Prospective Examination of Daily Life Traumatic Stress Symptom Expression Following Motor Vehicle Collisions

Objective: Motor vehicle collisions (MVCs) are a common source of traumatic stress, which could lead to the development of posttraumatic stress disorder. However, the natural course of symptom development is still poorly understood. The current study aimed to prospectively examine the expression of traumatic stress symptoms in mild-moderate injured MVC survivors, using a novel daily life repeated measurement approach. Method: Participants (N = 70) were screened and recruited upon hospital arrival. Daily assessments of traumatic stress symptoms were conducted via mobile phones, and the data during days 2-6 (acute phase) and 27-31 (1-month phase) following the MVC were used for the current study. Results: Latent growth curve analyses showed that at the acute phase, traumatic stress symptoms followed a reducing trajectory, with significant intercept and negative slope factors. At the 1-month phase, traumatic stress symptoms followed a low-stable trajectory, with a lower intercept and a nonsignificant slope factor. The acute-phase intercept and slope were both positively associated with 1-month symptomatology, such that higher initial symptoms and slower recovery rates were associated with greater traumatic stress symptoms at 1-month post-MVC. Trauma history and peritraumatic perceived life threat were indirectly associated with the 5-days end-of-the-month traumatic stress symptoms, through the mediation of the acute-phase intercept. Conclusions: An early screen of traumatic stress symptoms in the first few days following trauma exposure, together with trauma history and perceived peritraumatic life threat, may assist in identifying individuals at risk for subsequent posttraumatic psychopathology. Clinical Impact Statement On average, participants experienced a moderate level of acute stress symptoms following a motor vehicle collision, which decreased over the first days following the accident. Individuals with more severe initial reactions and with slower recovery rates were at higher risk of developing one-month posttraumatic stress symptoms. Trauma history and greater perception of life threat were associated with more acute symptoms, increasing the risk of later symptomatology. Our findings indicate that an early screening procedure including assessment of early symptoms and perceived life threat may assist in identifying those at higher risk.