"Sense of Coherence" and Traffic Accident PTSD
The authors of this study offer a definition of sense of coherence as, "Those subjects who can give meaning to a traumatic event can comprehend what has happened and have a sense of manageability of the sequelae, and are able to cope better with the traumatic event itself." In this study the authors attempt to see if sense of coherence [SOC] is related to the development of post-traumatic stress disorder (PTSD) following a car accident; they explored the patients' experienced emotions and cognition, physical and psychological symptoms, and internal and external coping methods to determine the relationship between these factors and SOC.
Of 179 severely injured road traffic accident victims, 51 were randomly selected to study the relationship between SOC and PTSD. They were evaluated approximately 8 days following injury and 6 months after the accident. Pre-accident risk factors were evaluated at the initial visit and the SOC scale was applied during the follow-up. The researchers also studied the cause and consequences of the accident.
The PTSD data collected at the initial visit strongly correlated to patients' low SOC scores. In addition, SOC scores correlated with general health, the degree of expected change due to accident, and pre-morbid traits. The patients with low SOC scores "stay longer in rehabilitation clinics, report that they have put more burden on their relatives, and experience more fears and tension while in traffic."
The study concludes that examining how a patient deals with trauma emotionally is just as important as the physical injury he or she may experience, and that the clinician must be aware of this in order to aid recovery:
"During the development of PTSD, psychological variables allow the individual to tolerate and modulate the distress. It has been pointed out that the way an individual perceives the trauma, and the meaning the actual trauma and its symptoms has for the individual, might be at least as important as the objective indicators of the trauma itself."
Frommberger U, Stieglitz RD, Straub S, et al. The concept of "sense of coherence" and the development of posttraumatic stress disorder in traffic accident victims. Journal of Psychosomatic Research 1999;46(4):343-348.