distress between different types of road injuries among 413 patients in Thai Binh hospitals from October to December 2018. The Kessler Psychological Distress Scale (K6) was used to assess mental health status. Sociodemographic and clinical characteristics were also collected. The results of Multiple Logistic and Tobit regression models were utilized. Psychological issues were found in 13.8% of the participants. In terms of K6 profile, nervous, restless/fidgety, and “everything was an effort” were the three most frequently endorsed aspects. Having soft-tissue injuries had a 0.32-time lower likelihood of psychological distress compared to those having other injuries. Additionally, patients who were diagnosed with fractures were 4.5-times more likely to report psychological distress. Our finding highlights the need for psychological screening to reduce disabilities associated with non-fatal injury related to road traffic crashes.

Global Research on Quality of Life of Patients with HIV/AIDS: Is It Socio-Culturally Addressed? (GAPRESEARCH)

Article

Full-text available

Mar 2020
Int J Environ Res Publ Health

Quality of life (QOL) has been considered as an important outcome indicator in holistic care for HIV-infected people, especially as HIV/AIDS transforms from a fatal illness to a chronic condition. This study aimed to identify trends and emerging topics among research concerning the QOL of people living with HIV/AIDS (PLWHA). The analyzed data were English papers published from 1996 to 2017, searched and extracted from the Web of Science Core Collection. Collaborations between countries and the correlation between the keywords were visualized by VOSviewer while the abstracts’ content was analyzed using exploratory factor analysis and Jaccard’s’ similarity index. There has been an increase in both the number of publications and citations. The United Nations of America leads in terms of paper volume. The cross-nation collaborations are mainly regional. Despite a rather comprehensive coverage of topics relating to QOL in PLWHA, there has evidently been a lack of studies focusing on socio-cultural factors and their impacts on the QOL of those who are HIV-infected. Further studies should consider investigating the role of socio-cultural factors, especially where long-term treatment is involved. Policy-level decisions are recommended to be made based on the consideration of cultural factors, while collaborations between developed and developing nations, in particular in HIV/AIDS-ridden countries, are strongly recommended.

Physical, psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries

Article

Full-text available

Oct 2018
J SAFETY RES

Introduction: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. Methods: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), "Impact of Event Scale" (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of 'Direct' and 'Indirect' costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. Results: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50-64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65+ and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50-64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. Conclusions: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. Practical implications: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.

The effects of Muslim praying meditation and transcendental meditation programs on mindfulness among the University of Nizwa students

Article

Full-text available

Apr 2018

Basim Aldahadha

Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries

Article

Nov 2016

The current study aimed to follow-up a group of road crash survivors for one year and assesses the impact of injury on their psychological and physical condition. All crash survivors that were admitted to the intensive or sub-intensive care units of selected hospitals in Greece, Germany and Italy over one year period (2013–2014), were invited to participate in the study and were interviewed at three different time-points as follows: (a) at one month (baseline data), (b) at six months, and (c) at twelve months. The study used widely recommended classifications for injury severity (AIS, MAIS) and standardized health outcome measures such as the Disability Assessment Schedule II (WHODAS 2.0) to measure disability, “Impact of Event Scale” (IES-R) to measure Post-Traumatic Stress Disorder (PTSD), Center for Epidemiological Studies Depression Scale (CES-D Scale) to measure depression. A total of 120 patients were enrolled in the study in all the partner countries and 93 completed all follow up questionnaires. The risk of physical disability was 4.57 times higher [CI 1.98–2.27] at the first follow up and 3.43 times higher [CI 1.43–9.42] at the second follow up as compared with the time before the injury. There was a 79% and an 88% lower risk of depression at the first and the second follow up respectively, as compared with the baseline time. There was also a 72% lower risk of Post-Traumatic Stress at the second follow up as compared with the baseline time. A number of factors relevant to the individuals, the road crash and the injury, were shown to distinguish those at higher risk of long-lasting disability and psychological distress including age, marital status, type of road user, severity and type of the injury, past emotional reaction to distress. The study highlights the importance of a comprehensive and holistic understanding of the impact of injury on an individual and further underlines the importance of screening and treating psychological comorbidities in injury in a timely manner.

The Process of EMDR Therapy for Post-Traumatic Stress

Research

Full-text available

May 2016

Mark Andrew McFetridge

The Process of EMDR Therapy for Post-Traumatic Stress

Non-fatal Injury on Duty and Associations with Mental Health, Maladaptive Coping, and Sleep Disturbance among Police Officers.

Article

Full-text available

Jan 2014

Christine West

Police work involves exposure to multiple critical incident stressors including the risk of being seriously injured or killed. The objective of the research was to examine the prevalence, frequency, duration, and recency of injury leave and the association of injury with perceived stress, mental health, substance use, and sleep quality in U.S. police officers. Methods: The sample population for this study included all 430 active duty police officers from a mid-sized urban police department enrolled in a cohort study between 2004 and 2009. Self-reported measures of mental health and behavioral outcomes and injury leave data were available from work history data. Bivariate and multivariate regression analyses were conducted comparing mental health, behavioral, and sleep outcomes in officers with and without injury and by increasing number, length and recency of injury. Results: Nearly two-thirds of the participants had experienced an injury. Among those injured, 67 percent experienced more than one duty-related injury with an average of 3 injuries (range 1-12). The median number of days on leave due to a duty-related injury was 86 (range of 1-2250) with 41% having had more than 90 days leave. Although trending in the hypothesized direction, mean perceived stress, depression, PTSD, anxiety scores, smoking, and alcohol use were not statistically significantly associated with injury occurrence or length of injury. Mean perceived stress, PTSD, anxiety, and cigarettes smoked increased with increasing number of injuries. Poor sleep quality mediated the effect of injury on adverse psychological outcomes after controlling for age, sex, and rank. Poor sleep quality was significantly associated with having had an injury, number of injuries, and length of injury after adjustment. Conclusion: Findings suggest work-related injury is common and repeated work-related injuries are psychologically distressing and associated with poor sleep quality in U.S. police officers. Targeted and timely clinical and workplace interventions to prevent injuries, improve sleep quality, and psychological symptom development are needed. Future longitudinal studies should examine these outcomes with more injury-specific information, with other first responder groups, and in nationally representative datasets.

Predictors of Posttraumatic Stress Disorder and Symptoms in Adults: A Meta-Analysis

Article

Full-text available

Aug 2008

A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.

Acidentes rodoviários : perturbação aguda de stress e PTSD nas vítimas directas

Article

Full-text available

Jan 2004

Introdução A perturbação aguda de stress e a perturbação de stress pós-traumática (PTSD) constituem duas das perturbações contempladas no Manual de Diagnóstico e Estatística das Perturbações Mentais (APA, 1994). A estas perturbações está associada a exposição ou confronto com um acontecimento que envolveu ameaça de morte ou ferimentos e que despertou no indivíduo respostas de medo intenso. Existe assim uma relação na vivência de um determinado acontecimento de vida (considerado traumático) e as respostas a essa situação. Essas reacções, quando excessivas e intensas, podem influenciar significativamente o funcionamento do indivíduo nas diversas áreas da sua vida: família, emprego, relações sociais e interpessoais, saúde, e noutros contextos em que se esteja inserido. Os acidentes rodoviários constituem um destes acontecimentos de ameaça, que muitas vezes está associado a ferimentos e perdas. Outras vezes, não é só o próprio, mas também outros significativos que estão envolvidos nestas ameaças, o que contribui para os efeitos cumulativos. Para além das respostas de perturbação aguda de stress e PTSD, os indivíduos podem apresentar quadros de comorbilidade, onde a depressão e a ansiedade (nomeadamente ansiedade fóbica) são as mais frequentemente descritas.

Prognosis of Outcome in Adult Survivors of Road Accidents in France: One-Year Follow-Up in the ESPARR Cohort. Traffic Injury Prevention, vol 15(2), pages 138-147

Article

Feb 2014
Traffic Inj Prev

Objective: The consequences of road crashes are various, and few studies have dealt with the multidimensionality of outcomes. The aim of the present study was to assess the multidimensional nature of outcomes one year after a crash and to determine predictive factors that could help in adapting medical and social care to prevent such consequences to improve road crash victims' prognosis. Methods: The study population was the 886 respondents to the one-year follow-up from the ESPARR (Etude et Suivi d'une Population d'Accidentés de la Route du Rhône) cohort, aged ≥ 16 years; the analysis was carried out only on the 616 subjects who fully completed a self-report questionnaire on health, social, emotional, and financial status one year after a crash. Multiple correspondence analysis and hierarchical clustering was implemented to produce homogeneous groups according to differences in outcome. Groups were compared using the World Health Organization Quality of Life Assessment (WHOQOL-BREF, a standard instrument of quality of life, assessing physical health, psychological health, social relationships, and environment) and the Injury Impairment Scale (IIS), a tool to predict road crash sequelae. Baseline predictive factors for group attribution were analyzed by weighted multinomial logistic regression models. Results: Three hundred seventeen of the 616 subjects (60.1%) were men. Mean age was 36.9 years (SD = 16.5). Five victim groups were identified in terms of consequences at one year: one group (206 subjects, 33.4%) with few problems, one with essentially physical sequelae, one with problems that were essentially both physical and social, and 2 groups with a wider range of problems (one including psychological problems but fewer environmental problems; the last one reported negative physical, psychological, social, and environmental impact; notably, all had post-concussion syndrome [PCS]). There were significant differences between groups in terms of family status, injury severity, and certain types of injury (thorax, spine, lower limbs). Comparison on the WHOQOL-BREF confirmed that groups reporting more adverse outcomes had a lower quality of life. Description of the 5 groups by IIS indicators showed that IIS underestimated physical consequences one year after the crash. In addition to the known prognostic factors such as age, initial injury severity, and injury type, socioeconomic fragility and having a relative involved in the accident emerged as predictive of poor outcome at one year. Conclusions: One year after the crash, victims may still be experiencing multiple problems in terms of not only physical health but also of mental health, social life, and environment. Poor outcome may be predicted from both accident-related factors and socioeconomic fragility. Our results are useful in catching the attention of both clinicians and the public administration regarding victims at risk of suffering from important consequences after an accident. If those suffering head injuries are recognized, it would be very important to better consider and treat posttraumatic stress disorder (PTSD) or PCS. Furthermore, subjects from lower socioeconomic backgrounds, with or without lower limb injuries, have numerous difficulties after an accident, notably for returning to work. An objective would be to provide them with more specific support. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Staff Perception of Aggressive Behaviour in Community Services for Adults with Intellectual Disabilities

Article

Aug 2013
COMMUNITY MENT HLT J

Experiencing aggressive behaviour has been associated with increased stress and turnover among staff who support adults with intellectual disabilities. Incident perception is a strong predictor of psychological outcomes after trauma but has not been studied in this staff group. This study clustered exposure to aggression and endorsement of emotional difficulties among 386 community residential group home staff and evaluated the contribution of four behavioural topographies to staff-rated perceived severity. Staff exposure varied considerably. Perceived severity correlated with subjective emotional difficulties. High perceived severity was associated with daily exposure, aggression towards others causing injury, and property aggression causing injury or damage. Therefore, the role the staff plays, whether a witness or target, may impact their experience.

The Impact of Event Scale

Article

Oct 2003
J PSYCHOSOM RES

Objective: To validate an Italian version of the Impact of Event Scale (IES) in patients addressing the emotional impact of a recent road accident. Methods: Seventy-nine subjects were examined within 1–34 weeks after an accident by means of (1) an Italian version of the IES, (2) a free description of the accident, and (3) a questionnaire assessing subjects' behaviour and feelings. Results: IES data were analysed by means of the principal component analysis (PCA) method, followed by a quartimax rotation, obtaining a two-factor solution interpreted as intrusion (Factor 1) and avoidance (Factor 2). Furthermore, the scores to the two subscales were considered in order to assess their predictive value on some variables linked to the traumatic event. Intrusion significantly discriminated the emotional intensity and fear level of subjects as a consequence of the accident. Conclusions: The IES is a two-dimensional test capable of evaluating posttraumatic stress. The intrusion and avoidance factors explained 40% of the total variance. The two-factor solution has a psychological counterpart and is similar to the findings of earlier studies conducted on a larger number of subjects in other countries.

Coping with pos-traumatic stress: Young, middle-aged and elderly comparisons

Article

Apr 2004
INT J GERIATR PSYCH

Debate persists about whether people of different ages react similarly to traumatic events, and whether elderly people are more vulnerable to such events, or better able to cope with them. The first aim of this paper was to shed light on this debate by comparing the post-traumatic responses of young, middle-aged and elderly community residents who had been exposed to technological disasters. The second aim was to differentiate between these three age groups in terms of coping strategies. One hundred and forty-eight community residents, who were exposed to two technological disasters, participated in the study. They were assessed using the Impact of Event Scale (IES), the General Health Questionnaire (GHQ-28) and the Ways of Coping Checklists (WOC). The results showed that in terms of IES, GHQ and WOC scores, no significant differences were found across the three age groups. However, main effects were found according to type of disaster and intensity of exposure to disaster. One significant interaction effect was that residents exposed to the aircraft crash used significantly more confrontive coping than those exposed to the train collision, in all three age groups. Correlation coefficients results showed that for all three age groups, on the whole, the more they experienced intrusive thoughts and avoidance behaviour, the more they experienced general health problems. Following exposure to technological disasters, young, middle-aged and elderly community residents could display similar post-traumatic responses and employ similar coping strategies, which contradicts the vulnerability hypothesis and the inoculation hypothesis.

Outcomes one year after a road accident: Results from the ESPARR cohort. Accident Analysis & Prevention, vol 50(1), pages 92-102

Article

Jan 2013

The process of EMDR therapy for post-traumatic stress /

Article

Full-text available

Mark Andrew McFetridge

Thesis (D. Clin. Psychol.)--University of Leeds (School of Medicine), 2001.

Ozer EJ, Best SR, Lipsey TL, Weiss DS. Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129: 52-73

Article

Full-text available

Jan 2003

A maritime disaster: Reactions and follow-up

Article

Feb 2003
Int J Emerg Ment Health

In 1999, 69 people survived a maritime disaster on the Norwegian coast, during which 16 others died. Besides immediate psychosocial assistance, post-disaster intervention included psychological debriefings after one week, follow-up debriefing a month later, screening of those in need of individual help, and help for those returning to the scene of the disaster. The results of the psychometric tests showed that a considerable number of survivors scored above clinical cut-off points for extreme stress reactions. These results were compared with results from other studies of maritime disasters. Although the life threat and exposure in this disaster were extreme, the scores were lower than for the other studies, with one exception. The authors concluded the lower distress scores compared to other maritime disasters were probably impacted by the structured and caring system that was implemented to care for survivors. Almost all (93%) considered the debriefing meetings as helpful, and they were able to discriminate between different functions served by the meetings.

The Impact of Event Scale: validation of an Italian version

Article

Nov 2003
J PSYCHOSOM RES

To validate an Italian version of the Impact of Event Scale (IES) in patients addressing the emotional impact of a recent road accident. Seventy-nine subjects were examined within 1-34 weeks after an accident by means of (1). an Italian version of the IES, (2). a free description of the accident, and (3). a questionnaire assessing subjects' behaviour and feelings. IES data were analysed by means of the principal component analysis (PCA) method, followed by a quartimax rotation, obtaining a two-factor solution interpreted as intrusion (Factor 1) and avoidance (Factor 2). Furthermore, the scores to the two subscales were considered in order to assess their predictive value on some variables linked to the traumatic event. Intrusion significantly discriminated the emotional intensity and fear level of subjects as a consequence of the accident. The IES is a two-dimensional test capable of evaluating posttraumatic stress. The intrusion and avoidance factors explained 40% of the total variance. The two-factor solution has a psychological counterpart and is similar to the findings of earlier studies conducted on a larger number of subjects in other countries.

Association between resilience, social support, and institutional trust and post-traumatic stress disorder after natural disasters

Article

Apr 2022
ARCH PSYCHIAT NURS

Disasters can cause significant personal and social distress and adversely affect mental health. Compared with research on the risk factors of post-disaster post-traumatic stress disorder (PTSD), limited studies have reported protective factors against PTSD. We investigated whether resilience, social support, and trust in government were associated with PTSD in disaster survivors, after adjustment for the perceived damage and demographic variables including sex, age, and economic status. We investigated 2311 disaster survivors, using data from the “Long-term survey on the change of life of Disaster victim” performed by NDMI(National Disaster Management Research Institute). Hierarchical regression analysis was used in this study. A high level of trust in institutions was associated with few PTSD symptoms after adjustment for resilience and social support. Among the subfactors of institutional trust, psychological counseling and environmental and facility restoration were associated with PTSD. Psychological counseling and environmental and facility restoration support for disaster survivors were associated with reduced PTSD symptoms. Post-disaster policy support, including psychological counseling and environmental and facility restoration services, is important. Our findings highlight the protective factors against PTSD symptoms and may serve as guidelines for specific interventions for the management of post-disaster PTSD.

A preliminary investigation of alcohol use during trauma and peritraumatic reactions in female sexual assault victims

Article

Aug 2002
J TRAUMA STRESS

The purpose of these analyses was to investigate the association between reported alcohol use during a sexual assault and perceptions of assault severity and physical and emotional peritraumatic reactions. Self‐report data were collected on 57 sexually assaulted college women. Multivariate regression analyses revealed that perception of assault severity mediated the relationship between alcohol use and peritraumatic physical reactions.

A systematic review of the association between fault or blame-related attributions and procedures after transport injury and health and work-related outcomes

Article

Dec 2019

Attributions of fault are often associated with worse injury outcomes; however, the consistency and magnitude of these impacts is not known. This review examined the prognostic role of fault on health, mental health, pain and work outcomes after transport injury. A systematic search of five electronic databases (Medline, Embase, CINAHL, PsycINFO, Cochrane Library) yielded 16,324 records published between 2000 and January 2018. Eligibility criteria were: adult transport injury survivors; prospective design; multivariable analysis; fault-related factor analysed; pain, mental health, general health or work-related outcome. Citations (n = 10,558, excluding duplicates) and full text articles (n = 555) were screened manually (Reviewer 1), and using concurrent machine learning and text mining (Reviewer 2; using Abstrackr, WordStat and QDA miner). Data from 55 papers that met all inclusion criteria were extracted, papers were evaluated for risk of bias using the QUIPS tool, and overall level of evidence was assessed using the GRADE tool. There were six main fault-related factors classified as: fault or responsibility, fault-based compensation, lawyer involvement or litigation, blame or guilt, road user or position in vehicle, and impact direction. Overall there were inconsistent associations between fault and transport injury outcomes, and 60% of papers had high risk of bias. There was moderate evidence that fault-based compensation claims were associated with poorer health-related outcomes, and that lawyer involvement was associated with poorer work outcomes beyond 12 months post-injury. However, the evidence of negative associations between fault-based compensation claims and work-related outcomes was limited. Lawyer involvement and fault-based compensation claims were associated with adverse mental health outcomes six months post-injury, but not beyond 12 months. The most consistent associations between fault and negative outcomes were not for fault attributions, per se, but were related to fault-related procedures (e.g., lawyer engagement, fault-based compensation claims).

The Effect of Psychosocial Factors on Post Traumatic Stress Disorder (PTSD) Groups of Natural Disaster Victims

Article

Sep 2019

Trauma-informed supervision: Historical antecedents, current practice, and future directions

Article

Jan 2018

Carolyn Knight

In this article, the author traces the development of the current emphasis on trauma-informed practice and care in behavioral and mental health treatment. Using the discrimination model of clinical supervision, the author then discusses the application of trauma-informed principles to supervision. Relevant research is cited, and case examples are employed to illustrate critical roles, responsibilities, and tasks. Challenges and future directions also are identified.

Contribution à une meilleure compréhension du devenir des blessés de la route: évaluation à un an dans la cohorte ESPARR

Article

Dec 2012

Hoang T N V

Background: it is possible that victims can suffer from multiple problems after an accident, and this can be seen in the people with the most serious consequences. However, few studies allow us to know the profile and prognostic factors of severity of consequences after the accident in this population of victims. Moreover, there are few tools to predict 1-year post-traumatic sequelae in road crash victims. The thesis aims to determine subgroups of victims with similar outcomes 1 year after the crash and predictive factors for attribution to these subgroups and validate sequelae prediction by the Injury Impairment Score (IIS), in comparison with the one year outcomes. Methods: the thesis is a part of the broader ESPARR study based on the Rhône Registry of Road Traffic Casualties. The ESPARR cohort comprised 1,372 subjects, including 1,168 aged ≥16 years. Among 886 adult subjects who responded to a follow-up questionnaire one year later, the main analysis was carried out on 616 participants, who completed a self-report questionnaire on health, social, emotional and financial status 1 year after a crash. The multiple correspondence analysis and hierarchical clustering method was implemented to produce homogeneous road-crash victim subgroups according to differences in outcome. Baseline (time of accident) predictive factors for subgroup attribution were analysed on weighted multinomial logistic regression models. We used outcomes data at 1-year follow-up of road injury to validate the ability of IIS to predict sequelae. Results: there were 5 different victim subgroups in terms of consequences 1 year after the crash: the first presented few problems, the second had essentially physical sequelae, the next 2 subgroups presented many problems at various levels but with a lower proportion of psychological problems (the difference being due to financial repercussions), and the fifth showed a high proportion of psychological, physical, social and environment problems. As well as the known prognostic factors of age, initial injury severity and lesion type, socioeconomic fragility and the fact of a relative being involved in the accident emerged as being predictive of poor outcome one year later. IIS, in this injured population, failed to predict sequelae one year later as measured by real data. Conclusion: one year after a road accident, victims may still experience multiple problems in terms not only of physical health but also of mental health, social life and environment. Poor outcome may be predicted both from accident-related factors and from victims' socioeconomic fragility. These findings are useful in guiding prevention in terms not only of recovery of health status but also of recovery of social life in the best possible environment.

Mental disorders resulting from road traffic accidents

Article

Mar 2001

The present review, which covers the literature on psychological consequences of road traffic accidents (RTAs) published since 1999, identifies three major areas of research in this field. The first area represents prospective research studies that longitudinally assess the progression of mental disorders, primarily post-traumatic stress disorder, after RTAs. The second examines the effects of RTAs on child and adolescent populations. Finally, recent developments in the psychological treatment of post-traumatic stress disorder among RTA survivors are discussed. Such research has identified promising as well as detrimental interventions that have been developed to treat this population.

Prehospital Echocardiography — A New Diagnostic Tool for Pulselessness and Resuscitation Management

Article

Dec 2002

PTSD Severity and Cognitive Reactions to Trauma Among a College Sample

Article

Sep 2006

Two hundred twenty-one undergraduate education students were assessed to determine trauma history and cognitive responses to traumatic events. Participants completed a demographic questionnaire, the Cognitive Distortions Scale, and the PTSD Symptom Scale (for those reporting a trauma history). The most common types of traumatic events were domestic violence, natural disasters, and severe transportation accidents. Differences in cognitive distortions of individuals with and without a trauma history also were assessed. Individuals with a trauma history were significantly higher on Preoccupation with Danger and Self-Blame subscales. Number of previous traumatic events and the subscale of Preoccupation of Danger significantly predicted PTSD severity.

The Epidemiology of Posttraumatic Stress Disorder

Article

Jun 2009

p>Posttraumatic stress disorder (PTSD) is highly prevalent and has substantial economic and social consequences. In this article, we review the epidemiology of PTSD. We begin by summarizing the evidence about the prevalence and correlates of traumatic event exposure. Next, we discuss the prevalence of PTSD, the conditional probability of PTSD given specific traumatic event exposure, the correlates, and demographic distribution of PTSD, and the trajectory of PTSD over the life course. Lastly, we discuss the consequences of PTSD and the challenges facing this field of research today. ABOUT THE AUTHORS Jennifer Johnson, MPH, is with the Center for Global Health, University of Michigan, Ann Arbor. Andrea Maxwell, BS, is with the School of Medicine, University of Michigan. Sandro Galea, MD, DrPH, is with the Department of Epidemiology, School of Public Health, the Survey Research Center, Institute for Social Research, and the Center for Global Health, the University of Michigan. Address correspondence to: Sandro Galea, MD, DrPH, Department of Epidemiology, 109 Observatory St., Room 3633, Ann Arbor, MI 48109-2029; fax 734.763.5706; or e-mail sgalea@umich.edu . Ms. Johnson; Ms. Maxwell; and Dr. Galea have disclosed no relevant financial relationships. doi: 10.3928/00485713-20090514-01 EDUCATIONAL OBJECTIVES Identify the prevalence of traumatic exposure and posttraumatic stress disorder (PTSD) and their correlates in the general population and in special populations. Review research on the trajectory of PTSD. Discuss the challenges associated with PTSD research today. </p

Psykologiska och sociala effekter av trafikolycka med lindriga eller inga personskador

Article

Full-text available

A Phenomenological Analysis of Disaster-Related Experiences in Fire and Emergency Medical Services Personnel

Article

Full-text available

May 2012

This article explores the experiences of fire and Emergency Medical Services (EMS) personnel during and immediately after a technological event using a phenomenological approach. Personnel engaged in the rescue operations during and immediately after the Ghislenghien gas explosion reflected upon their experiences in their responses to a specially designed, self-reporting questionnaire that included open-ended questions. Firefighters reported more perceived threat and direct exposure to death than did EMS personnel. Qualitative analysis indicates that the central characteristics of this potentially traumatizing event were the suddenness and massiveness of the impact, and the fact that it involved young victims and/or multiple deaths. With regard to emotions, powerlessness, horror, fear, a sense of apocalypse, and grief were experienced by both firefighters and EMS personnel. Firefighters noted that the death of colleagues, the involvement of friends and family, the massive impact, and exposure to the burned victims were most shocking. Emergency Medical Services personnel and in-hospital staff reported the impact, the confrontation with death, the involvement of friends and family, and the pain, suffering, and screaming of burned victims as the most shocking aspects of this event. Qualitative differences in the lived experiences of firefighters, EMS personnel, and in-hospital staff might be explained by differences in life threat, contact with death, and various degrees of training. De Soir E, Knarren M, Zech E, Mylle J, Kleber R, Van der Hart O. A phenomenological analysis of disaster-related experiences in fire and Emergency Medical Services personnel. Prehosp Disaster Med. 2012;27(2):1-8.

World assumptions, coping and attributions

Article

May 2007
PERS INDIV DIFFER

The aim of this study was to examine cognitive processes in the context of measures of world assumptions (Janoff-Bulman, 1985), attributions (Peterson et al., 1982) and coping (Endler & Parker, 1990) within the broad context of appraisal. Using 270 participants, results showed that the coping measure was psychometrically sound, but that the other measures' factor structures were not fully supported. The measures appeared to be independent, indicating that these cognitive processes can be considered separate processes. World assumptions may be a useful contribution to the conceptualisation of appraisal but the measure needs improvement. (c) 2006 Published by Elsevier Ltd.

Preinjury Psychiatric Status, Injury Severity, and Postdeployment Posttraumatic Stress Disorder

Article

May 2011

Physical injury has been associated with the development of posttraumatic stress disorder (PTSD). Previous studies have retrospectively examined the relationship of preinjury psychiatric status and postinjury PTSD with conflicting results, but no prospective studies regarding this subject have been conducted, to our knowledge. To prospectively assess the relationship of predeployment psychiatric status and injury severity with postdeployment PTSD. Prospective, longitudinal study. United States military personnel deployed in support of the conflicts in Iraq and Afghanistan. United States service member participants in the Millennium Cohort Study who completed a baseline questionnaire (from July 1, 2001, through June 30, 2003) and at least 1 follow-up questionnaire (from June 1, 2004, through February 14, 2006, and from May 15, 2007, through December 31, 2008) and who were deployed in the intervening period. Self-reported health information was used to prospectively examine the relationship between baseline psychiatric status and follow-up PTSD in injured and uninjured deployed individuals. A positive screening result using the PTSD Checklist-Civilian Version. Of 22 630 eligible participants, 1840 (8.1%) screened positive for PTSD at follow-up, and 183 (0.8%) sustained a deployment-related physical injury that was documented in the Joint Theater Trauma Registry or the Navy-Marine Corps Combat Trauma Registry Expeditionary Medical Encounter Database. The odds of screening positive for PTSD symptoms were 2.52 (95% confidence interval, 2.01-3.16) times greater in those with 1 or more defined baseline mental health disorder and 16.1% (odds ratio, 1.16; 95% confidence interval, 1.01-1.34) greater for every 3-unit increase in the Injury Severity Score. Irrespective of injury severity, self-reported preinjury psychiatric status was significantly associated with PTSD at follow-up. Baseline psychiatric status and deployment-related physical injuries were associated with screening positive for postdeployment PTSD. More vulnerable members of the deployed population might be identified and benefit from interventions targeted to prevent or to ensure early identification and treatment of postdeployment PTSD.

Mediating role of peritraumatic dissociation and depression on post-MVA distress: Path analysis

Article

Mar 2011
DEPRESS ANXIETY

The aim of this study was to examine the role of pre-trauma, traumatic event, and peri-traumatic psychological characteristics on post-motor vehicle accident (MVA) Posttraumatic Stress Disorder (PTSD) and depression. The sample comprised 333 (54% female) hospital accident and emergency attendees who completed a self-report postal screening survey approximately 1-month post-accident and 128 (62% female) participants who completed a follow-up survey at 3-months. Path analysis (Model 1) showed that dissociation partially mediated the relationship between past emotional problems and initial post-MVA distress, as well as between fear of dying and levels of distress. Level of alertness and perceived accident severity had no direct effects on post-MVA distress. However, higher levels of exposure contributed to distress predominantly in the presence of high levels of fear and subsequent dissociative experiences. When ongoing PTSD and depression symptoms were included (Model 2), feeling depressed/sad at 1-month was the strongest predictor of both PTSD and depression symptom severity at 3-months post-MVA, explaining 53% and 40% of the variance, respectively. Dissociation remained an important mediating variable at both time points. These models show the influence of previous emotional vulnerability factors and the important mediating role of peri-traumatic experiences (in the presence of fear due to increased levels of accident severity) on post-MVA morbidity. Additionally, MVA survivors who report feeling depressed/sad 1-month after their accident are at greater risk of developing both PTSD and depression.

Short-term psychological consequences of car accidents: An empirical study

Article

Full-text available

Nov 2009
RIV PSICHIATR

Aim of this study is to investigate short-term (3 and 5 months) psychological consequences of severe motor-vehicle accidents. The sample under investigation is composed of two groups: 8 survivors of severe motor-vehicle accidents with spinal cord injuries (SCI) hospitalized in a Spinal Cord Unit, and 6 survivors who did not require hospitalization. All subjects were assessed twice, three and five months after the accident, on a variety of measures including the CAPS and the BDI-SF. Prevalence of PTSD in the total sample was, 3 months after the accident, 14% with no significant differences between the two groups; some peculiarities in the symptomathological profile emerged as much as subjects with SCI experience avoidance of trauma-related stimuli more frequently. An overall decline in frequency and severity of post-traumatic symptoms between the two assessments was observed in the total sample, though some components (Criterion C symptoms) showed no relevant variations over time. Finally, depressive symptoms, which were characterized by higher severity in the SCI group, showed a significant decline between the two assessments. Our data, although based on a limited sample, might help in tailoring psychological interventions for prevention and treatment of PTSD in survivors of severe motor accidents.

Making Sense of the Meaning Literature: An Integrative Review of Meaning Making and Its Effects on Adjustment to Stressful Life Events

Article

Full-text available

Mar 2010

Crystal L Park

Interest in meaning and meaning making in the context of stressful life events continues to grow, but research is hampered by conceptual and methodological limitations. Drawing on current theories, the author first presents an integrated model of meaning making. This model distinguishes between the constructs of global and situational meaning and between "meaning-making efforts" and "meaning made," and it elaborates subconstructs within these constructs. Using this model, the author reviews the empirical research regarding meaning in the context of adjustment to stressful events, outlining what has been established to date and evaluating the strengths and weaknesses of current empirical work. Results suggest that theory on meaning and meaning making has developed apace, but empirical research has failed to keep up with these developments, creating a significant gap between the rich but abstract theories and empirical tests of them. Given current empirical findings, some aspects of the meaning-making model appear to be well supported but others are not, and the quality of meaning-making efforts and meanings made may be at least as important as their quantity. This article concludes with specific suggestions for future research.

Israeli Civilians under Heavy Bombardment: Prediction of the Severity of Post-Traumatic Symptoms

Article

Full-text available

Oct 2009

The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage. Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived life threat and peri-traumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity. Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment. None Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived life threat, and peri-traumatic dissociation. The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p <0.01); more prior trauma, (p <0.01); more life threat, (p <0.01); and greater PTSD symptomatology (12 % of KY participants and 38% of KS participants had probable PTSD), compared to residents in the comparison town (Kfar Yona; KY). Both groups reported a similar degree of peri-event dissociation (KS: M = 7.2 +/-3.7; KY: M = 7.3 +/-3.0). Perceived life threat mediated the relationship between exposure to bombardment and PTSD symptomatology. Time spent in bomb shelters was not associated with PTSD symptom severity. Prior shelling-related trauma negatively predicted PTSD. The terror of bombardment is a risk factor for PTSD among civilians. Although there is considerable resilience in chronically threatened communities, it is prudent to develop and implement public health approaches to prevent those most distressed during and after attacks from developing PTSD. Because, to a small degree, prior trauma exposure buffers the response to bombardment, interventions should consider leveraging citizens' past successful coping.

PREDICTOR VARIABLES OF PSYCHOLOGýCAL DISTRESS AND PERCEIVED GROWTH FOLLOWING MOTOR VEHICLE ACCIDENTS

Article

AÞKIM SEVÝNÇ BÝROL

This study aimed to examine the predictor variables of psychological distress and perceived growth among the survivors of motor vehicle accidents. Demographic characteristics as pre-accident variables, cognitive appraisals of the accident as accident related factors, coping strategies and social support as post-accident variables were used as predictors of distress and perceived growth. 200 adults (142 males and 58 females, ages between 18 and 65) participated in the study. Data was collected by a questionnaire which consisted of four parts. Three trained interviewers who were undergraduate psychology students, administered the questionaire individually. The first part examined on socio-demographic variables. The second part explored variables related to the accident, such as the status of the survivor as driver or non-driver, existence of injury or death to others in the accident, treatment after the accident, duration of hospitalization. The third part focused on the subjects accident related appraisals such as perceived level of responsibility, fear, helplessness, danger, thinking of death to oneself or others, sense of control, perceived level of injury severity. The fourth part contained five scales. Psychological distress was assessed by Impact of Event Scale (IES). Coping strategies were assessed by Ways of Coping Questionnaire (WCQ). Stress Related Growth Scale (SRGS) was used to examine perceived growth. Social support was assessed via Social Support Scale and Depression scores of the participants were assessed by Beck Depression Inventory. The results revealed that the present sample was moderately distressed. The current distress level was significantly related to perceived growth. The general distress level was predicted by age, perceived threat and helplessness coping. Considering intrusive symptoms, age, not having social security entitlement, depression, perceived threat and helplessness coping were found to be significant predictors. Considering avoidant symptoms, years of education, depression and fatalistic coping were found to be significant predictors. Not having an insurance policy, perceived threat, optimistic/problem solving coping and fatalistic coping were found to be significant predictors of percieved growth following motor vehicle accident. The findings are discussed within psychological distress and perceived growth. Limitations of the study, directions for future research and clinical implications are proposed.

The Aberdeen Trauma Screening Index: An instrument to predict post-accident psychopathology

Article

Aug 2002

A key challenge in trauma care is the prevention of psychopathology. However, no definitive method of identifying individuals at risk of developing psychopathology exists. The Aberdeen Trauma Screening Index (ATSI) is a brief screening tool developed for use in a clinical setting by non-mental health professionals to facilitate the early identification of individuals most at risk of psychopathology 3-months post-accident. The ATSI derived from a prospective study of a 150 out of an initial pool of 213 consecutive admissions to the Orthopaedic Trauma Unit and the Accident and Emergency Department of Aberdeen Royal Infirmary. Potential predictors were identified by a comprehensive assessment conducted within 1-week post-accident. Outcome at 3-months post-accident was measured using 'caseness' according to the General Health Questionnaire (GHQ-28). The ATSI is based on a final model comprising only seven variables with a sensitivity of 79% and specificity of 65%. A predictive index score (0-100) was produced to ensure the practical utility of the ATSI in a clinical setting. A ROC curve was constructed to illustrate the relationship between sensitivity and the specificity values with their corresponding threshold scores. On the basis of a prevalence rate of 55% 'caseness', as identified in the present study, a cut-off point of 45 provides the optimal outcome with a sensitivity value of 70% and a specificity value of 71%. The ATSI can accurately identify those most at risk of developing psychopathology 3-months post-accident in a sample of accidentally injured adult subjects recruited as consecutive admissions to an urban hospital in the North East of Scotland. However, to establish the generalizability of these findings, it is important that the ATSI be validated in both similar and diverse populations.

A preliminary investigation of alcohol use during trauma and re-traumatic reactions in female sexual assault victims

Article

Sep 2002

The purpose of these analyses was to investigate the association between reported alcohol use during a sexual assault and perceptions of assault severity and physical and emotional peritraumatic reactions. Self-report data were collected on 57 sexually assaulted college women. Multivariate regression analyses revealed that perception of assault severity mediated the relationship between alcohol use and peritraumatic physical reactions.

Capacity of Screening Questionnaires to Predict Psychiatric Morbidity 18 Months After Motor Vehicle Accidents

Article

Oct 2003

Motor vehicle accidents are one of the most common causes of trauma-related psychiatric morbidity. Previous studies have suggested that symptom screening instruments may be useful in predicting risk of longer-term psychiatric morbidity, but results have varied. The present study is based on 83 of an eligible 102 consecutive hospital-admitted survivors of road trauma who completed a structured clinical interview at baseline and 18-month follow-up. A subsample returned symptom questionnaires within 2 weeks of the accident, with between 60 and 66 completing the questionnaire. Receiver Operator Characteristic curve analyses were applied to obtain optimal predictive scores on each screening measure. Combining the derived cutoff scores on the Impact of Event Scale (measuring posttraumatic stress disorder symptoms) and the Beck Depression Inventory yielded an odds ratio of 82.9 in predicting any psychiatric morbidity at 18 months, with a specificity of 95%, and high positive (89%) and negative (91%) predictive indices. If these exploratory findings are confirmed by future studies, the case will be strengthened for routine screening of motor vehicle accident survivors to allow ongoing monitoring and selective early interventions for the high-risk subgroup. Compliance with completing and returning questionnaires remains a major challenge in this population, however, as indicated by the level of attrition in our study.

Traumatic stress in late pregnancy

Article

Feb 2004
J ANXIETY DISORD

Traumatic stress has traditionally been studied in the aftermath of traumatic events. In contrast, this study aimed to explore if traumatic stress can occur before an event that is perceived as threatening or feared. Traumatic stress, as related to the forthcoming delivery, was studied in 1224 women. Background data and psychological characteristics were assessed in early pregnancy and traumatic stress and fear of childbirth in late pregnancy. Of all subjects, 2.3% met all DSM-IV criteria for posttraumatic stress disorder (PTSD) and 5.8% fulfilled criteria B, C, and D in late pregnancy. Traumatic stress and fear of childbirth correlated significantly. High trait anxiety, depressive symptomatology, psychological/psychiatric counseling related to childbirth, and self-reported psychological problems, measured in early pregnancy, were risk factors for traumatic stress and fear of childbirth in late pregnancy. Results suggest the occurrence of "pre"traumatic stress (i.e., a threatening forthcoming event provoking symptoms similar to those after a traumatic event).

Prediction of Psychological Health After an Accidental Burn

Article

Sep 2004
J TRAUMA

Burn victims often display psychological symptoms that can impede recovery, but knowledge about risk factors for psychopathology is limited. This study aimed to predict psychological health 3 months after burn injury from coping and trauma-related factors assessed early in hospitalization. For this study, 34 burn patients were interviewed during hospitalization about their accident and coping. Questionnaires were administered during hospitalization and 3 months after the burn including the Impact of Event Scale-Revised for posttraumatic stress symptoms (intrusion, avoidance, arousal) and the Hospital Anxiety and Depression Scale for mood. Anxiety, depressive, and avoidant symptoms at 3 months were highly predicted by baseline levels of these symptoms and avoidant coping. The life threat at the burn event predicted intrusive and arousal symptoms, and coping by self-control predicted less intrusive symptoms. Burn severity was not predictive of psychological health. Coping style, life threat during the accident, and early symptoms are strong predictors of psychopathology after a burn.

Psychological distress after assaults and accidents

Article

Full-text available

Nov 1990

Psychological Predictors of Chronic Posttraumatic Stress Disorder After Motor Vehicle Accidents

Article

Full-text available

Aug 1998

A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.

Undiagnosed post‐traumatic stress disorder following motor vehicle accidents

Article

Oct 1993

Objectives To determine the pattern of emergence of post‐traumatic stress disorder (PTSD) among motor vehicle accident victims and to examine the influence of PTSD on subsequent levels of disability. Design A longitudinal study of motor vehicle accident victims one month and 18 months after the accident. Subjects Twenty‐four motor vehicle accident victims admitted by the trauma team at the Royal Adelaide Hospital. A 52% response rate was achieved. Main outcome measures Posttraumatic stress disorder as diagnosed by the Diagnostic Interview Schedule and disability as measured with the Sickness Impact Profile. Results Eighteen months after their accidents, six of the 24 subjects had clinically significant PTSD and one was considered borderline. None had been previously diagnosed or treated. The group with PTSD had higher scores on all measures of psychological distress one month after the accident and were more likely to use immature psychological defences. There was no association between physical outcome (measured with the modified Glasgow Outcome Scale) at six months and subsequent diagnosis of PTSD. However, the group with PTSD had higher levels of disability on assessment with the Sickness Impact Profile, particularly in the domain of social functioning. The results suggest PTSD was associated with work‐related dysfunction equal to that associated with severe physical handicap. Conclusion The data from this pilot study suggest that PTSD after motor vehicle accidents is an important cause of disability, which may also become the focus for damages in litigation. Thus, there is a need for further investigation of the early patterns of distress and to design preventive programs for victims of road accidents. (Med J Aust 1993; 159: 529‐534)

One year prospective follow up of motor vehicle accident victims

Article

Oct 1996
BEHAV RES THER

One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.

A Scaled Version of the General Health Questionnaire

Article

Mar 1979

SYNOPSIS This study reports the factor structure of the symptoms comprising the General Health Questionnaire when it is completed in a primary care setting. A shorter, 28-item GHQ is proposed consisting of 4 subscales: somatic symptoms, anxiety and insomnia, social dysfunction and severe depression. Preliminary data concerning the validity of these scales are presented, and the performance of the whole 28-item questionnaire as a screening test is evaluated. The factor structure of the symptomatology is found to be very similar for 3 independent sets of data.

Impact of Event Scale: A Measure of Subjective Stress

Article

Jun 1979

Clinical, field, and experimental studies of response to potentially stressful life events give concordant findings: there is a general human tendency to undergo episodes of intrusive thinking and periods of avoidance. A scale of current subjective distress, related to a specific event, was based on a list of items composed of commonly reported experiences of intrusion and avoidance. Responses of 66 persons admitted to an outpatient clinic for the treatment of stress response syndromes indicated that the scale had a useful degree of significance and homogeneity. Empirical clusters supported the concept of subscores for intrusions and avoidance responses.

The PTSD Interview: Rationale, description, reliability, and concurrent validity of a DSM-III-based technique

Article

Apr 1991

This paper describes the PTSD Interview (PTSD-I). It was developed to meet four specifications: (a) close correspondence to DSM-III standards; (b) binary present/absent and continuous severity/frequency outputs on each symptom and the entire syndrome; (c) administrable by trained subprofessionals; and (d) substantial reliability and validity. It was written to meet the first three criteria. It demonstrated very high internal consistency (alpha = .92) and test-retest reliability (Total score r = .95; diagnostic agreement = 87%). It correlated strongly with parallel DIS criteria (Total score vs. DIS diagnosis rbis = .94, sensitivity = .89, specificity = .94, overall hit rate = .92, and kappa = .84). Earlier studies revealed correlations with a military stress scale and Keane et al.'s MMPI PTSD subscale. It is apparently the only PTSD instrument that meets all of the above criteria.

Posttraumatic Stress Disorder in Victims of Motor Vehicle Accidents

Article

Apr 1989
Hosp Community Psychiatr

Allan Burstein

This paper describes some of the difficulties in identifying victims of motor vehicle accidents who may be suffering from PTSD and discusses some particularly problematic subgroups among those patients. In addition, a strategy for treating patients once they are identified is suggested. The recommendations offered in this paper are tentative because the characteristics of PTSD were formally delineated only eight years ago and knowledge about the illness continues to grow.

The Impact of severity of physical injury and perception of life threat in the development of post traumatic stress disorder in motor vehicle accident victims

Article

Jul 1995
BEHAV RES THER

For 98 victims of recent (1 to 4 months post-accident) motor vehicle accidents who sought medical attention as a result of the accident, we obtained data on the extent of physical injury using blind ratings with the Abbreviated Injury Scale (AIS), as well as victims reports of their perceptions of how much danger they perceived at the time of the accident and the degree of life threat (fear of dying) they perceived. AIS scores significantly predicted (P < 0.01) development of post-traumatic stress disorder (PTSD) (r point biserial = 0.302) and development of post-traumatic stress symptoms (PTSS) (r = 0.311) as did perception of life threat (r point biserial = 0.294 for PTSD and r = 0.229 for PTSS). A multiple regression equation combining AIS and life threat accounted for 12.2% of variance in PTSS scores.

Psychiatric Morbidity Associated with Motor Vehicle Accidents

Article

Sep 1995

The primary purpose of this report was to determine the extent of psychiatric morbidity and comorbidity among a sample of recent victims of motor vehicle accidents (MVAs) in comparison to a nonaccident control population. Victims of recent MVAs (N = 158), who sought medical attention as a result of the MVA, were assessed in a University-based research clinic, 1 to 4 months after the accident for acute psychiatric and psychosocial consequences as well as for pre-MVA psychopathology using structured clinical interviews (Clinician-Administered PTSD Scale, SCID, SCID-II, LIFE Base). Age- and gender-matched controls (N = 93) who had had no MVAs in the past year served as controls. Sixty-two MVA victims (39.2%) met DSM-III-R criteria for posttraumatic stress disorder (PTSD), and 55 met DSM-IV criteria. The MVA victims who met the criteria for PTSD were more subjectively distressed and had more impairment in role function (performance at work/school/homemaking, relationships with family or friends) than the MVA victims who did not meet the PTSD criteria or the controls. A high percentage (53%) of the MVA-PTSD group also met the criteria for current major depression, with most of that developing after the MVA. A prior history of major depression appears to be a risk factor for developing PTSD after an MVA (p = .0004): 50% of MVA victims who developed PTSD had a history of previous major depression, as compared with 23% of those with a less severe reaction to the MVA. A prior history of PTSD from earlier trauma also is associated with developing PTSD or a subsyndromal form of it (25.2%) (p = .0012). Personal injury MVAs exact substantial psychosocial costs on the victims. Early intervention, especially in vulnerable populations, might prevent some of this.

Psychiatric Consequences of Road Traffic Accidents

Article

Oct 1993

To determine the psychiatric consequences of being a road traffic accident victim. Follow up study of road accident victims for up to one year. Emergency department of the John Radcliffe Hospital, Oxford. 188 consecutive road accident victims aged 18-70 with multiple injuries (motorcycle or car) or whiplash neck injury, who had not been unconscious for more than 15 minutes, and who lived in the catchment area. Present state examination "caseness"; post-traumatic stress disorder and travel anxiety; effects on driving and on being a passenger. Acute, moderately severe emotional distress was common. Almost one fifth of subjects, however, suffered from an acute stress syndrome characterised by mood disturbance and horrific memories of the accident. Anxiety and depression usually improved over the 12 months, though one tenth of patients had mood disorders at one year. In addition, specific post-traumatic symptoms were common. Post-traumatic stress disorder occurred during follow up in one tenth of patients, and phobic travel anxiety as a driver or passenger was more common and frequently disabling. Emotional disorder was associated with having pre-accident psychological or social problems and, in patients with multiple injuries, continuing medical complications. Post-traumatic syndromes were not associated with a neurotic predisposition but were strongly associated with horrific memories of the accident. They did not occur in subjects who had been briefly unconscious and were amnesic for the accident. Mental state at three months was highly predictive of mental state at one year. Psychiatric symptoms and disorder are frequent after major and less severe road accident injury. Post-traumatic symptoms are common and disabling. Early information and advice might reduce psychological distress and travel anxiety and contribute to road safety and assessing "nervous shock."

Undiagnosed post-traumatic stress disorder following motor vehicle accidents

Article

Nov 1993

To determine the pattern of emergence of post-traumatic stress disorder (PTSD) among motor vehicle accident victims and to examine the influence of PTSD on subsequent levels of disability. A longitudinal study of motor vehicle accident victims one month and 18 months after the accident. Twenty-four motor vehicle accident victims admitted by the trauma team at the Royal Adelaide Hospital. A 52% response rate was achieved. Post-traumatic stress disorder as diagnosed by the Diagnostic Interview Schedule and disability as measured with the Sickness Impact Profile. Eighteen months after their accidents, six of the 24 subjects had clinically significant PTSD and one was considered borderline. None had been previously diagnosed or treated. The group with PTSD had higher scores on all measures of psychological distress one month after the accident and were more likely to use immature psychological defences. There was no association between physical outcome (measured with the modified Glasgow Outcome Scale) at six months and subsequent diagnosis of PTSD. However, the group with PTSD had higher levels of disability on assessment with the Sickness Impact Profile, particularly in the domain of social functioning. The results suggest PTSD was associated with work-related dysfunction equal to that associated with severe physical handicap. The data from this pilot study suggest that PTSD after motor vehicle accidents is an important cause of disability, which may also become the focus for damages in litigation. Thus, there is a need for further investigation of the early patterns of distress and to design preventive programs for victims of road accidents.

Who develops PTSD from motor vehicle accidents?

Article

Jan 1996
BEHAV RES THER

Within 1 to 4 months of their motor vehicle accident (MVA), we assessed 158 MVA victims who sought medical attention as a result of the MVA. Using the Clinician-Administered PTSD Scale (CAPS: Blake, Weathers, Nagy, Kaloupek, Klauminzer, Charney & Keane, 1990. National Center for Post-Traumatic Stress Disorder, Boston, MA)., we found that 62 (39%) met DSM-III-R (American Psychiatric Association, 1987. Washington, DC: American Psychiatric Press) criteria for Post-Traumatic Stress Disorder. Using variables from the victim's account of the accident and its sequelae, pre-MVA psychosocial functioning, demographic variables, pre-MVA psychopathology and degree of physical injury, we found that 70% of the subjects could be classified as PTSD or not with 4 variables: prior major depression, fear of dying in the MVA, extent of physical injury and whether litigation had been initiated. Using multiple regression to predict the continuous variable of total CAPS score, as a measure of post-traumatic stress symptoms, we found that 8 variables combined to predict 38.1% of variance (Multiple R = 0.617).

Blanchard EB, Hickling EJ, Barton KA, Taylor AE. One-year prospective follow-up of motor vehicle accident victims. Behav Res Ther 34: 775-786

Article

Nov 1996
BEHAV RES THER

Motor vehicle accident survivors and PTSD

Jan 1998
1

Blanchard E. B.

Blanchard, E. B., & Hickling, E. J. (1998). Motor vehicle accident survivors and PTSD. PTSD Research Quarterly, 9(3), 1-6.

Jan 1991
179

Watson

Accident cognitions and subsequent psychological trauma

Abstract

No full-text available

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Accident cognitions and subsequent psychological trauma