Karlehagen S, Malt U F, Hoff H, Tibell E, Herrstromer U, Hildingson K, Leymann H
Swedish Foundation for Occupational Health and Safety for State Employees (Statshälsan), Orebro.
J Psychosom Res. 1993 Dec;37(8):807-17. doi: 10.1016/0022-3999(93)90170-k.
The psychological impact on 101 train drivers of accidents causing major injuries or death to persons was studied by means of clinical interviews and questionnaires (Impact of Event Scale, General Health Questionnaire and a questionnaire addressing stress symptoms plus past and pre accident expectancies of being involved in accidents). The drivers were examined within hours to a few days after the accident and later at 1 month and 1 year. One month after the accident the symptoms of distress were significantly reduced and most so among the drivers with no preaccident risk experience according to self reports during the acute phase. A minor further reduction of distress was found at 1 year. Drivers with two or more previous accident experiences and those who had worried about being involved in accidents showed highest symptoms of distress at follow-up. Eleven out of 101 drivers reported sick leave more of than 1 week after the accident and this was related to higher intrusion scores. The few drivers who report longterm psychological distress are best predicted by a combination of acute high IES scores, experience of previous accidents and risk expectancy prior to the current accident. The study suggests that premorbid and non-accident related variables are more important for the 1 year psychological outcome of healthy drivers after on-the-track accidents than the stress event itself.
通过临床访谈和问卷调查（事件影响量表、一般健康问卷以及一份针对压力症状加上事故发生前和事故发生时对卷入事故的预期的问卷），研究了导致人员重伤或死亡的事故对101名火车司机的心理影响。这些司机在事故发生后的数小时至数天内接受检查，之后在1个月和1年时再次接受检查。事故发生1个月后，痛苦症状显著减轻，根据急性期的自我报告，在事故发生前没有风险经历的司机中减轻最为明显。在1年时发现痛苦症状有进一步轻微减轻。有两次或更多次先前事故经历的司机以及那些曾担心卷入事故的司机在随访时表现出最高的痛苦症状。101名司机中有11名在事故发生后请病假超过1周，这与更高的侵入分数有关。少数报告长期心理痛苦的司机，最能通过急性IES高分、先前事故经历以及当前事故前的风险预期来预测。该研究表明，对于健康司机在轨道事故后的1年心理结果，病前和与事故无关的变量比压力事件本身更重要。
