Acute and chronic posttraumatic stress disorder in motor vehicle accident victims

Objective: This study reports the rates of acute and chronic posttraumatic stress disorder (PTSD) in a suburban community study group of 122 victims o f serious motor vehicle accidents and a comparison group of 42 (who had bee n involved in minor, non-motor-vehicle accidents) followed over 12 months. Method: Motor vehicle accident victims were systematically recruited and ex amined with comparison subjects at 1, 3, 6, 9, and 12 months after the acci dent. The authors used the Structured Clinical Interview for DSM-III-R to a ssess DSM-III-R axis I disorders including PTSD. Results: One month after t he accident, 34.4% of the motor vehicle accident victims met criteria for P TSD (versus 2.4% of the comparison subjects). Similarly, at 3 and 6 months, rates of PTSD were higher (25.2% and 18.2%) in the motor vehicle accident victims than in the comparison group. Female victims were 4.64 times more l ikely than male victims to have PTSD at 1 month. Victims with a history of PTSD were 8.02 times more likely at 1 month and 6.81 times more likely at 3 months to have PTSD than those without a history of PTSD. Having an axis I I disorder increased the risk for PTSD at 6 months. After adjustment for a history of PTSD and potentially confounding variables, women were 4.39 time s more likely than men to develop PTSD at 1 month but did not have a higher risk for chronic PTSD; at 6 months, those with an axis II disorder were at greater risk of PTSD. Conclusions: Rates of PTSD are high in victims of se rious motor vehicle accidents and remain high 9 months later. Female victim s have an increased risk of acute but not chronic PTSD. Individuals with a history of PTSD are at risk of acute and chronic PTSD. An axis II disorder increases the risk for chronic but not acute PTSD.