Association between attributions of responsibility for motor vehicle crashes, depressive symptoms, and return to work

Perceptions surrounding the underlying causes of accidents and injuries may be a key mechanism influencing postaccident health and functional outcomes among people injured in road crashes. In particular, attributions of responsibility may influence rates of postcrash depressive symptomatology and return-to-work.

We studied a large sample of people injured in motor vehicle crashes who were working at their time of accident and needed to take time off as a result of their injuries. Interviews took place at 2 time points, 12 months apart (T1: n = 1,024, T2: n = 303). Comparisons were made between participants' levels of depressive symptoms and rates of return to work based on their assessment of responsibility for their accident.

People who did not attribute responsibility to themselves for their accident were 3 times more likely to exhibit symptoms of depression at follow-up than those who attributed responsibility to themselves. People with depressive symptoms were 3.5 times less likely to have returned to work. The effect of attributions of responsibility for accidents on return to work was mediated by the presence of depressive symptoms.

Functional and psychological recovery from road trauma is closely associated with the assessment of responsibility for accidents. Findings are discussed in light of established posttrauma cognitive theories, the potential explanatory power of broader, more socially oriented models, and the changing nature of road trauma populations.