Intrusive thoughts, crisis support and symptoms of post-traumatic stress disorders in adolescents involved in road traffic accidents

Meares, Kevin James Martin (1997). Intrusive thoughts, crisis support and symptoms of post-traumatic stress disorders in adolescents involved in road traffic accidents. PhD thesis The Open University.



This study aimed to survey an adolescent sample for the prevalence of PTSD symptoms following a road traffic accident (RTA). In addition, it aimed to examine the relationship between PTSD symptoms and a number of variables which have been suggested by Rachman's (1980) emotional processing theory to be important in the development of PTSD. Rachman's theory suggests that intrusive phenomena are indicative of emotional processing. His theory accounts for both everyday and trauma related intrusive phenomena and suggests that the same mechanisms are employed in both everyday and traumatic processing. This study examined the influence of controllability and affective discomfort associated with everyday intrusive thoughts on the levels of PTSD seen in adolescents involved in RTAs. In addition, other variables were assessed which were suggested by Rachman to be indicative of successful emotional processing (e.g. social support). 34 adolescents between the age of 10 and 16, who had been involves in RTAs were asked to complete a battery of questionnaires presented in a structured interview format. Each participant completed the Impact of Events Scale (Horowitz et al., 1979), the Revised Children's Manifest Anxiety Scale (Reynolds and Richmond, 1978), the Birleson depression inventory (Birleson, 1981), the Crisis Support Scale (Joseph et al., 1992) and two measures of accident related intrusive thoughts and everyday intrusive thoughts which have been adapted from previously used instruments (Salkovskis, 1985, Allsopp and Williams, 1996). A quarter of all adolescents involved in RTAs were found to suffer severe levels of PTSD psychopathology as measured by the IES. The experience of accident related intrusive thoughts was associated with higher levels of PTSD symptoms. Everyday intrusive thoughts, that were controllable and did not cause affective discomfort, were associated with lower levels of PTSD symptoms. Post-traumatic symptoms were predicted by accident severity variables such as collision speeds and degree of injury. Variables suggested by Rachman (e.g. controllability of intrusive thoughts) were found to supplement accident severity variables. While considering the methodological problems encountered, the results of this study are discussed along with their implications for clinical practice and future research.

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