The acute psychological impact on survivors following a train accident.

Sixty-six passengers surviving a collision of two trains were investigated concerning relevant background data, degree of personal injury, experience of a threat to life, symptoms and problems immediately after the accident, and thoughts about difficulty in coping. The most obvious impact on the survivors was the experience of being close to death. One result of this was that they developed a new coping strategy to minimize emotional pain. Some survivors also suffered problems of "re-living" the accident. This is important for the coping process. The process includes psychological integration of the accident as an important life event. The findings indicate that "re-living" of the accident through nightmares and intrusive thoughts is responsible for problems in carrying out ordinary tasks. The observations are in accordance with those made after other types of accidents and disasters.