A longitudinal follow-up of posttraumatic stress: from 9 months to 20 years after a major road traffic accident
Tóm tắt
Although 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. This 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. Stress 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 (p s < .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. The 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.
Tài liệu tham khảo
Swedish National Board of Health and Welfare: Attendance at Accident and Emergency Departments due to injuries - Statistics from the Injury Database (IDB) Sweden, 2008 [Swedish]. Stockholm, Sweden. 2009
Kahana SY, Feeny NC, Youngstrom EA, Drotar D: Posttraumatic stress in youth experiencing illnesses and injuries: an exploratory meta-analysis. Traumatology. 2006, 12: 148-161. 10.1177/1534765606294562.
Stallard P, Velleman R, Baldwin S: Prospective study of post-traumatic stress disorder in children involved in road traffic accidents. BMJ. 1998, 317: 1619-1623.
American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 2000, Washington: American Psychiatric Association, 4
Bryant B, Mayou R, Wiggs L, Ehlers A, Stores G: Psychological consequences of road traffic accidents for children and their mothers. Psychol Med. 2004, 34: 335-346. 10.1017/S0033291703001053.
Mayou R, Tyndel S, Bryant B: Long-term outcome of motor vehicle accident injury. Psychosom Med. 1997, 59: 578-584.
Stallard P, Velleman R, Baldwin S: Children involved in road traffic accidents: psychological sequelae and issues for mental health services. Clin Child Psychol Psychiatry. 2001, 6: 23-39. 10.1177/1359104501006001004.
American Psychiatric Association: Diagnostic and statistical manual of mental disorders. 1987, Washington: American Psychiatric Association, 3
Olofsson E, Bunketorp O, Andersson AL: Children and adolescents injured in traffic - associated psychological consequences: a literature review. Acta Paediatr. 2009, 98: 17-22. 10.1111/j.1651-2227.2008.00998.x.
Ehlers A, Clark DM: A cognitive model of posttraumatic stress disorder. Behav Res Ther. 2000, 38: 319-345. 10.1016/S0005-7967(99)00123-0.
Foa EB, Steketee G, Rothbaum BO: Behavioral/cognitive conceptualizations of post-traumatic stress disorder. Behav Ther. 1989, 20: 155-176. 10.1016/S0005-7894(89)80067-X.
Kassam-Adams N, Winston FK: Predicting child PTSD: the relationship between acute stress disorder and PTSD in injured children. J Am Acad Child Adolesc Psychiatry. 2004, 43: 403-411. 10.1097/00004583-200404000-00006.
Gillies ML, Barton J, Di Gallo A: Follow-up of young road accident victims. J Trauma Stress. 2003, 16: 523-526. 10.1023/A:1025774915005.
Le Brocque RM, Hendrikz J, Kenardy JA: The course of posttraumatic stress in children: examination of recovery trajectories following traumatic injury. J Pediatr Psychol. 2010, 35: 637-645. 10.1093/jpepsy/jsp050.
Yule W, Bolton D, Udwin O, Boyle S, O'Ryan D, Nurrish J: The long-term psychological effects of a disaster experienced in adolescence: I: the incidence and course of PTSD. J Child Psychol Psychiatry. 2000, 41: 503-511. 10.1111/1469-7610.00635.
Morgan L, Scourfield J, Williams D, Jasper A, Lewis G: The Aberfan disaster: 33-year follow-up of survivors. Br J Psychiatry. 2003, 182: 532-536. 10.1192/bjp.182.6.532.
Simon GE, VonKorff M: Recall of psychiatric history in cross-sectional surveys: implications for epidemiologic research. Epidemiol Rev. 1995, 17: 221-227.
Milgram NA, Toubiana YH, Klingman A, Raviv A, Goldstein I: Situational exposure and personal loss in children's acute and chronic stress reactions to a school bus disaster. J Trauma Stress. 1988, 1: 339-352. 10.1002/jts.2490010306.
Tyano S, Iancu I, Solomon Z, Sever J, Goldstein I, Touvtana Y, Bleich A: Seven-year follow-up of child survivors of a bus-train collision. J Am Acad Child Adolesc Psychiatry. 1996, 35: 365-373. 10.1097/00004583-199603000-00019.
Winje D, Ulvik A: Confrontations with reality: crisis intervention services for traumatized families after a school bus accident in Norway. J Trauma Stress. 1995, 8: 429-444. 10.1002/jts.2490080306.
Winje D: Psychological adjustment after severe trauma: a longitudinal study of adults' and children's posttraumatic reactions and coping after the bus accident in Måbødalen, Norway, 1988. PhD thesis. 1998, University of Bergen, Department of Clinical Psychology
Pynoos RS, Frederick C, Nader K, Arroyo W, Steinberg A, Eth S, Nunez F, Fairbanks L: Life threat and posttraumatic stress in school-age children. Arch Gen Psychiatry. 1987, 44: 1057-1063.
Sveen J, Low A, Dyster-Aas J, Ekselius L, Willebrand M, Gerdin B: Validation of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients with burns. J Anxiety Disord. 2010, 24: 618-622. 10.1016/j.janxdis.2010.03.021.
Weiss DS, Marmar CR: The Impact of Event Scale-Revised. Assessing Psychological Trauma and PTSD. Edited by: Wilson JP, Keane TM. 1997, New York: Guilford Press, 399-411.
Horowitz M, Wilner N, Alvarez W: Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979, 41: 209-218.
Goldberg DP: The Detection of Psychiatric Illness by Questionnaire: Maudsley Monograph No.21. 1972, London, England: Oxford University Press
Nilsson KW, Leppert J, Simonsson B, Starrin B: Sense of coherence and psychological well-being: improvement with age. J Epidemiol Community Health. 2010, 64: 347-352. 10.1136/jech.2008.081174.
Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C: The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997, 27: 191-197. 10.1017/S0033291796004242.
Furukawa T, Goldberg DP: Cultural invariance of likelihood ratios for the General Health Questionnaire. Lancet. 1999, 353: 561-562. 10.1016/S0140-6736(98)05470-1.
Goldberg DP, Williams P: A User's Guide to the General Health Questionnaire. 1988, Windsor, England: NFER-Nelson
Bergh Johannesson K, Lundin T, Hultman CM, Lindam A, Dyster-Aas J, Arnberg F, Michel P-O: The effect of traumatic bereavement on tsunami-exposed survivors. J Trauma Stress. 2009, 22: 497-504.
Prigerson HG, Maciejewski PK, Reynolds CF, Bierhals AJ, Newsom JT, Fasiczka A, Frank E, Doman J, Miller M: Inventory of Complicated Grief: a scale to measure maladaptive symptoms of loss. Psychiatry Res. 1995, 59: 65-79. 10.1016/0165-1781(95)02757-2.
Prigerson H: Complicated grief. Bereave Care. 2004, 23: 38-40.
Neria Y, Gross R, Litz B, Maguen S, Insel B, Seirmarco G, Rosenfeld H, Suh EJ, Kishon R, Cook J, Marshall RD: Prevalence and psychological correlates of complicated grief among bereaved adults 2.5-3.5 years after September 11th attacks. J Trauma Stress. 2007, 20: 251-262. 10.1002/jts.20223.
Arnberg F, Eriksson N-G, Hultman C, Lundin T: Traumatic bereavement, acute dissociation and posttraumatic stress: a 14-year follow-up of the MS Estonia disaster. J Trauma Stress.
Wild CJ, Seber GAF: Comparing two proportions from the same survey. Am Stat. 1993, 47: 178-181. 10.2307/2684972. Erratum in: Am Stat 1994, 48: 269-269
Lacey GN: Observations on Aberfan. J Psychosom Res. 1972, 16: 257-260. 10.1016/0022-3999(72)90007-4.
Bolton D, O'Ryan D, Udwin O, Boyle S, Yule W: The long-term psychological effects of a disaster experienced in adolescence: II: general psychopathology. J Child Psychol Psychiatry. 2000, 41: 513-523. 10.1111/1469-7610.00636.
Lichtenthal WG, Cruess DG, Prigerson HG: A case for establishing complicated grief as a distinct mental disorder in DSM-V. Clin Psychol Rev. 2004, 24: 637-662. 10.1016/j.cpr.2004.07.002.
Winje D, Ulvik A: Long-term outcome of trauma in children: the psychological consequences of a bus accident. J Child Psychol Psychiatry. 1998, 39: 635-642. 10.1017/S0021963098002479.
Hussain A, Weisaeth L, Heir T: Nonresponse to a population-based postdisaster postal questionnaire study. J Trauma Stress. 2009, 22: 324-328. 10.1002/jts.20431.
Lundin T, Jansson L: Traumatic impact of a fire disaster on survivors--a 25-year follow-up of the 1978 hotel fire in Borås, Sweden. Nord J Psychiatr. 2007, 61: 479-485. 10.1080/08039480701773329.