Surviving a Serious Traffic Accident

Abstract

Research on the consequences of motor vehicle accidents centres mainly on the assessment and treatment of post-traumatic psychological–behavioural reactions of the people involved. Few studies have explored the experience of surviving a serious accident and its impact on different dimensions of individuals' lives. This qualitative study aims at investigating adaptation strategies and quality of life of 20 severely injured accident survivors who spent several months in an intensive care unit of a hospital, and who still suffer permanent injuries of varying extent. Participants completed individual in-depth interviews which were subsequently analysed according to the grounded theory method. The findings indicate that the adaptation process follows a sequence of temporal phases (‘past–present’, ‘present’, ‘future’ and ‘being’), characterized by different emotional and behavioural reactions, perceived needs, and by the adoption of specific coping strategies. The duration of the adaptation process is influenced by the severity of the injury suffered, participants' age at the time of the trauma, the occurrence of coma and the availability of social support in participants' life environment.

Keywords

coping strategies grounded theory physical trauma qualitative research quality of life traffic accidents

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References

American Psychiatric Association . (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: APA.

Blanchard, E. B. , & Hickling, E. J. (1997). After the crash. Washington, DC: American Psychological Association.

Blanchard, E. B. , Hickling, E. J. , Mitnick, N. , Taylor, A. E. , Loos, W. R. , & Buckley, T. C. (1995). The impact of severity of physical injury and perception of life threat in the development of post-traumatic stress disorder in motor vehicle accident victims. Behaviour Research and Therapy, 33, 529–534.

Brom, D. , Kleber, R. J. , & Hofman, M. C. (1993). Victims of traffic accidents: incidence and prevention of post-traumatic stress disorder. Journal of Clinical Psychology, 49, 131–139.

Chamberlain, K. (1999). Using grounded theory in health psychology: practices, premises, and potential. In M. Murray & K. Chamberlain (Eds.), Qualitative health psychology (pp. 183–201). London: Sage.

Charmaz, K. (1995). Grounded theory. In J. A. Smith, R. Harrè , & L. Van Langenhove (Eds.), Rethinking methods in psychology (pp. 27–49). London: Sage.

Charmaz, K. (1997). Identity dilemmas of chronically ill men. In A. Strauss & J. M. Corbin (Eds.), Grounded theory in practice (pp. 35–62). London: Sage.

Davis, C. G. , Lehman, D. R. , Silver, R. C. , Wortman, C. B. , & Ellard, J. H. (1996). Self-blame following a traumatic event: the role of perceived avoidability. Personality and Social Psychology Bulletin, 22,557–567.

de L. Horne, D. J. (1996). Traumatic stress reactions to motor vehicle accidents. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 499–506). New York: Plenum Press.

10.

Delahanty, D. L. , Herberman, H. B. , Craig, K. J. , Hayward, M. C. , Fullerton, C. S. , Ursano, R. J. , & Baum, A. (1997). Acute and chronic distress and post-traumatic stress disorder as a function of responsibility for serious motor vehicle accidents. Journal of Consulting and Clinical Psychology, 65,560–567.

11.

Feinstein, A. (1996). A prospective study of victims of physical trauma. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 157–164). New York: Plenum Press.

12.

Gluhoski, V. L. , & Wortman, C. B. (1996). The impact of trauma on world views. Journal of Social and Clinical Psychology, 15, 417–429.

13.

Hagstrom, R. (1995). The acute psychological impact on survivors following a train accident. Journal of Traumatic Stress, 8, 391–403.

14.

ISTAT . (1997). Gli incidenti stradali negli anni '90. Argomenti, 7, 78-78.

15.

Janoff-Bulman, R. , & Wortman, C. B. (1977). Attributions of blame and coping in the ‘real world’: severe accident victims react to their lot. Journal of Personality and Social Psychology, 35, 351–363.

16.

Janoff-Bulman, R. (1989). Assumptive world and the stress of traumatic events: application of the schema contruct. Social Cognition, 7, 2, 113–136.

17.

Koopman, C. , Classen, C. , Cardena, E. , & Spiegel, D. (1995). When disaster strikes, acute stress disorder may follow. Journal of Traumatic Stress, 8, 29–46.

18.

Koutsosimou, M. , McDonald, A. S. , & Davey, C. G. L. (1996). Coping and psychopathology in surgery patients: a comparison of accident patients with other surgery patients. British Journal of Health Psychology, 1, 357–364.

19.

Lazarus, R. S. , & Folkman, S. (1984). Stress, appraisal and coping. New York: Springer.

20.

Reynolds, M. , & Tarrier, N. (1996). Monitoring of intrusions in post-traumatic stress disorder: a report of single case studies. British Journal of Medical Psychology, 69, 371–379.

21.

Shapiro, S. , Angus, L. , & Davis C. (1997). Identity and meaning in the experience of cancer. Journal of Health Psychology, 2, 539–554.

22.

Solomon, Z. , Iancu, I. , & Tyano, S. (1997). World assumptions following disaster. Journal of Applied Social Psychology, 27, 1785–1798.

23.

Strauss, A. , & Corbin, J. M. (1990). Basics of qualitative research. Grounded theory: procedures and techniques. London: Sage.

24.

Taylor, S. (1983). Adjustment to threatening events. American Psychologist, 11, 1161–1173.

25.

Wilson, J. P. , & Raphael, B. (1996). International handbook of traumatic stress syndromes. New York: Plenum Press.