Complicated bereavement and posttraumatic stress disorder following fatal car crashes: recommendations for death notification practice.

This article reviewed how four characteristics of car crash deaths--suddenness, untimeliness, preventability, and violent, mutilating injuries--may contribute to complicated bereavement syndromes or to the development of posttraumatic stress disorder (PTSD). The Fatality Analysis Reporting System was then used to assess the proportion of car crashes from 1990-1996 that involved one or more of these characteristics. At least 75% of all deaths involved suddenness, untimeliness, or were preventable, that is, due to alcohol or drug use. Twenty-eight percent of crash deaths involved 2 of these characteristics and 6% involved all 3. Recommendations for performing death notifications were provided with an emphasis on identifying and responding to circumstances that may lead to complicated bereavement or PTSD. Recommendations for further research also were provided.