Work potential of road accident survivors with post-traumatic stress disorder

School of Behavioural and Community Health Sciences, The University of Sydney, P.O. Box 170, Lidcombe 1825 NSW, Australia.
Behaviour Research and Therapy (Impact Factor: 3.85). 05/2005; 43(4):475-83. DOI: 10.1016/j.brat.2004.03.008
Source: PubMed


Work potential in adult survivors of road accidents with and without post-traumatic stress disorder (PTSD) was examined at a mean of 8.6 months (SD = 3.77) post-accident. All participants were working prior to their accident. Results showed that survivors with PTSD had significantly less work potential post-accident than survivors without PTSD. Specific barriers to employability for survivors with PTSD identified by this study included high levels of depression, reduced time-management ability, and an over-concern or anxiety with physical injuries. Respondents with PTSD, however, reported significantly greater extrinsic motivation to work than those without PTSD. Early intervention and referral to occupational rehabilitation programs that: (1) help address these barriers to employability and stimulate the existing motivation to return to work, and (2) work alongside clinical treatment programs, may assist in the reduction of poor work outcomes that people with PTSD following road accidents often experience.

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Available from: Lynda R. Matthews
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    • "Citation: European Journal of Psychotraumatology 2014, 5: 22612 - in RTC survivors (Beesdo et al., 2010; Matthews, 2005). It has become increasingly apparent that physical functioning/pain and mental health interact to produce longterm health outcomes (Sterling & Kenardy, 2011). "
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    ABSTRACT: To date research investigating how mental health impacts physical recovery following a road traffic crash (RTC) has focused on cohorts with severe injuries. The UQ SuPPORT study aims to study the physical and psychological outcomes of claimants with minor injuries following an RTC under the Queensland common law compulsory insurance scheme. This paper outlines the protocols of this study as a platform for future publications. The 2-year longitudinal cohort study collected interview and survey data from claimants at 6, 12, and 24 months post-RTC. Measures used in the telephone interview included the DSM-IV Composite International Diagnostic Interview for posttraumatic stress disorder, generalized anxiety disorder, major depressive episode, panic attacks, agoraphobia; and self-reported disability (WHO-DAS-II). Quality of life (SF-36v2), alcohol use (AUDIT), social support (MSPSS), quality-adjusted life years (EQ-5D), and return to work outcomes were assessed via postal questionnaires. A total of 382 claimants consented to participate at the beginning of the study, and these participants were approached at each wave. Retention was high (65%). The average age of participants at Wave 1 was 48.6 years, with 65% of the sample sustaining minor injuries (Injury Severity Score=1-3). This study has collected a unique sample of data to investigate recovery patterns of claimants with minor injuries. Future publications will more fully assess the effects of the collected measures on recovery rates 2 years post-RTC.
    Full-text · Article · May 2014 · European Journal of Psychotraumatology
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    • "Regard - less of the direction of the relationship between social disadvantage , mental illness and employment out - comes , both social disadvantage and unemployment are detrimental to mental health . Stakeholders also perceived problems with concentration , planning and organisation as important barriers to employment , consistent with the literature in this area ( Matthews 2005 , Rosenheck et al . 2006 , McGurk et al . "
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    ABSTRACT: This paper examines the barriers to employment faced by job seekers (JS) with mental illness and additional substance-use issues. Semi-structured interviews concerning barriers to employment for JS with mental illness and substance-use problems and strategies to improve employment outcomes were conducted with stakeholders associated with an employment service provider specialising in mental illness (n = 17). Stakeholders were JS, family members who provide significant support to JS [support persons (SP)] and staff [employment staff (ES)]. Data were collected between May and August 2009 at the premises of the employment service provider in metropolitan Sydney. Thematic analysis of transcribed interview data was conducted to develop a meaningful data framework. The expectations of JS and SP regarding employment outcomes were higher than those of ES. Length of time unemployed was perceived as the most important barrier to future employment associated with mental illness, and substance-use problems were associated with lower, more variable motivation, restrictions on the environments where JS could work and more negative community and employer perceptions. The findings are consistent with studies from non-vocational settings and provide direction for meeting the needs of clients with mental illness and additional substance-use problems. Ensuring alignment between JS and ES concerning service goals and expected timeframes may improve JS motivation, satisfaction with service delivery and ultimately, employment outcomes.
    Full-text · Article · Jul 2013 · Health & Social Care in the Community
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    • "Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD), particularly those injured in a motor vehicle accident (MVA) [1-10]. MVA survivors with psychiatric morbidity such as PTSD have also been found to have significantly lower quality of life and post-accident work potential than those without psychiatric morbidity [11,12]. Thus, it is important to detect MVA survivors at risk of developing later PTSD and prevent it when feasible. "
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    ABSTRACT: Introduction Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a motor vehicle accident (MVA) affects the subsequent development of PTSD symptoms. Methods We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA. Results Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890). Conclusions These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.
    Full-text · Article · Oct 2012 · Critical care (London, England)
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