In our prospective study, 168 adolescents exposed directly or indirectly to the same traumatic event-a fatal school bus accident-in which seven students were killed instantly, were assessed for post-traumatic stress, depression and grief symptoms at 2- and 18-months post-accident. Prevalence rates of likely PTSD and depression were noted across all types of physical proximity exposure: 77.6% and 48.1% respectively in the indirectly exposed group, 79.4% and 47.1% respectively in the directly in-the-area exposed group, and 77.8% and 42.1% respectively in the directly in-bus exposed group. One-fifth experienced high and unremitting levels of grief symptoms over time ("persistent grief"); 17% with initially high levels of grief symptoms showed a decrease at 18 months but were still within the low medium range ("towards recovery"); 39% with initially medium/high grief symptoms reported low levels of grief at the follow-up ("recovery"); and 23% of the participants experienced grief symptoms that remained persistently low ("resilient"). The absence of both PTSD and depression at 18 months predicted adjustment to loss, whereas the absence of depression at 18 months predicted a recovering course of grief. The findings highlight the impact of high levels of post-traumatic stress and depression symptoms on the long-term persistent grief outcome.

中文翻译：

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同伴丧失：受创伤青少年社区的创伤后压力、抑郁和悲伤症状

在我们的前瞻性研究中，168 名青少年直接或间接暴露于相同的创伤事件——致命的校车事故——其中 7 名学生立即死亡，在 2 个月和 18 个月时接受了创伤后压力、抑郁和悲伤症状的评估事故后。在所有类型的身体接触暴露中都注意到可能的 PTSD 和抑郁症的患病率：间接暴露组分别为 77.6% 和 48.1%，直接在该区域暴露组中分别为 79.4% 和 47.1%，以及 77.8% 和 47.1%直接在车内暴露组分别为 42.1%。随着时间的推移，五分之一的人经历了高度且持续不断的悲伤症状（“持续性悲伤”）；17% 最初具有高度悲伤症状的人在 18 个月时表现出减少，但仍处于中低水平（“走向康复”）；39% 最初有中度/高度悲伤症状的人在随访（“恢复”）时报告了低水平的悲伤；23% 的参与者经历了持续较低的悲伤症状（“弹性”）。18 个月时没有 PTSD 和抑郁症预示着对失去的调整，而 18 个月时没有抑郁症预示着悲伤的恢复过程。研究结果强调了高水平的创伤后压力和抑郁症状对长期持续悲伤结果的影响。而在 18 个月时没有抑郁症预示着悲伤的恢复过程。研究结果强调了高水平的创伤后压力和抑郁症状对长期持续悲伤结果的影响。而在 18 个月时没有抑郁症预示着悲伤的恢复过程。研究结果强调了高水平的创伤后压力和抑郁症状对长期持续悲伤结果的影响。