Abstract：Objective To investigate psychological and behavioral responses and the prevalence of acute stress disorder (ASD) among the injured from a serious road traffic accident. Methods The injured persons at ages of 7 years and older from a serious road traffic accident were enrolled, and individuals with severe injury were exclude. Participants' gender, age, educational level, marital status, injury severity, family member's injury and death during the accident and psychological and behavioral status were collected. The prevalence of ASD was estimated using a semi-structured interview and the ASD Scale, and the factors affecting the development of ASD were identified using a multivariable logistic regression model. Results A total of 132 survivors participated in psychological crisis assessment, including 82 men (62.12%) and 50 women (37.88%) and with a mean age of (46.50±18.57) years. There were 6 participants without obvious trauma (4.54%), 113 with mild injury (85.61%) and 13 with moderate injury (9.85%), and there were 6 participants with death of their family members during this accident. Insomnia, anxiety, flashback and fear were predominant psychological and behavioral responses, with prevalence rates of 42.42%, 35.58%, 26.52% and 23.48%, respectively. The prevalence of ASD was 30.30% among participants, and a higher rate of ASD was detected among women than among men (52.00% vs. 17.07%; χ2=17.940, P<0.001). The detection of ASD was higher among participants with death of their family members than among those without death of their family members (83.33% vs. 26.98%; χ2=8.370, P=0.004), and a higher detection rate of ASD was seen among participants with moderate injury (61.54%; χ2=6.786, P=0.034). Multivariable logistic regression analysis showed a higher risk of ASD among females (OR=7.764, 95%CI: 3.187-18.915) and those with a high educational level (high school/technical secondary school, OR=6.896, 95%CI: 1.030-46.152; diploma and above, OR=71.583, 95%CI: 4.145-1 236.270). Conclusions Insomnia and anxiety are predominant psychological and behavioral responses following serious road traffic accidents, and women and individuals with a high educational level present a high risk of ASD, which requires to be given timely psychological crisis interventions.
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