The Impact of Social Support on the Relationship between Trauma History and PTSD Symptoms in Motor Vehicle Accident Victims

The present study examined how different types of social support differentially moderated the relationship between trauma history characteristics and the development of posttraumatic stress disorder symptoms (PTSS) following a motor vehicle accident (MVA). Two hundred thirty-five MVA victims self-reported levels of social support and trauma history, and were evaluated for PTSS 6- and 12-months post-MVA. Results indicated that after controlling for gender, injury severity and income, number of prior trauma types and subjective responses to prior traumatization predicted subsequent PTSS (ps < .05). Appraisal social support was a significant moderator of the total number of types of trauma (appraisal: 6-months β = -.16, p < .05; 12-months β = -.17, p < .05) and subjective physical injury during the prior trauma (appraisal: 6-months β = -.14, p < .05; 12-months β = -.19, p < .05) in predicting PTSS. Results underscore the importance of examining both trauma history and social support as multi-dimensional constructs and suggest merit to addressing social support in trauma victims with a prior trauma history.     

Holding it together: Coping with vicarious trauma in sport

ObjectivesVicarious trauma refers to the negative effects that may be experienced after witnessing trauma (such as actual or threatened injury) in others. This study aims to examine vicarious trauma in sports coaches by drawing on the experiences of two trampoline coaches who have witnessed a serious athletic injury. In particular, this study focuses on how these coaches have responded to and coped with this traumatic event.DesignThe study draws on data from thematic, semi-structured, life history interviews that focus on the occurrence of one particular sports accident witnessed by both coaches.MethodMultiple interviews were conducted in which participants were invited to recall the accident, their own responses to the accident, and the coping strategies employed. Interviews were analyzed using a holistic-content analysis in which thematic similarities and differences between the narratives emerged.ResultsThere were three main themes that emerged, these were the need to make meaning following trauma, re-experiencing trauma, and acceptance and avoidance coping. Participants demonstrated the individual nature of coping with trauma. While one participant avoided the trauma by minimizing the events, blocking her emotions and giving support to others; the second participant showed acceptance of the trauma, was highly emotional, and received support from others.ConclusionsThis study demonstrates the difficulties that may be faced by coaches following vicarious trauma. Although each coach presents different experiences and coping strategies they provide some indications of the level and type of support that may be required after witnessing athletic injury.     

事故后飞行员心理健康状况动态研究

目的 研究飞行事故后,事故发生单位飞行员心理健康状况在时间维度上的变化规律。方法 采用症状自评量表（Symptom Checklist 90,SCL-90）对飞行事故发生单位的78名飞行员,于事故发生后3天、15天、2月以及6月进行调查分析。结果 飞行事故后,事故发生单位飞行员出现严重的急性心理应激反应,早期以躯体化为主,后期以焦虑、抑郁等负性情绪为主。结论 飞行事故后,应加强心理危机干预,消除和减轻飞行员的心理应激反应。     

Judgements of compensation for misfortune: The role of expectation

In three questionnaire studies, we asked subjects how much compensation should be provided, by a third party, to an accident victim. We tested the hypothesis, derived from norm theory, that compensation would be greater when the injury was less to be expected, e.g. when the injury was caused by failure - as opposed to success - of a safety routine. To rule out the possibility that such expectation effects depended on subjects' anticipations of the reactions of the parties involved in the accident. the parties were said to be ignorant of factors that could affect these reactions. Effects of expectation were still found, even when subjects themselves judged the accident to be equally serious in all conditions. Information about what would have happened in the absence of the cause (e.g. if the routine had succeeded instead of failed) affected compensation. as predicted by norm theory, but expectation effects were found even when this information about counterfactuals was held constant, so norm theory cannot account for all the results. We suggest that subjects are applying simple heuristics unreflectively Subjects may also have attempted to fulfil an implicit social contract through their awards. The results cannot be explained through the hypothesis that compensation was optimal: the accident was the same, and it had no deterrent effect, so optimal compensation should be the same in all cases.     

Longitudinal study of quality of life in acquired brain injury: A self- and proxy-report evaluation

Background/ObjectiveAfter an acquired brain injury (ABI), the person remains with several impairments and disabilities that cause a decrease in his/her quality of life (QoL), which could change over time. The objective of the study was to analyse the evolution patterns of QoL in a sample of persons with ABI for one-year as well as the differences in proxy- and self-report versions of a QoL instrument. Method: The sample comprised 402 persons with ABI with ages ranging between 18 and 91 years, whom 36.20% had had the accident recently (i.e., three years or less). Patients, professionals and relatives responded at three evaluation points to the CAVIDACE scale, an ABI-specific QoL tool. Results: ANOVAs showed an improvement in QoL in the two follow-ups; the improvement was especially significant in the period between baseline and six months. The respondent factor did not interact with the evaluation time, but significant differences were found between respondents, with scores of patients higher than that for proxies. Finally, the QoL’s evolution interacts with the time elapsed since injury, showing significant improvements in the most recent group (i.e., three years or less). Conclusions: QoL must be considered from the earliest moments after ABI to obtain more significant improvements.     

Personality of children with accident‐related injuries

Previous studies based on a variety of behaviour, temperament, and personality measures identified a pattern of over‐activity, impulsiveness, emotional instability, and aggressiveness in children who are prone to accidents. The present study is the first to study accident‐prone children by means of a comprehensive test for the assessment of the Five Factor model (Hierarchical Personality Inventory for Children (HiPIC) (Mervielde & De Fruyt, 1999 ). 118 children, aged 6–15 years, who were hospitalized due to an accident‐related injury, were contrasted with 184 school‐children of the same age. Lower socio‐economic status was under‐represented in both groups. Children who were exposed to accidents had higher scores on the facets of energy, optimism, and non‐shyness (Extraversion domain), and lower scores on the facets of concentration and achievement striving (Conscientiousness domain). There was no indication of higher aggressiveness, impulsiveness, or emotional instability in the group exposed to accidents, and there were no gender‐by‐accident interactions. Results suggest that there is a relatively benign pattern of personality traits that is related to greater accident hazard in children. Copyright © 2003 John Wiley & Sons, Ltd.     

港口门机事故驾驶员与非事故驾驶员身心素质比较

采用ＹＧ人格测验量表、团体智力筛选测验量表、复杂划消测验、双手调节器及深度知觉仪对港口门机事故驾驶员和非事故驾驶员所进行的研究表明：两组门机驾驶员在１２项人格特征以及智力、选择反应能力上未显示出显著性差异;事故组门机驾驶员双手协调及注意分配能力和深度知觉能力明显低于非事故组门机驾驶员;技能水平与事故之间存在显著的正相关．     

The Potential Transformation of Our Species by Neural Enhancement

ABSTRACT. Neural enhancement represents recovery of function that has been lost due to injury or disease pathology. Restoration of functional ability is the objective. For example, a neuroprosthetic to replace a forearm and hand lost to the ravages of war or industrial accident. However, the same basic constructs used for neural enhancement after injury could amplify abilities that are already in the natural normal range. That is, neural enhancement technologies to restore function and improve daily abilities for independent living could be used to improve so-called normal function to ultimate function. Approaching that functional level by use and integration of technology takes us toward the concept of a new species. This new subspecies—homo sapiens technologicus—is one that uses technology not just to assist but to change its own inherent biological function. The author uses examples from prosthetics and neuroprosthetics to address the issue of the limitations of constructs on the accepted range of human performance ability and aims to provide a cautionary view toward reflection on where our science may take the entire species.     

Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study

The purpose of the present study was to gather prospective longitudinal data on the long-term course and outcome of chronic posttraumatic stress disorder (PTSD). The target population for this study was 74 injured traffic accident victims who had been previously followed-up for one year after the trauma. Nineteen of the original 24 PTSD subjects (79%) and 39 of the original 50 Non-PTSD subjects (78%) were available for this study, which took place during the fourth year after the accident. Our results show that 10 (53%) of the 19 patients with PTSD at one-year still suffered from PTSD after another two-year follow-up interval, while 9 recovered from PTSD during this follow-up period. Only 2 of the 39 without PTSD at one year developed delayed onset PTSD. The best predictor of recovery from chronic PTSD was the initial level of posttraumatic reaction immediately after the accident. These results demonstrate that spontaneous recovery from PTSD can occur even among patients who are currently considered chronic. Severity of initial reaction to the trauma appears to be a major risk factor for non-remitting chronic PTSD.     

Decision-making deficit of a patient with axonal damage after traumatic brain injury

Patients with traumatic brain injury (TBI) were reported to have difficulty making advantageous decisions, but the underlying deficits of the network of brain areas involved in this process were not directly examined. We report a patient with TBI who demonstrated problematic behavior in situations of risk and complexity after cerebral injury from a traffic accident. The Iowa gambling task (IGT) was used to reveal his deficits in the decision-making process. To examine underlying deficits of the network of brain areas, we examined T1-weighted structural MRI, diffusion tensor imaging (DTI) and Tc-ECD SPECT in this patient. The patient showed abnormality in IGT. DTI-MRI results showed a significant decrease in fractional anisotropy (FA) in the fasciculus between the brain stem and cortical regions via the thalamus. He showed significant decrease in gray matter volumes in the bilateral insular cortex, hypothalamus, and posterior cingulate cortex, possibly reflecting Wallerian degeneration secondary to the fasciculus abnormalities. SPECT showed significant blood flow decrease in the broad cortical areas including the ventromedial prefrontal cortex (VM). Our study showed that the patient had dysfunctional decision-making process. Microstructural abnormality in the fasciculus, likely from the traffic accident, caused reduced afferent feedback to the brain, resulting in less efficient decision-making. Our findings support the somatic-marker hypothesis (SMH), where somatic feedback to the brain influences the decision-making process.     

Elucidating the psychosocial context of ‘post‐concussion syndrome’ (PCS): a case study from post‐Milan systemic family therapy

The literature on post‐concussion syndrome (PCS) following mild head injury includes biopsychosocial formulations. However, it is contended that the complexities of the psychosocial remain conceptually underdeveloped. An engagement with this complexity is presented via a case study from post‐Milan systemic family therapy. The work described is with grandparents, a mother and daughter. The latter two both initially experienced PCS following a road traffic accident, yet demonstrated contrasting outcomes in the year post‐injury. Implications for family therapy services and the wider literature are discussed.     

Emotional and pain-related factors in neuropsychological assessment following mild traumatic brain injury

A critical issue in the field of clinical neuropsychology is the idea that emotional or pain-related factors may compromise the validity of neuropsychological assessment. In this study, 53 individuals suffering from mild traumatic brain injury related to motor vehicle accident injury completed commonly used measures of emotional and pain-related functioning. A battery of commonly used neuropsychological tests, assessing attention, learning and memory, language, visuospatial and visuomotor functions, speeded processing, fine-motor skill, and symptom validity, was administered concurrently. Findings revealed a significant and negative correlation between anxiety and impaired delayed verbal memory, suggesting that as anxiety increased, delayed verbal memory decreased. The results otherwise provided little support for the idea that emotional or pain-related factors are detrimental to neuropsychological test performance following mild traumatic brain injury.     

创伤事件的痛苦程度对创伤后成长的影响：核心信念挑战的作用

采用创伤事件终身经历问卷—学生版、核心信念量表、创伤后成长评定量表,对3所大学进行问卷调查,探索具体创伤事件痛苦程度与创伤后成长(PTG)的关系,并检验核心信念挑战在其中的中介作用。结果发现：(1)家人患病或死亡类的创伤事件痛苦程度可负向预测PTG,并以核心信念挑战为中介;(2)目睹他人或自身相关的创伤事件痛苦程度和自身受虐待类的创伤事件痛苦程度可正向预测PTG,并以核心信念挑战为中介;(3)自然灾害类的创伤事件痛苦程度和家庭冲突类的创伤事件痛苦程度与核心信念挑战和PTG都无显著相关。因此不同领域的创伤事件痛苦程度引发创伤后成长的可能性不同。     

Driver's avoidance characteristics to hazardous situations: A driving simulator study

When analyzing the causes of an accident, it is critical to determine whether the driver could have prevented the accident. In previous studies on the reaction times of drivers, the definition and values of reaction times vary, so applying reaction time is difficult. In such analysis, the driver’s reaction time from perception is required to determine whether the driver could have prevented the accident, but past studies are difficult to utilize in accident analysis as reaction time measurements were taken after the occurrence of hazardous situations. In this study, 93 subjects from age groups ranging from 20 s to 40 s participated in an experiment inside a full-scale driving simulator, to determine reaction time values that can be practically applied to accident analysis. A total of 4 hazardous accident situations were reproduced, including driving over the centerline, pedestrian jaywalking, a vehicle cutting in, and intersection traffic signal violation. The Time-To-Collision (TTC) was 2.5 s and the driving speed was set to the common city road speed limits of 60 and 80 km/h. An eye tracker was used to determine the driver’s Saccade Latency (SL) during hazardous situations. Brake Reaction Time from Perception (BRT_P), Steer Reaction Time from Perception (SRT_P), and Driver Reaction Time from Perception (DRT_P) were derived, and the measurements were statistically analyzed to investigate differences by age group, gender, speed, and type of hazardous situation. Most participants were found to avoid collisions by braking first rather than steering for the presented hazardous situations, except for the cutting in situation. Also, to determine a reaction time that would cover most drivers, the 85th percentile of DRT_P was calculated. The 85th percentile of DRT_P was in the range of 0.550 – 0.800 s. Specifically for each hazardous situation, it was 0.650 s for driving over the centerline, 0.800 s for the pedestrian jaywalking, 0.660 s for cutting in, and 0.550 s for the intersection traffic signal violation. For all 4 hazardous situations combined, the 85th percentile of DRT_P was 0.646 s. The findings can be utilized to determine the driver’s likelihood of avoiding accidents when faced with similar hazardous situations.     

Evidence for the Altruistic Personality from Data on Accident Research

ABSTRACT The aim of this study was to test whether the concept of an altruistic personality was valid for first aiders who intervened to help the victims of a traffic accident. We derived a number of relevant personality variables that should be related to the willingness to administer first aid. These include locus of control, social responsibility, belief in a just world, empathy, and instrumentality. We obtained data from proven first aiders who had intervened after a traffic accident. Thirty-four of these first aiders were matched to respondents from a subject pool on the basis of sex, age, and socioeconomic status. In addition, the willingness of these respondents to offer help after a traffic accident was taken into account. Only people who indicated that they had witnessed an accident and had not helped were included in the control group. Multivariate analyses of variance and covariance indicated that proven first aiders deviated from the control group on several dimensions: They described themselves as more internal, believed more in a just world, and emphasized more social responsibility and empathy.     

Cognitive predictors of posttraumatic stress disorder in children: results of a prospective longitudinal study

The present study explored whether cognitive factors specified in the Ehlers and Clark model (Behav. Res. Ther. 38 (2000) 319) of posttraumatic stress disorder (PTSD) predict chronic PTSD in children who had experienced a road traffic accident. Children were assessed at 2 weeks, 3 months, and 6 months after the accident. Data-driven processing during the accident, negative interpretation of intrusive memories, alienation from other people, anger, rumination, thought suppression and persistent dissociation at initial assessment predicted PTSD symptom severity at 3 and 6 months. On the basis of sex and stressor severity variables, 14% of the variance of PTSD symptoms at 6 months could be explained. The accuracy of the prediction increased to 49% or 53% when the cognitive variables measured at initial assessment or 3 months, respectively, were taken into account.     

Safety culture,safety management and accident risk in trucking companies

The Safety ladder for goods transport describes an approach with an increasing prevalence of safety structural measures at four Safety ladder levels in trucking companies. This paper validates the Safety ladder approach in empirical research by comparing safety structure, safety culture and accident risk for trucking companies. The study has four aims: 1) To map the safety structure at the different levels of the Safety ladder, 2) Examine whether safety culture is improved with increased structural measures at each Safety ladder level, 3) Examine whether the accident risk decreases at each Safety ladder level, and 4) Discuss practical implications. The study is based on survey data (N = 533) from 17 companies at different levels of the Safety ladder, a Reference sample, and qualitative interviews (N = 30) with management and employee representatives in the companies. Based on the interviews, we describe the safety structural measures at each level of the Safety ladder. Survey results indicate increasing safety culture scores at each level of the Safety ladder, while the accident risk decreases. The safety culture level was 12 points higher at Level 4, than in the Reference sample, and the accident risk at Level 4 was half the risk of Level 2. We conclude by suggesting the concrete management practices related to each level. Thus, the current study identifies and describes management practices in trucking companies that are associated with high safety culture scores and low accident risk.     

Posttraumatic stress disorder after motor vehicle accidents: 3-year follow-up of a prospective longitudinal study

The paper presents a 3-year follow-up of a prospective longitudinal study of posttraumatic stress disorder (PTSD) after motor vehicle accidents (J. Abnormal Psychol., 107 (1998) 508). Participants were 546 patients who had been assessed when attending an emergency clinic shortly after a motor vehicle accident, and at 3 months and 1 year afterwards. The prevalence of posttraumatic stress disorder PTSD at 3 years was 11%. Maintaining psychological factors, i.e. negative interpretation of intrusions, rumination, thought suppression and anger cognitions, were important in predicting the persistence of PTSD at 3 years, as were persistent health and financial problems after the accident. Other predictors were female sex, hospital admission for injuries, perceived threat and dissociation during the accident, and litigation.     

Cross-cultural comparison of drivers’ tendency to commit different aberrant driving behaviours

The first aim of the present study was to identify key items which are rated differently by drivers from Finland, Sweden, Greece and Turkey. The second aim was to examine how these key items relate to drivers’ self-reported accident involvement. Similar comparisons have previously been conducted in Europe but these have only included items classified as violations and errors, but not lapses. A sample of Finnish (N = 200), Swedish (N = 200), Greek (N = 200) and Turkish (N = 200) drivers completed the driver behaviour questionnaire (DBQ) and reported their accident involvement during the previous 3 years. The results showed that nine key items (which drivers from different countries rated differently) could be identified. These items included two aggressive violations, four ordinary violations, three lapses, but no errors. Out of these nine items, five items (Become angered by a certain type of driver and indicate your hostility by whatever means you can, Disregard the speed limit on a motorway, Overtake a slow driver on the inside, Pull out of a junction so far that the driver with right of way has to stop and let you out and Get into the wrong lane approaching a roundabout or a junction) could explain differences in drivers’ self-reported yearly accident involvement when all four countries were taken together. At the same time, none of the items could explain differences in self-reported yearly accident involvement in Finland and Sweden while one of the items (Overtake a slow driver on the inside) could explain differences in self-reported yearly accident involvement in Greece and two of the items (Become angered by a certain type of driver and indicate your hostility by whatever means you can and Disregard the speed limit on a residential road) could explain differences in self-reported yearly accident involvement in Turkey. This shows that different countries have different problems with regard to aberrant driving behaviours which need to be taken into account when promoting traffic safety interventions and the driver behaviour questionnaire (DBQ) can be used to diagnose risk areas and to better inform road safety practitioners within and between countries.