Predictors of Acute and Chronic PTSD in Road Trauma Survivors: Insights from a 12-Month Cohort Study

The present study reports the prevalence of acute post-traumatic stress disorder (PTSD) symptoms (2 months post-injury) and chronic PTSD symptoms (6 and 12 months post-injury) among road trauma survivors. We also examine baseline factors as potential predictors of acute and chronic PTSD symptoms post-injury.

This study followed a prospective cohort, enrolling 1480 survivors in Canada, between July 2018 and March 2020. PTSD symptoms were measured with the Post-traumatic Check-List Scale (PCL-S) at 2, 6, and 12 months post-injury. Baseline sociodemographic, psychological, medical, and injury-related factors were examined as predictors of acute and long-term PTSD symptoms using multivariable logistic regression.

PTSD symptoms were reported by 241 of 1074 participants (22.4%) at 2 months, 167 of 935 (17.9%) at 6 months, and 141 of 872 (16.2%) at 12 months. Female sex, Asian ethnicity, more retrospectively reported pre-injury somatic symptoms, greater pre-injury psychological distress, and being a pedestrian (vs a driver) were consistently linked to higher odds of PTSD symptoms at 2 and 6 months. At 2 months, younger age, greater pre-injury pain catastrophizing, uncertain recovery expectations, and head or spine/back injuries were additional significant predictors, while by 6 months, having neck injury remained significant. By 12 months, chronic PTSD symptoms was associated with greater pre-injury pain catastrophizing, lower pre-injury health-related quality of life, and spine/back injury. Injury pain remained a predictor across all follow-ups.

PTSD symptom prevalence among survivors decreased between 2 and 6 months post-injury, but recovery rate slowed thereafter, with reduction between 6 and 12 months being much smaller than the earlier decrease. Furthermore, as some significant factors are modifiable, early interventions-such as effective pain management, psychological support, and coping strategy training-may help mitigate PTSD symptoms. Brief screening for psychological distress and pain catastrophizing could further support timely identification and referral of high-risk patients.