7-YEAR FOLLOW-UP OF CHILD SURVIVORS OF A BUS-TRAIN COLLISION

Objective: To assess the long-term effects of a traumatic bus-train co llision and to examine the effect of levels of exposure and immediate reactions on long-term adjustment. Method: Seven years after the accid ent, 389 subjects, all doing compulsory army service, filled out self- report questionnaires assessing symptoms of posttraumatic stress disor der (PTSD), psychiatric symptomatology, and military functioning. In a ddition, subjects were questioned about their immediate reactions to t he traumatic event. Results: The most highly exposed subjects reported the highest levels of somatization, depression, phobic anxiety, and p sychoticism and more PTSD symptoms. Acute stress symptoms and manifest ations of fear immediately after the accident were strongly related to long-term maladjustment. Conclusions: The results suggest that the in vestigation and assessment of long-term adjustment after traumatic eve nts should take into account both contextual factors, such as the leve l of exposure to the event, and personal factors, such as the victims' immediate reactions.