One-year prospective follow-up of motor vehicle accident victims. Behav Res Ther

Center for Stress and Anxiety Disorders, University at Albany-SUNY 12203, USA.
Behaviour Research and Therapy (Impact Factor: 3.85). 11/1996; 34(10):775-86. DOI: 10.1016/0005-7967(96)00038-1
Source: PubMed

ABSTRACT One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.

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    • "Australia 355 9 months Minor & severe PCL (DSM-IV [63]) 29 Blanchard [72] USA 132 1 year Sought medical attention CAPS (DSM-IV [25]) 14 Koren [73] Israel 102 1 year Hospitalized, mild to moderate SCID (DSM-III-R [43]) 26 Green [74] "
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    ABSTRACT: Posttraumatic stress disorder (PTSD) is one of the most common psychological consequences for adult road traffic crash (RTC) survivors and can have serious and long-lasting consequences for recovery if left untreated. Prevalence rates of PTSD following a RTC vary from 6% to 45% (based on 51 prevalence estimates across 35 studies). Explanations for this wide variance are explored. A systematic review of published studies found 49 papers (44 unique studies) investigating predictors of later PTSD in RTC survivors. Consistent predictors of PTSD include rumination about the trauma, perceived threat to life, a lack of social support, higher Acute Stress Disorder symptom severity, persistent physical problems, previous emotional problems, previous anxiety disorder and involvement in litigation/compensation. Moderate predictors of PTSD are discussed, as well as factors, which consistently do not predict PTSD in RTC survivors. The results inform future models of post-RTC traumatic stress aetiology.
    Injury 08/2013; 44(11). DOI:10.1016/j.injury.2013.07.011 · 2.46 Impact Factor
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    • "The possible range of scores is 17–65. Test–retest reliability at 2–3 days has been reported at .96 (Weathers et al., 1993) and the overall diagnostic efficiency has been found to be acceptably high at .90 (Blanchard, Hickling, et al., 1996; Blanchard, Jones-Alexander, Buckley, & Forneris, 1996). In our study, the scale demonstrated high internal consistency (Cronbach's a = .89). "
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    • "Additionally, the first point at which ASD can be diagnosed may be changed from 2 to 3 days posttrauma. Although this change may not appear substantial, it reflects an effort to prevent overpathologizing normative distress responses in the immediate aftermath of a traumatic event (Blanchard et al., 1996; Rothbaum et al., 1992). "
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    ABSTRACT: Acute stress disorder (ASD) was included as a diagnosis to the 4th edition of the Diagnostic and Statistical Manual (American Psychiatric Association, 1994) as a way of describing pathological reactions in the first month following a trauma. Since that time, ASD has been the focus of some controversy, particularly regarding the theoretical basis and practical utility of the disorder. Despite this controversy, ASD has demonstrated usefulness in identifying individuals experiencing a high level of distress in the acute aftermath of a trauma as well as those at risk for developing posttraumatic stress disorder (PTSD). This paper reviews the clinical application of ASD, the current controversy surrounding its conceptual basis, and then discusses the dilemmas regarding this diagnosis that might occur in clinical practice. A review of the randomized control trial treatment outcome literature for ASD is also included in an effort to assist clinicians selecting interventions for clients recently exposed to traumatic events. Throughout this paper, the relationship between research and applied clinical practice is highlighted.Highlights► ASD has clinical utility in describing pathological posttraumatic reactions. ► We review treatment outcome studies for ASD. ► CBT for ASD is effective and beneficial.
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