A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident

Abstract

BackgroundAlthough road traffic accidents (RTA) are a major cause of injury and a cause of posttraumatic stress (PTS) in the aftermath, little is known about the long-term psychological effects of RTA.MethodsThis prospective longitudinal study assessed long-term PTS, grief, and general mental health after a bus carrying 23 sixth-grade schoolchildren crashed on a school outing and 12 children died. Directly affected (i.e., children in the crash) and indirectly affected children (i.e., all pupils in the sixth grade who were not in the crash) were surveyed at 9 months (N = 102), 4 years (N = 51), and 20 years (N = 40) after the event. Psychological distress was assessed by single items, including sadness, avoidance, intrusions, and guilt. After 20 years, PTS was assessed by the Impact of Event Scale-Revised.ResultsStress reactions were prevalent 9 months after the event, with sadness (69%) and avoidance (59%) being highly represented in both directly and indirectly affected groups, whereas, nightmares (60%) and feelings of guilt (50%) were only frequent in those directly affected. The frequency of sadness and avoidance decreased after 4 years in the indirectly exposed (ps < .05). After 20 years, the directly affected had a higher prevalence of PTS (p = .003), but not decreased general mental health (p = .14), than those indirectly affected.ConclusionsThe limitations preclude assertive conclusions. Nonetheless, the findings corroborate previous studies reporting traumatic events are associated with long-term PTS, but not with decreased general mental health.

Sleep Disturbance in Pediatric PTSD: Current Findings and Future Directions

“…38,41,43,44,52 Other studies do not distinguish between disturbance of individuals who have been exposed to a trauma and individuals who have developed PTSD. 32,39,42,45 In addition, the nature, intensity, and duration of the trauma experienced by the populations vary greatly across studies. Some subjects directly experienced a traumatic event, while others were witnesses.…”

“…27,41,44 Arnberg et al found that 50% of a group of sixth-grade children (ages 11 to 12 years) who were involved in a serious bus accident reported nightmares 9 months after the accident, compared to only 8% of indirectly affected children (classmates of the children in the crash). 45 Cumulatively, these data strongly indicate high prevalence of nightmares among children exposed to trauma ( Table 2). However, it should be noted that use of control groups is rare in these studies.…”

The association between positive screen for future persistent posttraumatic stress symptoms and injury incident variables in the pediatric trauma care setting

“…8Y12 Without intervention, PTSD has been found to persist for months or years in children. 13,14 The trauma care setting provides a unique environment for screening of potential PTS in children and adolescents after an injury. Trauma care providers and staff have the unique advantage of accessing peritraumatic information salient to the prediction of future PTSD in children.…”

Measuring situations that stress Mexicans while driving

“…Research on stress and driving has centered on: terrorist attacks and an increase in mortality rates in traffic accidents (Su et al, 2009), traffic accident survivors and PTSD (Aleksandra et al, 2010;Wu, Chan, & Yiu, 2008), PTSD on long term basis in major traffic accidents (Amberg, Rydelius, & Lundin, 2011). Research in Mexico has focused on natural and technological catastrophes (López-Vázquez & Marván, 2003, 2004, 2012, as well as labor conditions imposed on public transportation workers (Espinosa-Yañez, 2012;Lima-Aranzaes, Juárez-García, & Arias-Galicia, 2012;Rodriguez-Chica & Vite-San-Pedro, 2012).…”