AccScience Publishing / HPR / Online First / DOI: 10.36922/HPR026050027
Submit to HPR
Cite this article
69
Views
Related Info Links
Google Scholar
More by Authors Links
Franziska Epe-Jungeblodt
Journal Browser
Volume | Year
Issue
Search
News and Announcements
View All
RESEARCH ARTICLE

Psychological treatment utilization following motor vehicle accident exposure: An exploratory longitudinal study

Franziska Epe-Jungeblodt1* ,  Katja Bertsch1,2 ,  Marta Andreatta3,4
Show Less
1 Department of Psychology I Clinical Psychology and Psychotherapy, Faculty of Human Sciences, Julius-Maximilians-Universität Würzburg, Würzburg , Germany
2 German Center for Mental Health, Site Munich, Augsburg , Germany
3 Department of General Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen , Germany
4 Center for Mental Health, University Hospital Tübingen, Tübingen , Germany
HPR, 026050027 https://doi.org/10.36922/HPR026050027
Received: 27 January 2026 | Revised: 10 August 2026 | Accepted: 11 August 2026 | Published online: 9 November 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Download PDF
XML
Cite
Abstract

Background: Motor vehicle accidents (MVAs) are associated with elevated psychological distress, yet many affected individuals do not seek psychological treatment, despite it being generally available within the health care system.

Objective: This exploratory prospective cohort study examined psychological distress, psychological treatment utilization, and perceived barriers over 12 months among individuals with and without MVA exposure.

Methods: Individuals with (n = 60) and without (n = 108) MVA exposure completed two online surveys 12 months apart. Psychological distress was assessed using the Brief Symptom Checklist and the Posttraumatic Stress Disorder Checklist for DSM-5. Utilization of psychological treatment and perceived barriers were also measured. Analyses compared distress between groups, examined associations between distress and treatment utilization, explored an indirect association of MVA exposure with treatment utilization via baseline distress, compared perceived barriers, and examined continuity in treatment utilization over time.

Results: MVA-exposed individuals reported higher distress than unexposed individuals (d = 0.53, confidence interval [CI]: 0.14–0.92). MVA exposure was not associated with treatment utilization (b = −0.10, CI: −0.74–0.55), but it was indirectly associated through elevated baseline distress (b = 0.25, CI: 0.05–0.45). No group differences emerged in perceived barriers. Previous psychological treatment was associated with treatment utilization during follow-up independent of baseline distress (b = 2.43, CI: 1.04–3.99).

Conclusion: MVA-exposed individuals reported persistently elevated psychological distress but were no more likely than unexposed individuals to receive psychological treatment. These exploratory findings suggest that specific factors may limit help-seeking following MVAs despite elevated psychological distress. Future research should identify these factors using larger samples and more comprehensive barrier assessment.

Keywords
Motor vehicle accident
Psychological distress
Help-seeking behavior
Psychological treatment
Barriers to mental health care
Funding
The authors received funding from the University of Würzburg (Faculty of Human Sciences Overhead Fund Number OH 04 2023_03-07) and the Bundesanstalt für Straßenwesen, BASt (FE 82.0734/2019/).
Conflict of interest
The authors declare no conflict of interest.
References
  1. Benjet C, Bromet E, Karam EG, et al. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychol Med. 2016;46(2):327-343. doi: 10.1017/S0033291715001981
  2. European Commission. Facts and Figures: Gender. European Road Safety Observatory. Brussels, Belgium: European Commission, Directorate General for Transport; 2025. Accessed November 5, 2026. https://road-safety.transport.ec.europa.eu/document/download/1e7b4666-fb5c-435e-bc45-82ed910d3549_en?filename=ff_gender_2025.pdf
  3. Eurostat. Persons killed in road accidents by type of vehicle. Published 2025. doi: 10.2908/TRAN_SF_ROADVE
  4. Bhateja A, Kumar P, Gaidhane S, et al. Post-traumatic stress disorder among road traffic accident survivors: a systematic review and meta-analysis. Transp Res Interdiscip Perspect. 2025;30:101374. doi: 10.1016/j.trip.2025.101374
  5. Kovacevic J, Miskulin M, Degmecic D, et al. Predictors of mental health outcomes in road traffic accident survivors. J Clin Med. 2020;9(2):309. doi: 10.3390/jcm9020309
  6. Fischer IC, Na PJ, Harpaz-Rotem I, Marx BP, Pietrzak RH. Prevalence, correlates, and burden of subthreshold PTSD in US veterans. J Clin Psychiatry. 2024;85(4). doi: 10.4088/JCP.24m15465
  7. Cuijpers P, Miguel C, Harrer M, et al. Cognitive behavior therapy vs control conditions, other psychotherapies, pharmacotherapies and combined treatment for depression: a comprehensive meta-analysis including 409 trials with 52,702 patients. World Psychiatry. 2023;22(1):105-115. doi: 10.1002/wps.21069
  8. Gaskell C, Simmonds-Buckley M, Kellett S, et al. The effectiveness of psychological interventions delivered in routine practice: systematic review and meta-analysis. Adm Policy Ment Health. 2023;50(1):43-57. doi: 10.1007/s10488-022-01225-y
  9. Öst LG, Enebrink P, Finnes A, et al. Cognitive behavior therapy for adult post-traumatic stress disorder in routine clinical care: a systematic review and meta-analysis. Behav Res Ther. 2023;166:104323. doi: 10.1016/j.brat.2023.104323
  10. Brandstetter S, Dodoo-Schittko F, Speerforck S, et al. Trends in non-help-seeking for mental disorders in Germany between 1997-1999 and 2009-2012: a repeated cross-sectional study. Soc Psychiatry Psychiatr Epidemiol. 2017;52(8):1005-1013. doi: 10.1007/s00127-017-1384-y
  11. Sharifian N, LeardMann CA, Kolaja CA, et al. Factors associated with mental healthcare utilization among United States military personnel with posttraumatic stress disorder or depression symptoms. Am J Prev Med. 2025;68(2):289-299. doi: 10.1016/j.amepre.2024.10.006
  12. Auerbach K, Surges F. Versorgung Psychischer Unfallfolgen [Accident-Related Mental Health Care]. Bremen, Germany: Fachverlag NW in Carl Ed. Schünemann KG; 2019. [In German]. Accessed November 5, 2026. https://www.amazon.de/Versorgung-psychischer-Unfallfolgen-Bundesanstalt-Strassenwesen/dp/3956064747
  13. Nordbrandt MS, Vindbjerg E, Mortensen EL, Carlsson J. Chronicity of posttraumatic stress disorder and comorbid pain as predictors of treatment response for trauma-affected refugees. J Trauma Stress. 2022;35(5):1393-1404. doi: 10.1002/jts.22839
  14. Hammer JH, Vogel DL, Grzanka PR, et al. The integrated behavioral model of mental health help seeking (IBM-HS): a health services utilization theory of planned behavior for accessing care. J Couns Psychol. 2024;71(5):315-327. doi: 10.1037/cou0000754
  15. Kantor V, Knefel M, Lueger-Schuster B. Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: a systematic review. Clin Psychol Rev. 2017;52:52-68. doi: 10.1016/j.cpr.2016.12.001
  16. Huff NR, Dunderdale L, Kellogg AJ, Isbell LM. Factors related to help-seeking and service utilization for professional mental healthcare among young people: an umbrella review. Clin Psychol Rev. 2024;114:102504. doi: 10.1016/j.cpr.2024.102504
  17. Hawn SE, Cusack SE, Amstadter AB. A systematic review of the self-medication hypothesis in the context of posttraumatic stress disorder and comorbid problematic alcohol use. J Trauma Stress. 2020;33(5):699-708. doi: 10.1002/jts.22521
  18. Sheerin C, Berenz EC, Knudsen GP, et al. A population-based study of help seeking and self-medication among trauma-exposed individuals. Psychol Addict Behav. 2016;30(7):771-777. doi: 10.1037/adb0000185
  19. Singer S, Maier L, Paserat A, et al. Wartezeiten auf einen Psychotherapieplatz vor und nach der Psychotherapiestrukturreform. Psychotherapeut. 2022;67(2):176-184. doi: 10.1007/s00278-021-00551-0
  20. Schreiber V, Renneberg B, Maercker A. Seeking psychosocial care after interpersonal violence: an integrative model. Violence Vict. 2009;24(3):322-336. doi: 10.1891/0886-6708.24.3.322
  21. Kamali M, Edwards J, Anderson LN, Duku E, Georgiades K. Social disparities in mental health service use among children and youth in Ontario: evidence from a general, population-based survey. Can J Psychiatry. 2023;68(8):596-604. doi: 10.1177/07067437221144630
  22. Loef B, Meulman I, Herber GCM, et al. Socioeconomic differences in healthcare expenditure and utilization in The Netherlands. BMC Health Serv Res. 2021;21(1):643. doi: 10.1186/s12913-021-06694-9
  23. Üzümçeker E. Traditional masculinity and men's psychological help-seeking: a meta-analysis. Int J Psychol. 2025;60(2):e70031. doi: 10.1002/ijop.70031
  24. Wuthrich VM, Frei J. Barriers to treatment for older adults seeking psychological therapy. Int Psychogeriatr. 2015;27(7):1227-1236. doi: 10.1017/S1041610215000241
  25. Statistisches Bundesamt (Destatis). Verkehrsunfälle 2021 [Road Traffic Accidents in 2021]. Wiesbaden, Germany: Statistisches Bundesamt (Destatis); 2022. Accessed February 22, 2023. https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Verkehrsunfaelle/Publikationen/Downloads-Verkehrsunfaelle/verkehrsunfaelle-zeitreihen-pdf-5462403.pdf?__blob=publicationFile&v=18 [In German].
  26. Lui JC, Sagar-Ouriaghli I, Brown JSL. Barriers and facilitators to help-seeking for common mental disorders among university students: a systematic review. J Am Coll Health. 2024;72(8):2605-2613. doi: 10.1080/07448481.2022.2119859
  27. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191-2194. doi: 10.1001/jama.2013.281053
  28. Tomzig M, Metzulat M, Hoffmann S, Kenntner-Mabiala R, Epe-Jungeblodt F. Einfluss psychischer Unfallfolgen auf die verkehrssicherheitsrelevante Fahrkompetenz verunfallter Pkw-Fahrer [Influence of Psychological Consequences of Accidents on the Road Safety-Relevant Driving Competence of Car Drivers Involved in Accidents]. Bergisch Gladbach, Germany: Bundesanstalt für Straßenwesen; 2024. [In German]. Accessed November 5, 2026. https://www.bast.de/DE/Publikationen/BerichteBASt/Berichte/unterreihe-m/2024-2023/m350.html
  29. Franke GH. BSCL: Brief-Symptom-Checklist. Göttingen, Germany: Hogrefe; 2017.
  30. Krüger-Gottschalk A, Knaevelsrud C, Rau H, et al. The German version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): psychometric properties and diagnostic utility. BMC Psychiatry. 2017;17(1):379. doi: 10.1186/s12888-017-1541-6
  31. Margraf J, Cwik JC. Mini-DIPS Open Access: Diagnostisches Kurzinterview bei psychischen Störungen [Mini-DIPS Open Access: Short Diagnostic Interview for Mental Disorders]. Bochum, Germany: Ruhr-Universität Bochum; 2017. [In German]. doi: 10.13154/RUB.102.91
  32. Lampert T, Hoebel J, Kuntz B, Müters S, Kroll LE. Messung des sozioökonomischen Status und des subjektiven sozialen Status in KiGGS Welle 2 [Assessment of socioeconomic status and subjective social status in KiGGS wave 2]. J Health Monit. 2018;3(1). [In German]. doi: 10.17886/RKI-GBE-2018-016
  33. Kuch K, Cox BJ, Direnfeld DM. A brief self-rating scale for PTSD after road vehicle accident. J Anxiety Disord. 1995;9(6):503-514. doi: 10.1016/0887-6185(95)00029-N
  34. Blanchard EB, Hickling EJ. After the Crash: Psychological Assessment and Treatment of Survivors of Motor Vehicle Accidents. 2nd ed. Washington, DC: American Psychiatric Association; 2004. doi: 10.1037/10676-000
  35. R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2023. Accessed November 5, 2026. https://cran.r-project.org/doc/manuals/r-release/fullrefman.pdf
  36. Rosseel Y. lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48(2):1-36. doi: 10.18637/jss.v048.i02
  37. Bates D, Mächler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1):1-48. doi: 10.18637/jss.v067.i01
  38. Aust F, Barth M. papaja: prepare reproducible APA journal articles with R Markdown. 2023. Accessed November 5, 2026. https://www.rdocumentation.org/packages/papaja/versions/0.1.4/topics/papaja
  39. Lüdecke D, Ben-Shachar MS, Patil I, Waggoner P, Makowski D. performance: an R package for assessment, comparison and testing of statistical models. J Open Source Softw. 2021;6(60):3139. doi: 10.21105/joss.03139
  40. Kenardy J, Shannon LE, Shourie S, et al. Changing patterns in the prevalence of posttraumatic stress disorder, major depressive episode and generalized anxiety disorder over 24 months following a road traffic crash: results from the UQ SuPPORT study. J Affect Disord. 2018;236:172-179. doi: 10.1016/j.jad.2018.04.090
  41. Hayes AF. Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Commun Monogr. 2009;76(4):408-420. doi: 10.1080/03637750903310360
  42. Saint Arnault D, Zonp Z. Understanding help-seeking barriers after gender-based violence: validation of the Barriers to Help Seeking-Trauma version (BHS-TR). Arch Psychiatr Nurs. 2022;37:1-9. doi: 10.1016/j.apnu.2021.12.004
Share
Back to top
Health Psychology Research, Electronic ISSN: 2420-8124 Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept