Long-term outcome of trauma in adults: The psychological impact of a fatal bus accident

The psychological impact of trauma on 35 parents and spouses was examined 1 year( 1989), 3 years (1991), and 5 years (1993)after a fatal school bus accident in Western Norway in 1988. The course and outcome of posttraumatic symptoms (Impact of Event Scale [IES]) and symptoms of general psychological distress (SCL-90) were examined in relation to type of trauma (loss vs. no loss) and prior exposure to trauma. A large proportion of the sample reported high levels of symptoms on SCL-90 and IES ( Intrusion). No associations were observed between type of trauma and any of the symptom measures. Prior exposure to trauma did not affect the scores on IES but was associated with a sustained vulnerability for general psychological distress (SCL90). Different trajectories of the symptoms indicate that two psychological processes may be involved in long-term adjustment to trauma.