ABSTRACT
This chapter describes the acute pattern of reaction in road accident survivors. Clinical interviews were carried out two and ten days after the accident, and on the day following admission. Dissociative experiences were described but the memory of the accident was intense and was not experienced as intrusions or flashbacks. The group not distressed after their accident challenges the views of the ‘normal working through’ of a traumatic event. Patterns of acute psychological response to trauma were detailed by Lindemann although he focused on patterns of grief in people who had lost a relative or friend. Increasingly there have been many attempts to characterise better both the prevalence of experiences which might cause post-traumatic stress disorder (PTSD) as well as the relative risk of PTSD arising after different types of traumatic events. The realistic models for the development of PTSD must account for a modification of a range of biological systems.
