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Abstract
Background:
Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease
and lead to subsequent post-traumatic stress disorder (
PTSD). However, the relevan
tliteratureoriginatesin
only a few countries, and much remains unknown abo
ut MVC-related PTSD prevalence and predictors.
Methods:
Data come from the World Mental Health Survey In
itiative, a coordinated series of community
epidemiological surveys of mental disorders throu
ghout the world. The subset of 13 surveys (5 in high
income countries, 8 in middle or low income countr
ies) with respondents reporting PTSD after life-
threatening MVCs are considered here. Six classes o
f predictors were assessed: socio-demographics,
characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent
history of prior mental disorders. Logistic regre
ssion was used to examine predictors of PTSD. Mental
disorders were assessed with the fully-structured Compos
ite International Diagnostic Interview using DSM-IV
criteria.
Results:
Prevalence of PTSD associated with MVCs percei
ved to be life-threatening was 2.5 % overall and
did not vary significantly across countries. PTSD was significantly associated with low respondent education,
someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior
MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly
predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having
highest PTSD risk.
Conclusion:
Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases
occur among the relatively small proportion of people with highest predicted risk. This raises the question whether
MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based
on predictors assessed in the immediate aftermath of the MVCs |
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