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Cited by 40Posttraumatic Stress Disorder ResearchTraumatic Brain Injury ResearchTraffic and Road Safety

Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys

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Stein, Dan J., Karam, Elie G., Shahly, Victoria, Hill, Eric D., King, Andrew, Petukhova, Maria, Atwoli, Lukoye, Bromet, Evelyn J. +11 more·2016·BMC Psychiatry
DOI 10.1186/s12888-016-0957-8PMC PMC4957291
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Abstract

BACKGROUND: Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. METHODS: Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 surveys (5 in high income countries, 8 in middle or low income countries) with respondents reporting PTSD after life-threatening MVCs are considered here. Six classes of predictors were assessed: socio-demographics, characteristics of the MVC, childhood family adversities, MVCs, other traumatic experiences, and respondent history of prior mental disorders. Logistic regression was used to examine predictors of PTSD. Mental disorders were assessed with the fully-structured Composite International Diagnostic Interview using DSM-IV criteria. RESULTS: Prevalence of PTSD associated with MVCs perceived to be life-threatening was 2.5 % overall and did not vary significantly across countries. PTSD was significantly associated with low respondent education, someone dying in the MVC, the respondent or someone else being seriously injured, childhood family adversities, prior MVCs (but not other traumatic experiences), and number of prior anxiety disorders. The final model was significantly predictive of PTSD, with 32 % of all PTSD occurring among the 5 % of respondents classified by the model as having highest PTSD risk. CONCLUSION: Although PTSD is a relatively rare outcome of life-threatening MVCs, a substantial minority of PTSD cases occur among the relatively small proportion of people with highest predicted risk. This raises the question whether MVC-related PTSD could be reduced with preventive interventions targeted to high-risk survivors using models based on predictors assessed in the immediate aftermath of the MVCs.

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  • Prior WMH analyses have found models with dummy variables for three and four or more disorders and constant multiplier constraints to be useful.

    “Models of this form have been shpwn to be useful in a number of prior WMH analyses (e.g., Stein et al. 2016; McGrath et al. 2016).”

    From Socio-economic variations in the mental health treatment gap for people with anxiety, mood, and substance use disorders: Results from the WHO World Mental Health (WMH) surveys (2018) · cites this paper as Stein et al. 2016

    In Results > Predictors of PTSD (page unavailable), Stein et al. use a model in which each additional prior anxiety disorder from zero to three has the same incremental odds ratio. This supports the constant-multiplier aspect, but our copy does not show dummy variables for three and four or more disorders; it says three was the maximum count with enough respondents for a stable estimate. (LLM, conf=0.84)

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Authors
Stein, D. J., Karam, E. G., Shahly, V., Hill, E. D., King, A., Petukhova, M., Atwoli, L., Bromet, E. J., Florescu, S., Haro, J. M., Hinkov, H., Karam, A., Medina-Mora, M. E., Navarro-Mateu, F., Piazza, M., Shalev, A., Torres, Y., Zaslavsky, A. M., & Kessler, R. C.
Affiliations
  • University of Cape Town (ZA)
  • University of Balamand (LB)
  • Harvard University (US)
  • Moi University (KE)
  • Stony Brook School (US)
  • National School of Public Health, Management and Professional Development (RO)
  • Parc Sanitari Sant Joan de Déu (ES)
  • National Center of Public Health and Analyses (BG)
  • NYU Langone Health (US)
  • Universidad CES (CO)
Corresponding author
Stein, Dan J.
ORCID
Venue
BMC Psychiatry
Publisher
Springer Science and Business Media LLC
Published
2016-07-22
Volume
16
Issue
1
Pages
257-257
ISSN
1471-244X (ISSN-L)
DOI
10.1186/s12888-016-0957-8
PMC
PMC4957291
OpenAlex
W2486857726
Cited by
40
References
60
Citations by year
2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 10 · 2021: 8 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 1
FWCI
4.46
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RECERCAT (Consorci de Serveis Universitaris de Catalunya) (publishedVersion, other-oa)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • eCommons - AKU (Aga Khan University) (submittedVersion)
  • Dipòsit Digital de la Universitat de Barcelona (Universitat de Barcelona) (submittedVersion, cc-by)
  • Open University of Cape Town (University of Cape Town) (submittedVersion, cc-by)
Funders
  • National Institute of Mental Health (RO1 MH070884)
  • U.S. Public Health Service (R13-MH066849, R01-MH069864, R01-DA016558)
  • Fogarty International Center (FRICA RO3-TW006481)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
Keywords
post-traumatic stress disorder, traffic accidents, PTSD prevalence, PTSD risk factors, trauma survivors, PTSD prevention, cross-national comparison
MeSH terms
Accidents, Traffic, Adolescent, Adult, Child, Child, Preschool, Female, Health Surveys, Humans, Infant, Life Change Events, Male, Surveys and Questionnaires, Stress Disorders, Post-Traumatic, Prevalence, Diagnostic and Statistical Manual of Mental Disorders, Young Adult

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