Psychological distress following a road accident : Investigation of two neglected road-user groups

Abstract

Road traffic accidents are common sources of trauma experienced by adults, adolescents, and children. Trauma may arise as a direct result of physical injury, may occur due to experiencing perceived threat to one's life or physical self, or may develop due to witnessing death or injury to others. While there has been growing interest in the development of psychological distress, including post-traumatic stress disorder (PTSD), phobias, and adjustment disorder, among survivors of road accidents, there has been no systematic investigation of cyclists involved in road accidents and little specific research into child and adolescent road accident victims. In regard to cyclists, the first of these under-researched groups, study one investigated the occurrence of psychological distress in New Zealand adult cycling victims. In 1999, 619 cyclists were injured on New Zealand roads, with 86 of these accident victims from the Christchurch region. A sample of 27 Christchurch adult cyclists, who had been involved in an accident with a motor vehicle, at least one month prior to the interview, completed a structured interview and number of questionnaires. Results indicated that one third of the participants suffered ongoing psychological distress following their accident. Implications for mental health, personal wellbeing, and potential costs to the community are discussed. Study two examined the occurrence of psychological distress in New Zealand child and adolescent road accident survivors. In 2000, 1216 under-15 year-olds were injured on New Zealand roads. A national sample of 19 young people (8-17 year-olds) and their parents completed a variety of assessment measures, including a structured clinical interview in 16 cases. Of the 16 interviewed child/adolescent survivors, 19% were diagnosed with PTSD, and 69% exhibited some significant, enduring psychological distress following their accident. Implications for mental health, educational attainment, family adjustment, and personal wellbeing are discussed. Part three considered the need for secondary prevention for young road accident victims, including as a priority, means for the identification and recognition of young, road accident survivors who are at risk of developing psychopathology following a road accident. To this end, a draft of a screening guide to enable teachers and medical practitioners to identify these young at risk, road accident victims was developed.