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| Assessment of psychological crisis among the injured from a serious road traffic accident |
| TANG Luhan, WANG Heqiu, ZHANG Ying, SHEN Fang, GUO Zhongwei, JIANG Bo, WANG Ping, WEI Honghui, XU Fangzhong
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| Department of Clinical Psychology, Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang 310012, China |
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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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Received: 31 May 2022
Revised: 25 July 2022
Published: 30 September 2022
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[1] American Psychiatric Association.Diagnostic and statistical manual of mental disorders[M] .5th ed.Washington D.C.:American Psychiatric Association,2013.
[2] BRYANT R A.The current evidence for acute stress disorder [J/OL] . Curr Psychiatry Rep, 2018, 20 (12)[2022-07-25]. https://10.1007/s11920-018-0976-x.
[3] LI X,SUN L,LI Q,et al.Prediction of posttraumatic stress disorder by acute stress disorder in traffic accident survivors[J] .Turk J Med Sci,2021,51:2502-2509.
[4] BRYANT R A,HARVEY A G.Gender differences in the relationship between acute stress disorder and posttraumatic stress disorder following motor vehicle accidents[J].Aust N Z J Psychiatry,2003,37(2):226-229.
[5] 李秀丽,车力凡,郭秀红.交通事故伤后急性应激障碍预测后期应激障碍的价值[J].山东医药,2012,52(31):87-89.
LI X L,CHE L F,GUO X H.The value of acute stress disorder after traffic accident injury in predicting late stage stress disorder[J].Shandong Med J,2012,52(31):87-89.
[6] VISSER E,DEN OUDSTEN B L,LODDER P,et al.Psychological risk factors that characterize acute stress disorder and trajectories of posttraumatic stress disorder after injury:a study using latent class analysis[J/OL].Eur J Psychotraumatol,2022,13(1)[2022-07-25].https://doi.org/10.1080/20008198.2021.2006502.
[7] WANG L,LI Z Q,SHI Z B,et al.Factor structure of acute stress disorder symptoms in Chinese earthquake victims:a confirmatory factor analysis of the acute stress disorder scale[J].Pers Individ Differ,2010,48(7):798-802.
[8] 付琳,程锦,刘正奎.芦山地震后儿童急性应激障碍症状、创伤后应激障碍症状与抑郁症状的交叉滞后分析[J].中国心理卫生杂志,2017,31(7):548-553.
FU L,CHENG J,LIU Z K.Cross-lagged analysis of acute stress disorder,posttraumatic stress disorder and depressive symptoms among children after Lushan earthquake[J].Chin Ment Health J,2017,31(7):548-553.
[9] 刘瑞安,黄垒,李小麟,等.168名芦山地震伤员急性应激障碍发生情况及影响因素分析[J].护理学报,2015,22(19):22-26.
LIU R A,HUANG L,LI X L,et al.Prevalence of acute stress reaction among victims from Lushan earthquake and its influence factors[J].J Nurs,2015,22(19):22-26.
[10] 张月儿,张骏,葛汾汾,等.交通事故幸存者急性应激症状及相关因素[J].中国心理卫生杂志,2019,33(3):203-207.
ZHANG Y E,ZHANG J,GE F F,et al.Acute stress symptoms and related factors of traffic accident survivors[J].Chin Ment Health J,2019,33(3):203-207.
[11] KARAM E,SAAB D,AL BARATHIE J,et al.Predictors and severity of probable acute stress disorder following the Beirut Port Blast[J/OL].Eur J Psychotraumatol,2022,13(1)[2022-07-25].https://doi.org/10.1080/20008198.2022.2040232.
[12] GEOFFRION S,GONCALVES J,ROBICHAUD I,et al.Systematic review and meta-analysis on acute stress disorder:rates following different types of traumatic events[J].Trauma Violence Abuse,2022,23(1):213-223.
[13] DAI W J,LIU A Z,KAMINGA A C,et al.Prevalence of acute stress disorder among road traffic accident survivors:a meta analysis[J/OL].BMC Psychiatry,2018,18[2022-07-25].https://doi.org/10.1186/s12888-018-1769-9.
[14] PORCHERET K,IYADURAI L,BONSALL M B,et al.Sleep and intrusive memories immediately after a traumatic event in emergency deparrtment patients[J/OL].Sleep,2020,43(8)[2022-07-25].https://doi.org/10.1093/sleep/zsaa033.
[15] GROSSMAN E S,HOFFMAN Y S,SHRIRA A.Trauma-related context increase sleep disturbances in people with acute stress disorder symptoms[J/OL].Stress Health,2017,33(2)[2022-07-25].https://doi.org/10.1002/smi.2679.
[16] VISSER E,DEN OUDSTEN B L,LODDER P,et al.Psychological risk factors that characterize acute stress disorder and trajectories of post-traumatic stress disorder after injury:a study using latent class analysis[J/OL].Eur J Psychotraumatol,2022,13(1)[2022-07-25].https://doi.org/10.1080/20008198.2021.2006502.
[17] VIANA A G,PAULUS D J,BAKHSHAIE J,et al.Emotional nanacceptance within the context of traumati event exposure:the explanatory role of anxiety sensitivity foro traumatic stress symptoms and disability among Latinos in a primary care setting[J].Gen Hosp Pstchiatry,2017,44:30-37.
[18] BOISCLAIR DEMARBLE J,FORTIN C,D'ANTONO B,et al.Gender differences in the prediction of acute stress disorder from peritraumatic dissociation and distress among victims of violent crimes[J].J Interpers Violence,2020,35(5/6):1229-1250.
[19] KIM S Y,YANG K,OH I H,et al.Incidence and direct medical cost of acute stress disorder and post-traumatic stress disorder in Korea:based on national health insurance service claims data from 2011 to 2017[J/OL].J Korean Med Sci,2021,36(18)[2022-07-25].https://doi.org/10.3346/jkms.2021.36.e125.
[20] BRIERE J,DIAS C P,SEMPLE R J,et al.Acute stress symptoms in seriously injured patients:precipitating versus cumulative trauma and the contribution of peritraumatic distress[J].J Trauma Stress,2017,30(4):381-388.
[21] 武涧松,黄兆同,王凤香,等.汶川地震山区幸存成人急性应激障碍回顾性分析[J].中国健康心理学杂志,2017,25(8):1121-1125.
WU J S,HUANG Z T,WANG F X,et al.Retrospective analysis on ASD of adults survived Wenchuan earthquake in mountainous area[J].China J Health Psychol,2017,25(8):1121-1125. |
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