PSYCHOLOGICAL PREDICTORS OF CHRONIC POSTTRAUMATIC-STRESS-DISORDER AFTER MOTOR-VEHICLE ACCIDENTS

A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stre ss disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, percei ved threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psycholog ical factors, that is, negative interpretation of intrusions, ruminati on, thought suppression, and anger cognitions, enhanced the accuracy o f the prediction. Negative interpretation of intrusions, persistent me dical problems, and rumination at 3 months were the most important pre dictors of PTSD symptoms at 1 year. Rumination, anger cognitions, inju ry severity, and prior emotional problems identified cases of delayed onset.