Smith, Benjamin J; (2000) Prevalence, aetiology and maintenance of poor psychological morbidity following a minor road traffic accident: A prospective longitudinal study. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

The current study aimed to investigate the prevalence, aetiology and maintenance of poor psychological morbidity following a minor road traffic accident (RTA). A prospective longitudinal research design was employed and participants completed assessments within one month of their RTA and three months later. It was anticipated that, in accordance with published empirical evidence, participants would report clinically significant levels of anxiety, depression and Post-Traumatic Stress Disorder (PTSD). Informed by recent cognitive conceptualisations of PTSD (e.g. Ehlers and Clark, 2000; Brewin et al., 1996) it was hypothesised that a number of psychological factors would predict and maintain PTSD. It was found that in this sample of minor-RTA victims clinically significant levels of anxiety, depression and PTSD were present. Further examination revealed that PTSD could be significantly predicted by a number of independent variables. Anxiety sensitivity, immediate post-traumatic reaction and peri-traumatic dissociation were all found to predict PTSD. Negative interpretation of symptoms, rumination and thought suppression (taken together) were found to heavily mediate the relationships of all these predictive factors with follow-up PTSD. These maintenance factors were the only variables to independently and significantly predict follow-up PTSD. The results reinforce the importance of both negative attribution and avoidant coping in the persistence of PTSD and a number of clinical and theoretical implications are discussed.

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