Estrés postraumático luego de siniestros viales: una revisión sistemática / Post-traumatic stress disorder after road traffic accidents: a systematic review

Resumen Las lesiones físicas y los trastornos psicológicos que se producen como consecuencia de un siniestro de tránsito (ST) constituyen un grave problema de salud pública. En este trabajo se realiza una revisión sistemática y actualización de estudios sobre prevalencia y variables predictoras de estrés postraumático (TEPT) luego de un ST. Se realizó una búsqueda en bases de datos incluyendo Medline, PsycINFO, Scopus, y Elsevier de artículos entre 2015 y 2019, siguiendo las directrices PRISMA. La búsqueda inicial mostró un total de 1062 artículos, de los cuales 28 cumplieron criterios de inclusión. La literatura disponible es heterogénea en cuanto a objetivos y metodología. La prevalencia oscila entre 2,39 y 62%. Entre los predictores más robustos de TEPT se incluyen: sexo femenino, percepción de riesgo de vida en el ST, falta de apoyo social, secuelas físicas, y problemas emocionales previos. Se destaca la importancia de la detección temprana para prevenir secuelas psicológicas.

Abstract Physical injuries and psychological disorders following a road traffic accident (RTAs) are a serious public health problem. The objective of this work was to conduct a systematic review and update of studies on the prevalence and predictive variables of post-traumatic stress disorder (PTSD) after RTAs. A systematic search was performed in databases including Medline, PsycINFO, Scopus and Elsevier, of articles published between January 2015 and August 2019, following PRISMA guidelines. Initial search showed a total of 1062 articles, and 28 met inclusion criteria. The available literature is heterogeneous in regards to aims and methodology. Prevalence rates ranged from 2,39 % to 62%. The most robust predictors of PTSD include: female gender, perceived threat to life, lack of social support, persistent physical problems and previous emotional problems. The importance of early detection to prevent psychological sequelae is highlighted.

Inventario de Personalidad para el DSM-5: propiedades psicométricas en población argentina. Estudio preliminar / Personality Inventory for the DSM-5: Psychometric Properties in Argentine Population. Preliminary Study

Resumen El DSM-5 presenta un modelo dimensional alternativo para los trastornos de personalidad, que incluye rasgos patológicos organizados en cinco grandes áreas: Desapego, Afectividad Negativa, Psicoticismo, Antagonismo y Desinhibición. Para evaluar dicho modelo, se desarrolló el Personality Inventory for DSM-5. El objetivo de este trabajo fue estudiar las propiedades psicométricas de una versión adaptada del instrumento a población argentina. Se trabajó con una muestra no probabilística de 393 sujetos de población general. Se administró la versión adaptada del Personality Inventory for DSM-5 junto con el Listado de Adjetivos para Evaluar Personalidad, una medida de los cinco rasgos del modelo de los Grandes Factores de Personalidad (Amabilidad, Responsabilidad, Extraversión, Neuroticismo y Apertura a la experiencia), equivalentes normales de los rasgos patológicos del modelo alternativo. Los resultados mostraron propiedades psicométricas satisfactorias. La versión argentina del Inventario mostró una estructura de cinco factores similar a la original, con niveles adecuados de consistencia interna e ítems con buenos índices de discriminación. Se observaron diferencias por género y edad. Los hombres puntuaron más alto en Antagonismo, Psicoticismo y Desapego, y las mujeres en Afectividad Negativa. Los jóvenes puntuaron más alto en todas las escalas salvo en Desapego. Por último, se encontraron correlaciones significativas con los cinco factores correspondientes del modelo de los "cinco grandes" (ej., entre Afectividad Negativa y Neuroticismo). Los resultados brindan evidencia preliminar de validez y confiabilidad para la versión local del instrumento, y se espera que sirvan como base para su posterior perfeccionamiento, para ser implementado en tareas clínicas como de investigación.

Abstract The DSM-5 presents an alternative dimensional model for personality disorders, which includes pathological traits organized in five major areas: Detachment, Negative affectivity, Psychoticism, Antagonism and Disinhibition. To evaluate this model, the Personality Inventory for DSM-5 (PID-5) was developed. However, it is unknown how the PID-5 would work adapted to our context. On the other hand, the PID-5 suffers from various limitations (e.g., not all facets are represented in the brief version, affecting the construct validity). The objective of this paper was to study the psychometric properties of an adapted version of the PID-5 to the Argentine population. We worked with a non-probabilistic sample of 393 subjects from the general population. The adapted version of the Personality Inventory for DSM-5 was administered together with the Adjectives Checklist to Assess the Big Five Personality Factors (AEP), a measure of the five traits of Big Five Model, normal equivalents of the pathological traits of the alternative model. The following data analyzes were performed: a) Exploratory Factor Analysis to evaluate the internal structure of PID-5; b) reliability analysis to assess the internal consistency of the different scales of the PID-5; c) item analysis to assess discriminating power; d) bivariate correlation analysis to analyze the relationship between PID-5 scores and the AEP; e) multivariate analysis of covariance (MANCOVA) to analyze significant differences due to gender, age, and possible interaction effects. Results indicated satisfactory psychometric properties. The Argentinean version of the PID-5 showed a five-factor structure similar to the original, with adequate levels of internal consistency and good discrimination indices. Regarding gender, men scored higher in Antagonism, Psychoticism and Detachment, and the effect size was significant although weak. On the other hand, women scored higher in negative affectivity, but the differences were not significant. Regarding age, young people presented higher scores than adults at all scales except in Detachment, and the effect size was significant although weak. Finally, significant relationships were found with the five factors of the big five model (e.g., strong and positive correlation between Negative Affectivity and Neuroticism; moderate and negative correlations between Detachment and Extraversion, and between Disinhibition and Conscientiousness). Additionally, other high correlations were found (e.g., between Agreeableness and Detachment; Conscientiousness and Psychoticism; Neuroticism and Disinhibition). These results are in line with those found in previous studies. Finally, moderate correlations were found between PID-5 scales (e.g., Disinhibition and Antagonism; Negative Affectivity and Disinhibition; Psychoticism and Disinhibition; and Detachment and Negative Affectivity). These correlations would imply the existence of some higher order factor that would cover the dimensions of the model. Although the results found are acceptable, this study has some limitations. First, we worked with general population, and in future work it would be important to administer the instrument in clinical samples. Second, the Antagonism scale was left with only 4 items, which may affect the construct validity of the instrument. In this regard, it would be convenient to add new items, not only on this scale, to obtain a final version with an intermediate length between 25 and 220 items of the two versions of the original scale. A version of approximately 60 items may be a good solution, that includes both the different facets of the model as well as time constraints if the instrument is pretended to be used within a diagnostic battery. Beyond these limitations, the present study provides preliminary evidence of validity and reliability for the adapted version of the PID 5, and could be a start point for its deepening and improvement to be implemented in clinical and research tasks.

Una tarea de estimación de colisiones y tiempo de llegada: evidencias preliminares de fiabilidad y validez / Uma tarefa de estimativa de colisões e tempo de chegada: evidências preliminares de confiabilidade e validade / A time-to-contact and collision estimation task: preliminary evidences of reliability and validity

Este trabajo analiza algunas propiedades psicométricas de una tarea estimativa de la trayectoria de objetos móviles. Este tipo de tarea suele utilizarse como parte de las baterías de evaluación de conductores en muchos países, pero son escasas las evidencias disponibles sobre validez. Sesenta participantes (treinta conductores profesionales y treinta de población general) completaron la prueba en dos ocasiones. Los resultados fueron positivos en algunos aspectos (e.g., consistencia interna), pero también muestran la necesidad de realizar algunos cambios y mejorías. Se requieren más estudios que ofrezcan evidencias externas de validez para este tipo de tarea. (AU)

Este trabalho analisa algumas propriedades psicométricas de uma tarefa na estimativa da trajetória de objetos móveis. Esse tipo de tarefa costuma ser utilizado como parte das baterias na avaliação de condutores em muitos países, mas são escassas as evidências disponíveis sobre a validade. Sessenta participantes (30 condutores profissionais e 30 da população geral) completaram a prova em duas ocasiões. Os resultados foram positivos em alguns aspectos (e.g., consistência interna), mas também mostram a necessidade de realizar mudanças e melhorias na prova. Requer-se mais estudos que ofereçam evidências externas que dê validade para esse tipo de tarefa. (AU)

This study analyzes some psychometric properties of a Time-to-contact and Collision Estimation Task. This type of measure is often used as part of driver testing in many countries. However, available evidences of validity are scarce. Sixty participants (split evenly between professional drivers and general population) completed the task on two occasions. The results were positive in some respects (e.g., internal consistency), but also show the need for changes and improvements in the task design. Further studies are needed to support the use of this type of measures. (AU)

Prevalencia y evolución del uso de casco en ocupantes de motocicletas en una ciudad argentina (Mar del Plata, 2006-2014) / Prevalence and evolution of helmet use in motorcycle riders in an Argentine city (Mar del Plata, 2006-2014)

RESUMEN Los siniestros viales que involucran a motociclistas conforman un problema creciente en los países de ingresos bajos y medios. La medida de protección por excelencia en estos usuarios viales es el casco. Sin embargo, una proporción considerable de motociclistas no lo usa. El objetivo de este trabajo es informar la evolución del uso de casco durante el periodo 2006-2014 en una ciudad de Argentina, y conocer los factores asociados durante el año 2014. La muestra incluye más de 6.900 observaciones de motociclistas, registradas en los años 2006 (n=962), 2008 (n=977), 2012 (n=2.542) y 2014 (n=2.466). Los datos indican un aumento progresivo del uso de casco a través del tiempo, aunque se sostienen las diferencias por género y función. Los factores asociados al uso de casco en conductores durante el año 2014 fueron el uso en pasajeros, el tipo de moto, la presencia de patente y el género. Aunque los resultados son positivos, conviene alertar sobre las consecuencias negativas del aumento del parque de motos.

ABSTRACT Traffic collisions involving motorcyclists are a growing problem in low and middle income countries. Helmet use is the foremost protective measure for this group of road users, however many riders do not wear them. The objective of the present study is to report the changes in helmet use during the period 2006-2014 in an Argentine city and discover associated factors for the year 2014. The sample includes more than 6,900 observations of motorcyclists carried out during the years 2006 (n=962), 2008 (n=977), 2012 (n=2,542), and 2014 (n=2,466). The data indicates a progressive increase in helmet use over time, but differences due to gender and type of rider remain. Factors associated to helmet use in motorcycle drivers during 2014 were: passenger helmet use, motorcycle type, license plate use and gender. Although the results are positive, it is necessary to be attentive to the negative consequences of the growing fleet of motorcycles.

[Prevalence and evolution of helmet use in motorcycle riders in an Argentine city (Mar del Plata, 2006-2014)]. / Prevalencia y evolución del uso de casco en ocupantes de motocicletas en una ciudad argentina (Mar del Plata, 2006-2014).

Traffic collisions involving motorcyclists are a growing problem in low and middle income countries. Helmet use is the foremost protective measure for this group of road users, however many riders do not wear them. The objective of the present study is to report the changes in helmet use during the period 2006-2014 in an Argentine city and discover associated factors for the year 2014. The sample includes more than 6,900 observations of motorcyclists carried out during the years 2006 (n=962), 2008 (n=977), 2012 (n=2,542), and 2014 (n=2,466). The data indicates a progressive increase in helmet use over time, but differences due to gender and type of rider remain. Factors associated to helmet use in motorcycle drivers during 2014 were: passenger helmet use, motorcycle type, license plate use and gender. Although the results are positive, it is necessary to be attentive to the negative consequences of the growing fleet of motorcycles.

Measuring individual differences in driver inattention: further validation of the attention-related driving errors scale.

OBJECTIVE: The aim of this research was (a) to study driver inattention as a trait-like variable and (b) to provide new evidence of validity for the Attention-Related Driving Errors Scale (ARDES). BACKGROUND: Driving inattention is approached from an individual differences perspective. We are interested in how drivers vary in their propensity to experience failures of attention and in the methods to measure these differences. METHOD: In a first sample (n = 301), we tested, via confirmatory factor analysis, a new theoretical model for the ARDES. In a second sample (n = 201), we evaluated the relationship between inattention and internal and external sources of distraction and social desirability bias in ARDES responses. A subsample (n = 65) was reevaluated to study temporal stability of the ARDES scores. RESULTS: Errors measured by the ARDES can be classified according to the driving task level at which they occur (navigation, maneuvering, or control). Differences in ARDES scores based on collision history were observed. ARDES was related to internal sources of distraction and was independent of the level of exposure to distracting activities. Test-retest showed a high degree of stability in ARDES scores. Low correlations were found with a social desirability measure. CONCLUSION: ARDES appears to measure a personal trait that remains relatively stable over time and is relatively independent of distracting activities. New evidence of validity emerged for this self-report. APPLICATION: ARDES can be used to measure individual differences in driving inattention and to help tailor preventive interventions for inattentive drivers. It can serve as an instrument of driver self-assessment in educational and training contexts.

La inatención como factor de riesgo en conductores de moto

Los choques que involucran motociclistas constituyen un problema creciente. No obstante, es poco lo que se conoce sobre sus patrones de desplazamiento, y sus comportamientos de riesgo y protección. En este trabajo se evalúa si la inatención en conductores de motos constituye un factor de riesgo para choques de tránsito y si ciertas variables personales se relacionan con las fallas atencionales durante la conducción. Se trabajó con una muestra de 110 motociclistas de población general de la ciudad de Mar del Plata (Argentina), que respondieron un instrumento de evaluación de la inatención durante la conducción, una medida general sobre error atencional, una escala de experiencias disociativas, una medida de deseabilidad social, un cuestionario de actividades distractoras durante la conducción, y un cuestionario de datos sociodemográficos e historial de incidentes de tránsito. La escala de inatención durante la conducción para motociclistas (Attentional Related Driving Errors Scale-Motorcyclists –ARDES-M) fue desarrollada y validada en este estudio. Se brindan datos sobre su validez dimensional y de constructo y sobre su fiabilidad en términos de consistencia interna. Según los resultados, los errores atencionales durante la conducción están correlacionados con características generales de funcionamiento atencional. Por otra parte, los conductores que incurrieron en más fallas de atención informaron un mayor historial de choques y multas de tránsito. Los resultados de esta investigación pueden proporcionar información relevante para el diseño de medidas preventivas y educativas para motociclistas.(AU)

As colisões que envolvem motociclistas constituem um problema crescente. Não obstante, é pouco o que se conhece sobre os padrões de deslocamento, os comportamentos de risco e os comportamentos de proteção dos motociclistas. Este trabalho avalia se a falta de atenção em condutores de motos constitui um fator de risco para acidentes de trânsito e se certas variáveis pessoais se relacionam com as falhas de atenção durante a condução. Trabalhou-se com uma amostra de 110 motociclistas da população geral da cidade de Mar del Plata (Argentina), que responderam um instrumento de avaliação de desatenção durante a condução (ARDES-M), uma medida geral sobre erro de atenção (ARCES), uma escala de experiências dissociativas (DES), uma medida de desejabilidade social, um índice de atividades distrativas durante a condução e um questionário de dados sociodemográficos e histórico de incidentes de trânsito. A escala de desatenção durante a condução para os motociclistas (Attentional Related Driving Errors Scale – ARDES-M) foi desenvolvida e validada neste estudo. Segundo os resultados, os erros relacionados à falta de atenção durante a condução estão correlacionados com características gerais de funcionamento da atenção. Por outro lado, os condutores que incorrem em mais falhas de atenção informaram um maior histórico de colisões e multas de trânsito. Esta investigação poderia proporcionar informação relevante para o planejamento de medidas preventivas e educativas para motociclistas.(AU)

La inatención como factor de riesgo en conductores de moto / Inattention as a risk factor for motorcycle drivers

Los choques que involucran motociclistas constituyen un problema creciente. No obstante, es poco lo que se conoce sobre sus patrones de desplazamiento, y sus comportamientos de riesgo y protección. En este trabajo se evalúa si la inatención en conductores de motos constituye un factor de riesgo para choques de tránsito y si ciertas variables personales se relacionan con las fallas atencionales durante la conducción. Se trabajó con una muestra de 110 motociclistas de población general de la ciudad de Mar del Plata (Argentina), que respondieron un instrumento de evaluación de la inatención durante la conducción, una medida general sobre error atencional, una escala de experiencias disociativas, una medida de deseabilidad social, un cuestionario de actividades distractoras durante la conducción, y un cuestionario de datos sociodemográficos e historial de incidentes de tránsito. La escala de inatención durante la conducción para motociclistas (Attentional Related Driving Errors Scale-Motorcyclists –ARDES-M) fue desarrollada y validada en este estudio. Se brindan datos sobre su validez dimensional y de constructo y sobre su fiabilidad en términos de consistencia interna. Según los resultados, los errores atencionales durante la conducción están correlacionados con características generales de funcionamiento atencional. Por otra parte, los conductores que incurrieron en más fallas de atención informaron un mayor historial de choques y multas de tránsito. Los resultados de esta investigación pueden proporcionar información relevante para el diseño de medidas preventivas y educativas para motociclistas.

As colisões que envolvem motociclistas constituem um problema crescente. Não obstante, é pouco o que se conhece sobre os padrões de deslocamento, os comportamentos de risco e os comportamentos de proteção dos motociclistas. Este trabalho avalia se a falta de atenção em condutores de motos constitui um fator de risco para acidentes de trânsito e se certas variáveis pessoais se relacionam com as falhas de atenção durante a condução. Trabalhou-se com uma amostra de 110 motociclistas da população geral da cidade de Mar del Plata (Argentina), que responderam um instrumento de avaliação de desatenção durante a condução (ARDES-M), uma medida geral sobre erro de atenção (ARCES), uma escala de experiências dissociativas (DES), uma medida de desejabilidade social, um índice de atividades distrativas durante a condução e um questionário de dados sociodemográficos e histórico de incidentes de trânsito. A escala de desatenção durante a condução para os motociclistas (Attentional Related Driving Errors Scale – ARDES-M) foi desenvolvida e validada neste estudo. Segundo os resultados, os erros relacionados à falta de atenção durante a condução estão correlacionados com características gerais de funcionamento da atenção. Por outro lado, os condutores que incorrem em mais falhas de atenção informaram um maior histórico de colisões e multas de trânsito. Esta investigação poderia proporcionar informação relevante para o planejamento de medidas preventivas e educativas para motociclistas.

Propiedades psicométricas de la escala de deseabilidad social del conductor (versión en español) / Psychometric properties of the diver social desirability scale (Spanish version)

La deseabilidad social del conductor se refiere a las descripciones positivamente sesgadas que las personas hacen al evaluar su propio comportamiento al conducir. Se trata de un factor que puede afectar la validez de los auto-informes, por ello, resulta necesario evaluar su presencia y posibles efectos. Este trabajo analiza las propiedades psicométricas de la Escala de Deseabilidad Social del Conductor (DSDS) en una muestra argentina de población general. Se aplicó a una muestra de 332 conductores de la ciudad de Mar del Plata la escala DSDS en diferentes condiciones de administración, conjuntamente con un cuestionario de datos socio-descriptivos y medidas de estilos de conducción (MDSI) y personalidad (ZQPK-50). Los resultados indican un comportamiento globalmente satisfactorio de la versión en español de la DSDS. Se obtuvo evidencia interna y externa de validez. No obstante, los resultados sugieren que podría tratarse tanto de una medida específica de sesgo de deseabilidad como de una medida relacionada con estilo de conducción.(AU)

Driver Social Desirability refers to positive biased self-descriptions given by drivers. As it could affect self-reported results, its assessment is necesary. The present study analyzes the psychometric properties of the Driver Social Desirability Scale (DSDS) in an Argentine sample. A sample of 332 drivers from Mar del Plata city was collected in different administration conditions. Participants answer a descriptive socio-demographic questionnaire, driving style measures (MDSI), and personality measures (ZKPQ-50) under four different administration conditions. A 2x2 quasiexperimental factor design was used to assess possible effects of social desirability bias. The first manipulated factor was type of administration (self-administration vs. face-to-face administration). The second manipulated factor was the anonymity of responses (anonimous vs. non- anonimous conditions). Results indicated good overall properties for the argentinean version of the DSDS. Evidence on the external and internal validity of DSDS was also gathered. However, results obtained suggest that DSDS could assess a extremely careful and law abiding driving style besides driver social desirability.(AU)

Propiedades psicométricas de la escala de deseabilidad social del conductor (versión en español) / Psychometric properties of the diver social desirability scale (Spanish version)

La deseabilidad social del conductor se refiere a las descripciones positivamente sesgadas que las personas hacen al evaluar su propio comportamiento al conducir. Se trata de un factor que puede afectar la validez de los auto-informes, por ello, resulta necesario evaluar su presencia y posibles efectos. Este trabajo analiza las propiedades psicométricas de la Escala de Deseabilidad Social del Conductor (DSDS) en una muestra argentina de población general. Se aplicó a una muestra de 332 conductores de la ciudad de Mar del Plata la escala DSDS en diferentes condiciones de administración, conjuntamente con un cuestionario de datos socio-descriptivos y medidas de estilos de conducción (MDSI) y personalidad (ZQPK-50). Los resultados indican un comportamiento globalmente satisfactorio de la versión en español de la DSDS. Se obtuvo evidencia interna y externa de validez. No obstante, los resultados sugieren que podría tratarse tanto de una medida específica de sesgo de deseabilidad como de una medida relacionada con estilo de conducción.

Driver Social Desirability refers to positive biased self-descriptions given by drivers. As it could affect self-reported results, its assessment is necesary. The present study analyzes the psychometric properties of the Driver Social Desirability Scale (DSDS) in an Argentine sample. A sample of 332 drivers from Mar del Plata city was collected in different administration conditions. Participants answer a descriptive socio-demographic questionnaire, driving style measures (MDSI), and personality measures (ZKPQ-50) under four different administration conditions. A 2x2 quasiexperimental factor design was used to assess possible effects of social desirability bias. The first manipulated factor was type of administration (self-administration vs. face-to-face administration). The second manipulated factor was the anonymity of responses (anonimous vs. non- anonimous conditions). Results indicated good overall properties for the argentinean version of the DSDS. Evidence on the external and internal validity of DSDS was also gathered. However, results obtained suggest that DSDS could assess a extremely careful and law abiding driving style besides driver social desirability.