Though posttraumatic stress disorder is most commonly associated with military combat or violent assault, motor vehicle accidents are actually the leading cause of PTSD development in Americans.[1] With over one percent of Americans experiencing a serious motor vehicle accident (MVA) annually, MVAs account for over three million injuries and over 100 billion dollars in damage costs each year.[2] At least 10% of serious MVA survivors develop PTSD or other mental health afflictions, so while physical injuries may be more apparent, the psychological damage caused by car accidents are just as imperative to address in medical and legal settings. Here is an overview of current research and important information to keep in mind when addressing cases involving MVAs:
The Relationship between MVAs and PTSD
While posttraumatic stress disorder was initially treated as a disorder traumatically induced by fear, more recent theories also acknowledge that it is a condition that strongly affects an individual’s judgment of danger, personal competence, and the trustworthiness of the world after an event that threatens one’s life or physical well-being.[3] PTSD is causally intertwined with chronic pain and physical illness; PTSD exacerbates common pain conditions like post-traumatic headaches, a common consequence of whiplash, and the presence of chronic pain several months after an MVA can predict the presence of PTSD.[4] Reminder of the emotional trauma can stimulate a physical response, and vice versa, and this linkage can cause pain and PTSD symptoms to persist long after the initial injury.
Symptoms of PTSD after a Severe Accident
- Psychologically reliving the trauma (e.g., intrusive thoughts about the accident, dreams about the accident)[5]
- Persistent avoidance of situations associated with the accident (e.g., reluctance or refusal to drive, actively avoiding being in cars)
- Increased arousal (e.g., sleep disturbance, concentration difficulties, quick to startle, irritability)
- A state of decreased interests or emotional numbness
- Depressive episodes
Risk Factors
Different variables have been identified that increase the likelihood of an individual developing traumatic stress disorders after a serious accident. These risk factors can be placed into one of three categories: pre-accident variables, accident-related variables, and post-accident variables. The first category, pre-accident variables, can include a poor social support system, poor ability to cope with previous traumatic events, and the presence of a pre-existing mental health problem.[6] Accident-related variables include serious physical injury, potential life-threat, and loss of significant others.[7] Finally, post-accident variables include the rate of physical recovery, the level of social support received, and the level of reengagement in work and social activities.[8]
Treatment Options
Unfortunately, because many survivors of MVAs are primarily concerned with the physical injuries and chronic pain resulting from the trauma, they may not realize they have developed PTSD and won’t consider psychological treatment for some time.[9] One set of treatment approaches is designed to prevent the development of PTSD in individuals who have experienced a serious MVA, but these treatments must be started immediately following the accident.[10] Another approach involves treatments that address diagnosed PTSD in MVA survivors, typically later in the physical healing process.[11] In either case, treatments can include behavior therapy, cognitive therapy, working with a chronic pain specialist, and medications.
There is no way to erase traumatic events, but it is important to acknowledge when the memories of those events have strong, negative effects on our lives, and when seeking help for them is advisable. Make sure that your clients are receiving the assistance and support for all of their struggles during recovery, whether their needs are obvious to bystanders or not.
[1] “Motor Vehicle Accidents Are Leading Cause of Posttraumatic Stress Disorder, According to New Book,” American Psychological Association, Dec. 7, 2003, http://www.apa.org/news/press/releases/2003/12/accidents-ptsd.aspx
[2] Buckley, Todd, “Traumatic Stress and Motor Vehicle Accidents,” U.S. Department of Veterans Affairs, Feb. 23, 2016, http://www.ptsd.va.gov/professional/trauma/other/traumatic-stress-vehicle-accidents.asp
[3] Koch, William J. “Post-traumatic stress disorder and pain following motor vehicle collisions.” BC Medical Journal, July/August 2002, http://www.bcmj.org/article/post-traumatic-stress-disorder-and-pain-following-motor-vehicle-collisions
[4] Ibid
[5] Beck, J. Gayle and Scott F. Coffey, “Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations,” National Center for Biotechnology Information, Dec. 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2396820/
[6] Buckley, “Traumatic stress”
[7] Ibid
[8] Ibid
[9] Ibid
[10] Beck, J. Gayle and Scott F. Coffey, “Assessment and treatment of PTSD”
[11] Ibid