DEPRESSION AND ANXIETY 30:483–488 (2013) Research Article THE ROLE OF ATTRIBUTION OF TRAUMA RESPONSIBILITY IN POSTTRAUMATIC STRESS DISORDER FOLLOWING MOTOR VEHICLE ACCIDENTS Angela Nickerson, Ph.D., 1,2∗ Idan M. Aderka, Ph.D., 3 Richard A. Bryant, Ph.D., 1 and Stefan G. Hofmann, Ph.D. 3 Background: Motor vehicle accidents (MVAs) are highly prevalent and associ- ated with adverse psychological outcomes. Methods: The present study used data from the National Comorbidity Survey-Replication (NCS-R) to examine the as- sociation between injury, role in an MVA (driver/nondriver), attributions of re- sponsibility for the accident, and posttraumatic stress disorder (PTSD), amongst 165 MVA survivors. Results: Findings indicated that drivers with external at- tributions of the MVA (i.e. who considered others to be at fault for the MVA) were significantly more likely to have a diagnosis of PTSD than drivers with internal attributions (i.e. considering themselves to be at fault) and nondrivers with external attributions of the accident. Further, serious injury sustained in the accident was related to greater likelihood of developing PTSD. Conclusions: External attributions for the MVA among drivers, as well as serious injury dur- ing the accident, were related to higher rates of PTSD. The present findings have implications for models that highlight the importance of posttraumatic cognitions in contributing to mental health following a traumatic event. Depression and Anxiety 30:483–488, 2013. C  2012 Wiley Periodicals, Inc. Key words: motor vehicle accident; posttraumatic stress disorder; anxiety; men- tal health Motor vehicle accidents (MVAs) are associated with substantial psychiatric morbidity, including high rates of posttraumatic stress disorder (PTSD), acute stress disorder, and major depression. [1–8] For example, Blanchard et al. [1] estimated that between 15 and 45% of MVA survivors develop PTSD within the first year 1 School of Psychology, University of New South Wales, Sydney, New South Wales, Australia 2 Massachusetts Veterans Epidemiological Research and Infor- mation Center, Boston University, Boston, Massachusetts 3 Department of Psychology, Boston University, Boston, Massachusetts ∗ Correspondence to: Angela Nickerson, School of Psychology, Uni- versity of New South Wales, Sydney NSW 2052, Australia. E-mail: a.nickerson@unsw.edu.au; anickerson@psy.unsw.edu.au Received for publication 30 December 2011; Revised 16 July 2012; Accepted 3 September 2012 DOI 10.1002/da.22006 Published online 22 October 2012 in Wiley Online Library (wileyonlinelibrary.com). of the accident. Further, approximately 40% of those with PTSD following an MVA also suffer from major depression (Blanchard et al., [2] ). Considering the high prevalence of MVAs internationally, [9] with over 3 mil- lion people per year being injured in MVAs (Blanchard et al., [1] ), it is important to elucidate factors that predict psychological disorders following MVAs. Two accident- related factors that have been identified as potentially im- portant in influencing psychological disorders are injury severity and attributions related to the accident. There have been mixed findings regarding the role of injury in post-accident psychological disorders, with some studies demonstrating that injury severity predicts psychological disorders (e.g. [10–12] ), whereas others have failed to find evidence to support this link (e.g. [13–16] ). Research inves- tigating the role of attributions of responsibility in psy- chological disorders following an MVA has also yielded mixed findings. Although some studies have found that MVA survivors who perceive themselves as responsible for the accident are less likely to experience symptoms of PTSD, [17–19] others have suggested that self-blame is not related to subsequent development of PTSD (e.g. [20,21] ). C  2012 Wiley Periodicals, Inc.