A grounded theory study was conducted to identify, describe and provide a theoretical analysis of the conditions and events surrounding the occurrence of physical trauma. Research questions addressed were: What pattern of behavior is present in individuals prior to experiencing a motor vehicle collision (MVC)?; To what degree do trauma patients view themselves as active participants in a MVC that results in physical injury? Twenty one informants participated in the study. Theoretical sampling involved the use of a variety of sources of data. Vignettes, interviews, songs, commercials and automobile advertisements were triangulated with existing literature. Constant comparative analysis revealed a grounded theory of self protection. Self protection consists of three phases; perceptions of actual control over the environment, experiencing a traumatic event that signifies loss of control over their environment, and self protection to enhance perceptions of actual control over the environment post event. Controlling perceptions influenced use of protection devices and post trauma driving behavior. Self protection involved emotional focused and problem focused strategies similar to that described in the literature. Perceptions of actual control over the environment was not a static trait but appeared to be situationally dependent. The theory explained the behavior of the majority of the informants regardless of their mechanisms of injury; although patients with injuries resulting from violence were omitted from the study. Informants who viewed driving as a pleasurable action with unpredictable outcomes, as a form of risk taking behavior, did not identify self protection strategies post event. The other informants viewed driving as an unconscious, automatized behavior and denied engaging in risk taking prior to the MVC. Findings indicate the need to explore the social context of the American lifestyle and the image of the automobile when explaining self protective strategies. Automobile manufacturers provide the illusion of control over the environment in their advertisements perhaps negating the need for self protection. Rationale for not supporting mandatory protection for the use of seat belts and helmets was provided by the informants. Further testing with contrasting groups is indicated to determine the usefulness of the theory outside the trauma patient population.

M.Com. (Industrial Psychology) / Please refer to full text to view abstract

Traditional personality research on accident behavior has produced conflicting opinions as to the traits that describe the "accident-prone" personality type. Other research has shown that psychosocial life stress, while partially determining the temporal onset of a variety of illnesses, may also be a factor contributing to increased accident liability. This study examined the role of temporary and stress-producing life changes in groups of accident-free and accident-involved industrial employees. The accident sample was found to have significantly higher stress over baseline during the period of accident involvement, but generally lower pre-accident levels than the non-accident sample. A cause-effect analysis of the data from within the accident-involved sample proved inconclusive. Several implications for future research and managerial actions to alleviate stress were also discussed.

It is the purpose of this study to determine the relationship between personality and accident-proneness in a group of pupils in the North Dallas High School.

The post traumatic symptoms of children (6-16 yrs) involved in automobile accidents were assessed an average of 9 months following the event. Measures included children's ratings of post traumatic symptoms on the Reaction Index, the Impact of Events Scale, and the Diagnostic Interview for Children and Adolescents-Revised (DICA-R). Results indicated a range of posttraumatic symptomatology among accident victims. Despite low levels of physical injury, approximately one fourth of the sample children reported moderate to severe levels of trauma. As expected, higher injury levels were related to more PTSD symptoms on the diagnostic interview. When controlling for injury level, bicyclists and pedestrians reported higher levels of PTSD symptoms than motor vehicle occupants. Younger children reported higher levels and more frequent PTSD symptoms. As indicated on the diagnostic interview, prior history of an accident was related to fewer PTSD symptoms, suggesting a buffering effect of prior history. Also, children who reported higher levels of social support reported less frequent PTSD symptoms. Lastly, reciprocal processes of fear and avoidance were supported as greater self-reported fear was related to increased PTSD symptomatology. A discussion of the differences between self-report and interview measures of PTSD is included, as factors related to PTSD varied according to the measurement utilized. The importance of direct assessment of children's symptoms is stressed and areas of future research are suggested. / Ph. D.

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. / Ph. D.

Falls in the elderly Canadian population pose a serious health problem; they are the leading cause of accidental death in persons aged 65 and older. The most common serious injuries associated with falling are hip fractures; more than 19,000 Canadians sustain a hip fracture yearly as a result of a fall. A review of the literature reveals that most of the studies on falling have been conducted in institutional settings. Community-based studies have identified the risk factors associated with falling to assist in case-finding and fall prevention. However, qualitative studies of falling for elderly community-dwelling individuals are non-existent. The purpose of this study is to describe the meaning of falling for elderly community-dwelling individuals. The phenomenological approach to qualitative methodology was used for this study. This approach seeks to describe human experience as it is lived. Individuals 65 years of age or older were contacted through a Long Term Care Unit. Eight women became informants, participating in repeated interviews guided by open-ended questions. From the content analysis of the data, three major categories of data that were common to the participants were identified and developed. The three categories represent levels of perception in relation to falling, which together represent the entire meaning of falling. At the first level, participants interpreted the various aspects of their falls. The second level describes the reactions to falling. The third level describes how participants coped with falling in the context of coping with aging. These findings revealed that falling was viewed as a symbol of aging and therefore, the emotional reaction to falling occurred in the context of growing old. Furthermore, it was found that coping with falling occurred in the broader context of coping with aging. The implications for nursing practise, education, and research were identified in light of the research findings. / Applied Science, Faculty of / Nursing, School of / Graduate

It was hypothesized that field dependence and attention measures would differentiate accident-loaded and accident-free employees of a petroleum services company. Analysis of variance revealed main effects and a three-way interaction for the Rod-and-Frame Test. Main effects occurred for the Attention-Diagnostic Method and Embedded- Figures Test. No differences occurred for the Closure Test. Regression analysis produced an R (76) = .41, p < .01, with the Attention-Diagnostic Method contributing more to prediction. Equality-symmetry violations occurred in the data. Cautious interpretation was advised because of the assumption violations. The accident-loaded subjects produced consistently greater performance variances, which suggested general performance characteristics in several respects. Future research should be longitudinal-predictive, oriented from Kerr 's complementary safety theories.

Transportation-related collisions are ubiquitous and often traumatic. Identifying post-collision psychological distress and the characteristics of the collision survivor that lead to distress are vital to the development of early and appropriate interventions. The goals of this study were: 1) to use a questionnaire as opposed to a typical diagnostic interview, 2) to confirm that psychological distress is present in currently hospitalized transportation-related collision survivors, 3) to confirm that different types of distress co-occur, 4) to determine if distress is more likely to occur in those who have had prior distress, and 5) to explore the relationship between symptoms of distress and perception of control by self, others, and God/Higher Power of past, present, and future collision-related events. Subjects were 100 English speaking adult inpatients, 16 years and older, who were less than 3 weeks post-injury, and receiving some rehabilitation. Participants completed a questionnaire which included the Center for Epidemiologic Studies Depression Scale (CES-D), Beck Anxiety Inventory (BAI), and Davidson Trauma Scale (DTS) as well as questions regarding demographics, details of the collision/injury, alcohol/drug use, pain, past and present stressors, social support, and perceptions of life change. Information about head injury and collision-concurrent alcohol and/or drug use was collected from the patient's medical chart. Compared to other traumatic experiences (e.g., physical/sexual abuse, war combat), transportation-related collisions share the characteristics of being sudden, unexpected, relatively brief in duration, and potentially lethal. Prior studies used diagnostic interviews to identify psychological distress in post hospitalized collision survivors. This study used questionnaire-based depression, anxiety, and trauma symptom inventories in a currently hospitalized sample and included head injured patients. As hypothesized there was a significant correlation between the CES-D total score and the BAI total score [Hypothesis 1], the DTS total score [Hypothesis 2], and collision concurrent alcohol and/or drug use (as indicated by medical chart records or score on the CAGE) [Hypothesis 3]. Further, there was a significant correlation between the patient's self-reported history of depression, anxiety, or stress reaction and CES-D, BAI, and DTS total scores, respectively [Hypothesis 4]. Also as hypothesized, perceived personal control of the past "events that caused the collision" was significantly correlated with the CES-D total score [Hypothesis 5] while perceived control of the present "life in general right now" was negatively correlated to the CES-D total score [Hypothesis 6]. Contrary to hypothesis, perceived control of the present "recovery process right now" was not correlated to the CES-D total score [Hypothesis 6] nor was perceived control of the future "preventing a collision like this from happening...again" [Hypothesis 7]. Perception of control by "others" of the present "recovery process right now" was negatively correlated to the CES-D total score. Results support the theory that perceived personal control of past traumatic events increases the likelihood of psychological distress. Some evidence of post traumatic growth was found.

This study assessed the predictive validity of four independent factors (Rotter Locus of Control Scale, Safety Locus of Control, Organizational Attribution Style Questionnaire, and Rosenburg Self-Esteem Scale) in the establishment of a measure of safety consciousness in predicting on-the-job injuries and the filing of workers' compensation claims. A 125-item questionnaire was designed and administered to assess participants' disposition on each of the four psychological dimensions, demographic data and on-the-job injury information.