Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Jun 27;19(1):343.
doi: 10.1186/s13063-018-2716-2.

Psychological distress following a motor vehicle crash: preliminary results of a randomised controlled trial investigating brief psychological interventions

Rebecca Guest  1 , Yvonne Tran  2 , Bamini Gopinath  2 , Ian D Cameron  2 , Ashley Craig  2
Affiliations
Randomized Controlled Trial

Psychological distress following a motor vehicle crash: preliminary results of a randomised controlled trial investigating brief psychological interventions

Rebecca Guest et al. Trials. .

Abstract

Background: The preliminary results of a randomised controlled trial are presented. The aim of the trial is to determine the efficacy, feasibility and acceptability of email-delivered psychological interventions with telephone support, for adults injured in a motor vehicle crash engaged in seeking compensation. The primary intention for this preliminary analysis was to investigate those who were psychologically distressed and to stop the trial midway to evaluate whether the safety endpoints were necessary.

Methods: The analysis included 90 adult participants randomised to one of three groups, who were assessed at baseline and post-intervention at 3 months. Cognitive behaviour therapy (CBT) or healthy lifestyle interventions were delivered over 10 weeks, involving fortnightly emailed modules plus clinically focussed telephone support, with the aim of reducing psychological distress. An active waiting list of control subjects received non-clinically focussed telephone contact over the same period along with claim-related reading material. Depression Anxiety Stress Scales (DASS) and Impact of Events Scale (Revised) (IES-R) were used to assess psychological distress. Psychiatric interviews were used to diagnose major depressive disorder and post-traumatic stress disorder. Aspects of acceptability and feasibility were also assessed.

Results: For those diagnosed with depression at baseline in the CBT group, psychological distress reduced by around 16%. For those with depression in the healthy lifestyle group, distress increased marginally. For those in the control group with depression, distress also decreased (by 18% according to DASS-21 and 1.2% according to IES-R). For those without depression, significant reductions in distress occurred, regardless of group (P < .05). The results suggest that for those with depression, a healthy lifestyle intervention is contraindicated, necessitating the cessation of recruitment to this intervention. The interventions were reported as acceptable by the majority and the data indicated that the study is feasible.

Conclusions: CBT with telephone support reduced psychological distress in physically injured people with depression who are engaged in seeking compensation. However, time plus fortnightly telephone contact with claim-related reading material may be sufficient to reduce distress in those who are depressed. For those who were not depressed, time plus telephone support is most likely sufficient enough to assist them to recover. The trial will continue with further recruitment to only the CBT and control groups, over longer follow-up periods.

Trial registration: Australian and New Zealand Clinical Trials Registry: Preventing psychological distress following a motor vehicle accident; ACTRN12615000326594 . Registered on 9 April 2015.

Keywords: Anxiety; CBT/cognitive behaviour therapy; Depression; Injury; MVC/motor vehicle crash; PTSD/post-traumatic stress disorder.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

This research received approval from each site and was fully compliant with the code of ethics of the World Medical Association (Declaration of Helsinki), as well as the standards established by the authors’ institutional review board and the granting agency. Written informed consent has been sought from all participants prior to participation. The Human Research Ethics Committee granted approval on 26 February 2015 (number 2015/016), as did the multi-site insurance companies, and the trial was registered on 9 April 2015 (registration number ANZCTR – ACTRN12615000326594).

Consent for publication

Written informed consent has been obtained from the participants for publication of the manuscript’s grouped data and figures (data relating to any single individual will not be published). The completed consent forms are securely held by the authors’ institution and are available for review by the editor-in-chief.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Consort flow diagram. CBT cognitive behaviour therapy, HL healthy lifestyle
Fig. 2
Fig. 2
DASS total score for the three groups for those without a diagnosis of MDD. CBT cognitive behaviour therapy, DASS Depression, Anxiety and Stress Scale, MDD major depressive disorder
Fig. 3
Fig. 3
IES Total for the three groups for those without diagnosis of MDD. The analysis was adjusted for baseline SF12 physical health composite index and baseline IES Intrusion domain
Fig. 4
Fig. 4
DASS total for three groups for those with diagnosis of MDD. The analysis was adjusted for baseline SF12 physical health composite index and baseline DASS depression domain
Fig. 5
Fig. 5
IES Total for the three groups for those with a diagnosis of MDD. The analysis was adjusted for baseline SF12 physical health composite index and baseline IES Intrusion domain
See this image and copyright information in PMC

References

    1. Bryant RA, O'Donnell ML, Creamer M, McFarlane AC, Clark CR, Silove D. The psychiatric sequelae of traumatic injury. Am J Psychiatry. 2010;167(3):312–320. doi: 10.1176/appi.ajp.2009.09050617. - DOI - PubMed
    1. Bryant RA, O'Donnell ML, Creamer M, McFarlane AC, Silove D. A multisite analysis of the fluctuating course of posttraumatic stress disorder. JAMA Psychiatry. 2013;70(8):839–846. doi: 10.1001/jamapsychiatry.2013.1137. - DOI - PubMed
    1. Hodgson RC, Webster RA. Mediating role of peritraumatic dissociation and depression on post-MVA distress: path analysis. Depress Anxiety. 2011;28(3):218–226. doi: 10.1002/da.20774. - DOI - PubMed
    1. Nickerson A, Aderka IM, Bryant RA, Hofmann SG. The role of attribution of trauma responsibility in posttraumatic stress disorder following motor vehicle accidents. Depress Anxiety. 2013;30(5):483–488. doi: 10.1002/da.22006. - DOI - PubMed
    1. Craig A, Tran Y, Guest R, Gopinath B, Jagnoor J, Bryant RA, et al. Psychological impact of injuries sustained in motor vehicle crashes: systematic review and meta-analysis. BMJ Open. 2016;6(9):e011993. doi: 10.1136/bmjopen-2016-011993. - DOI - PMC - PubMed

Publication types

MeSH terms