Permanent disability following road traffic accidents in Brazil: A serial mediation model of PTSD, self-hate, and suicidal ideation

• RTA survivors with permanent disability had poorer mental health than their peers. • Self-hate emerged as a key psychosocial mechanism linking trauma and suicidality. • Findings highlight the need for integrated psychological care for RTA survivors. Road traffic accidents (RTA) result in over 1 million deaths annually worldwide, with survivors often suffering permanent psychological damage. However, research on the mental health outcomes for RTA survivors with and without permanent disabilities, particularly in non-WEIRD (Western, Educated, Industrialized, Rich, Democratic) contexts remains scarce. This correlational study sought to address this gap by investigating 42 Brazilian RTA survivors (50% with permanent disabilities; M age = 33.3, SD = 8.52, range = 21–56 years) through measures of post-traumatic stress disorder (PTSD) symptoms, suicidal ideation, self-hate, and life satisfaction. The results showed that RTA survivors who developed permanent disabilities after the accident exhibited significantly more PTSD symptoms, increased suicidal ideation, and lower life satisfaction than their non-disabled counterparts. In addition, we observed a serial mediation effect of PTSD symptoms and self-hate in the relationship between permanent disability status (i.e., without vs. with permanent disability after the RTA episode) and suicidal ideation. These findings demonstrate how the combination of physical trauma, post-traumatic stress, and negative self-perception was associated with elevated mental health risks among RTA survivors. We discuss these findings in relation to some psychological theories (e.g., the interpersonal theory of suicide and the social suffering theory) and propose new perspectives for future research (e.g., longitudinal studies to track symptom progression, and integration of clinical assessments of pre-accident mental health).