Chronic psychological and psychophysiological sequelae among adolescents following a traumatic bus crash

This study examined chronic psychological and psychophysiological post-traumatic sequelae among eleven adolescent survivors of a fatal bus crash by means of a multimethod strategy. Measures included a structured DSM-m-R post-traumatic stress disorder (PTSD) interview using the Diagnostic Interview for Children and AdolescentsRevised (DICA-R), self-report measures of PTSD symptoms with the Reaction Index, and the Impact of Events Scale. Other measures of stress-related symptomatology included the State-Trait Anxiety Inventory, Fear Survey Schedule-IT, Anxiety Sensitivity Index, Anxiety Frequency Index, and Beck Depression Inventory. In addition, heart rate (HR) reactivity to mental arithmetic (MA), demographic questions, and crash questions was assessed. Survivors were compared to control subjects matched for age, gender, race, and socioeconomic status, among other demographic characteristics. Multivariate analyses of the psychiatric interview data indicated that survivors evidenced significantly higher levels of past PTSD symptoms experienced after the crash, with a significant group by gender interaction, F (3,17) = 5.22, P = .01. Current (past month) levels of PTSD symptoms were also significantly higher among survivors four years after the crash, F (3,17) = 8.82, P < .01, although PTSD symptomatology decreased overall during that time, F (3,17) = 15.52, P < .01. Survivors and controls did not differ significantly on other measures of PTSD and other stress-related symptomatology. Repeated measures analyses of HR response scores revealed greater HR reactivity to questions about the crash among survivors, F (1, 14) = 18.55, P < .01, and by gender, F (1, 14) = 5.21, P = .04. Similar analyses found greater variability in survivors' HR standard deviations (an index of autonomic lability) F (1,14) = 5.21, P = .03 in response to the crash interview. Survivors' HR did not differ from controls' on the MA task. Findings are discussed theoretically and methodologically within the contexts of neurological and conditioning models of PTSD. No relationship between HR reactivity and psychiatric symptomatology was found. Furthermore, this investigation did not find support for the neurological kindling theory. Areas of future research using psychophysiological assessment are proposed to more specifically elicit autonomic arousal. Detailed case studies of four individual response patterns are included as a heuristic for further physiological research and for clinical applications with adolescent trauma victims.

Name thesis:degree_name

Ph. D.

Level thesis:degree_level

doctoral

Discipline thesis:degree_discipline

Psychology

Department dc:contributor.department

Psychology

Grantor dc:publisher

Virginia Tech

Year dc:date.issued

1993

Author dc:creator

• Ribbe, David Paul

Chair dc:contributor.committeechair

• Jones, Russell T.

Committee members dc:contributor.committeemember

• Clum, George A.
• Ollendick, Thomas H.
• Cooper, Robin P.
• Frary, Robert B.

Statement dc:rights

• In Copyright

Licence dc:rights.uri

• http://rightsstatements.org/vocab/InC/1.0/

Language dc:language.iso

en

Dc Identifier Other

etd-12222005-090701

OAI identifier oai:identifier

oai:vtechworks.lib.vt.edu:10919/40472