Prediction of posttraumatic stress disorder by immediate reactions to trauma: a prospective study in road traffic accident victims

Abstract

Road traffic accidents often cause serious physical and psychological sequelae. Specialists of various medical faculties are involved in the treatment of accident victims. Little is known about the factors which might predict psychiatric disorders, e.g. Posttraumatic Stress Disorder (PTSD) after accidents and how psychological problems influence physical treatment. In a prospective study 179 unselected, consecutively admitted road traffic accident victims were assessed a few days after the accident for psychiatric diagnoses, severity of injury and psychopathology. All were inpatients and had to be treated for bone fractures. At 6-months follow-up assessment 152 (85%) of the patients were interviewed again. Of the patients, 18.4% fulfilled the criteria for Posttraumatic Stress Disorder (DSM-III-R) within 6 months after the accident. Patients who developed PTSD were injured more severely and showed more symptoms of anxiety, depression and PTSD a few days after the accident than patients with no psychiatric diagnosis. Patients with PTSD stayed significantly longer in the hospital than the other patients. Multiple regression analysis revealed that the length of hospitalization was due mainly to a diversity of factors such as severity of injury, severity of accident, premorbid personality and psychopathology. Posttraumatic stress disorder is common after road traffic accidents. Patients with PTSD at follow-up can be identified by findings from early assessment. Untreated psychological sequelae such as PTSD cause longer hospitalization and therefore more costs than in non-PTSD patients.

Pathways to intrusive memories in a trauma analogue paradigm: a structural equation model

“…Those findings are consistent with a body of clinical literature suggesting that preexisting emotional states increase an individual's risk of developing PTSD symptoms [e.g., [11][12][13]15] ]. The truly prospective measure of preexisting vulnerabilities afforded by this analogue research strengthens earlier clinical findings, which generally relied on recalled pretrauma emotional status.…”

Posttraumatic Syndromes in Children and Adolescents after Road Traffic Accidents – A Prospective Cohort Study

“…The high predictive value of the initial range of symptoms in view of later psychological problems has been revealed in a number of studies for adult accident victims [32][33][34] and has now been confi rmed for child victims by our fi ndings. The second model emphasises the clinical importance of including the assessment of peritraumatic symptoms in children and adolescents after traumatic events and the need for standardized instruments for this age group.…”

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

“…Trauma severity most significantly predicted PTSD severity, followed by posttrauma interpersonal connection, and pretrauma conduct disorder in a study of prisoners of war [61]. Severity of injury was also related to PTSD diagnosis 6 months after MVAs in another study [62]. In a community sample of survivors of severe TBI, a PTSD symptom report was not related to TBI severity, survivors' educational background, preinjury or current IQ (intelligence quotient), or memory impairment.…”