The Psychological Impact of Road Traffic Injuries
Almost one in two traffic injury survivors experience elevated risk of psychological distress, according to new research funded by Australian Rotary Health (ARH).
Dr Ilaria Pozzato from the University of Sydney received an ARH Ian Scott PhD Scholarship between 2018 and 2021 to conduct research exploring the mental health and physical health consequences of motor vehicle accidents.
Two studies looking at data of people who have sustained a minor-to-moderate injury due to a motor vehicle crash, confirmed that psychological distress is extremely common among traffic injury survivors, affecting almost 38-42% (i.e., around 1 in 2 people).
“Almost one in three people continued to be distressed 12 months post-injury,” Dr Pozzato said.
“The risk of developing post-traumatic stress disorder varied between 16-21% in 6 months and 17-18% in 12 months post-injury, while risk of developing major depressive disorder was 24-26% at 6 months and 20-26% 12-months post injury.”
Additionally, the studies found that psychological distress symptoms such as post-traumatic stress and depressed mood can co-occur and exacerbate one another.
“Screening only for post-traumatic stress is insufficient for estimating the real psychological impact of road traffic injuries,” she said.
Among those developing persistent psychological distress, risk of chronic pain-related disability and poor physical recovery is also much higher in the long-term.
Dr Pozzato’s research also explored individual stress vulnerability when compared to a healthy non-injured population.
Vulnerability was based on six predisposing pre-injury factors such as age, sex, education, socioeconomic level, pre-injury mental health, and physical health issues.
“The injured group with high pre-injury vulnerability had almost twice the risk of developing psychiatric disorders such as depression or PTSD 12-months post-injury (42% risk) compared to the low vulnerability group (23% risk).”
Further, the high vulnerability group was found to have dysfunctional autonomic nervous system activity, reflected by biological markers of hyper stress reactivity.
“Autonomic measures should therefore be regarded as potential stress vulnerability markers,” Dr Pozzato said.
“We argue that pre-injury vulnerability and autonomic biomarkers should be employed in Emergency Departments as early screening after a traffic injury to detect those high at risk of poor mental health outcomes.”
As a result of Dr Pozzato’s PhD research, a book chapter and 6 journal articles have been published. Additional papers are expected to be published in 2022 and 2023.
Read Dr Pozzato’s work below:
- Pozzato, I., Craig, A., Gopinath, B. (2019). Biomarkers of the risk of psychosocial adversity following a motor vehicle crash. In A. Craig and R. Guest (Eds.): Adversity after the Crash: The physical, psychological and social burden of motor vehicle crashes. Nova Science, New York. ISBN: 978-1-53614-563-2
- Pozzato, I., Craig, A., Gopinath, B., Tran, Y., Dinh, M., Gillett, M., & Cameron, I. (2019). Biomarkers of autonomic regulation for predicting psychological distress and functional recovery following road traffic injuries: protocol for a prospective cohort study. BMJ Open, 9(4), e024391. https://doi.org/doi: 10.1136/bmjopen-2018-024391
- Pozzato, I., Craig, A., Gopinath, B., Kifley, A., Tran, Y., Jagnoor, J., & Cameron, I. (2020). Outcomes after traffic injury: mental health comorbidity and relationship with pain interference. BMC Psychiatry, 20, 1-13. https://doi.org/doi: 10.1186/s12888-020-02601-4
- Gopinath, B., Jagnoor, J., Kifley, A., Pozzato, I., Dinh, M., Craig, A., & Cameron, I. D. (2021). Twelve-month health outcomes for bicyclists and car occupants after a non-catastrophic traffic crash injury. Annals of Physical and Rehabilitation Medicine, 64(2), 101368. https://doi.org/10.1016/j.rehab.2020.02.007
- Pozzato, I., Kifley, A., Craig, A., Gopinath, B., Tran, Y., Jagnoor, J., & Cameron, I. (2020). Effects of seeking compensation on the psychological health and recovery of injured patients: the role of stress vulnerability and injury-related disability. Psychological Medicine, 1-12. https://doi.org/doi: 10.1017/S003329172000166X.
- Pozzato, I., Tran, Y., Gopinath, B., Cameron, I. D., & Craig, A. (2021). The contribution of pre-injury vulnerability to risk of psychiatric morbidity in adults injured in a road traffic crash: Comparisons with non-injury controls. Journal of Psychiatric Research, 140, 77–86. Advance online publication. https://doi.org/10.1016/j.jpsychires.2021.05.064
- Pozzato, I., Tran, Y., Gopinath, B., Thuraisingham, R. A., Cameron, I. D., & Craig, A. (2021). The role of stress reactivity and pre-injury psychosocial vulnerability to psychological and physical health immediately after traumatic injury. Psychoneuroendocrinology, 127, 105190.
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