Psycho-physiological responses and health outcomes following road traffic injury: an integrated biopsychosocial approach.

Abstract

Psychological distress is a major, often underestimated, consequence of road traffic injuries (RTI) that interferes with injury recovery and can lead to serious mental disorders. The inconsistencies surrounding the understanding of psychological distress and contributors to individual stress vulnerability, particularly physiological factors, strongly affect current policies and practices. This Project adopts an integrative biopsychosocial perspective of health, so as to clarify (i) the occurrence and trajectory of psychological distress symptoms, (ii) main contributors and (iii) plausible physiological early markers of stress vulnerability. A total of seven publications are included, all with an emphasis on minor to moderate RTI. From these publications it was found that:

Prolonged psychological distress is extremely common after a traffic injury and increases risk of pain-related disability. Post-traumatic stress symptoms and depressive mood highly co-occur after a traffic injury, calling for a broader screening than just trauma-related symptoms and disorders. Injury compensation alone is not toxic for people’s mental health, and the individual’s stress vulnerability plays an important role in the way people cope with a traffic injury. Pre-injury vulnerability is important for the early identification of those who are likely to develop chronic mental health disorder after a traffic injury. Autonomic biomarkers show an intrinsic biological vulnerability of individuals with high pre-injury vulnerability who are highly distressed immediately after a traffic injury. In conclusion, this is a “World-First” study that will substantially contribute to the unravelling of the variability in recovery following RTI. The challenge now is to re-orient health, compensation and other systems involved in injury recovery to implement coordinated actions to address the issues raised by this Project.