OBJECTIVE: To investigate the psychological impact of traffic injuries in bicyclists (cyclists) with comparisons to car occupants who also have sustained traffic injuries. Factors predictive of elevated psychological distress were also investigated. METHODS: An inception cohort prospective design was used. Participants included cyclists who sustained a physical injury (n = 238) aged >/=17 years (mean age 41.7yrs), assessed within 28 days of the crash, following medical examination by a registered healthcare practitioner. Injury included musculoskeletal and soft tissue injuries, and minor/moderate traumatic brain injury (TBI), excluding severe TBI, spinal cord injury and severe multiple fractures. Assessment also occurred 6-months post-injury. Telephone-administered interviews assessed a suite of measures including socio-demographic, pre-injury health and injury factors. Psychological impact was measured by pain catastrophization, trauma related distress and general psychological distress. The psychological health of the cyclists was compared to that of the car occupants (n = 234; mean age 43.1 yrs). A mixed model repeated measures analysis, adjusted for confounding factors, was used to determine differences between groups and regression analyses were used to determine contributors to psychological health in the cyclists 6 months post-injury. RESULTS: Cyclists had significantly better psychological health (e.g. lower pain catastrophizing, lower rates of probable PTSD and lower general distress levels) compared to car occupants at baseline and six-months post-injury. Factors predictive of cyclists' psychological distress included younger age, greater perceived danger of death, poorer pre-injury health, and greater amount of time in hospital after the injury. CONCLUSIONS: This data provides insight into how cyclists perceive and adjust to their traffic injuries compared to drivers and passengers who sustain traffic injuries, as well as direction for preventing the development of severe psychological injury. Future research should examine the utility of predictors of psychological health to improve recovery.
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