Latent trajectories of PTSD over 12 months following road trauma and their association with recovery trajectories.

Background: Post-traumatic stress disorder (PTSD) is one of the most common psychological consequences following road trauma (RT), leading to physical and psychological impairments.Objectives: This study aims to identify distinct PTSD trajectories following RT and examine their association with recovery outcomes.Methods: We analyzed data from a prospective cohort of 1042 survivors recruited from Canadian emergency departments between July 2018 and March 2020. PTSD symptoms were assessed using the PTSD Checklist-Specific version (PCL-S) at 2, 4, 6, and 12 months post-injury. Health-related quality of life (HRQoL) was measured using the Short Form and the 5-level EuroQol instrument at baseline and follow-up. Self-reported recovery outcomes, including full recovery and return to work and daily activities, were also evaluated at these intervals.Results: Three distinct trajectories were identified for PTSD measures: Chronic, Delayed-Recovery, and Resilient. Participants in the Chronic and Delayed-Recovery trajectories were identified as high-risk groups. These individuals were characterized by high pre-injury HRQoL, followed by a sharp decline thereafter. They exhibit the most significant and persistent deficits in full recovery, return to work, and return to usual daily activities compared to the Resilient class. Patients in these classes are also more likely to be female and exhibit more pre-injury somatic symptoms, pain catastrophizing, psychological distress, no expectations for a fast recovery, higher injury severity, and greater injury pain.Conclusions: This study demonstrates the heterogeneity of PTSD symptom trajectories and emphasizes the importance of addressing PTSD early in the recovery process. The strong link between high-risk trajectories, pain catastrophizing, and greater injury pain suggests that early interventions should target the mutually reinforcing relationship between PTSD and chronic pain.