Psychological
Effect of Motor Vehicle Accidents
This study reviewed the
literature that deals with the psychological complaints of whiplash and traffic
accident patients, in particular, PTSD. 1
The author focused on the
characteristics of PTSD and a victim’s phobic anxiety to both the traumatic
event, and driving a car, in general. Overall, he concluded that although psychological
morbidity decreases with time, in the long term, victims will have higher than
average psychological complaints over the long-term.
The most important predicative
risk factor for PTSD is the psychological impact of the stressor: studies show
that when patients are tested for intrusion and avoidance reactions immediately
following a traumatic event, high scores indicate the onset of PTSD at a later
stage. Other predictive factors include a previous PTSD episode, premorbid psychological
state, and questionable coping strategies. Severity of physical pain and possible
financial compensation has not been shown as predictive risk factors in other
studies.
The author dedicates attention
to the psychology of coping. She cites a Radanov3 study that found:
“The authors concluded
that it was not so much the subject’s premorbid psychological functioning that
determined the course of whiplash, but more the psychological problems (including
the cognitive ones) that affected the subject’s ability to cope with the somatic
problems, particularly pain.”
Avoidance behavior seems
to a common pitfall/coping strategy for most car accident victims—avoiding thoughts
or emotional reactions to the accident, or just avoiding driving altogether.
Mayou2 found that even 4-6 years after the accident, one out of three
victims still had anxiety or avoidance behavior towards road travel.
Due to the trend of avoidance
behavior, a major aspect of treatment is exposure. Exposing the client to their
trauma-related emotions and memories relieves the victim of the emotional weight
of the stressful event, and anxiety and other symptoms may very well disappear.
For other aspects of treatment the author recommends combining biological, psychological,
and psychosocial disciplines. And, treatment should focus on the patient’s response
to trauma, not just the physical whiplash symptoms:
“Overall it can
be assumed that psychological problems resulting from an accident are underestimated
for traffic accident victims in general and for whiplash patients in particular.
PTSD is especially common, but usually goes untreated. Instead of focusing most
attention on the chronic whiplash complaints, it is recommended that priority
be given to coping with the trauma. Afterwards it can be decided whether other
complaints require treatment. “
Other studies have demonstrated,
on the other hand, that the psychological symptoms disappear after the physical
pain has been alleviated. Thus, waiting to decide whether the physical symptoms
warrant attention may lead to chronic pain and dissatisfied patients. Very few
patients would be willing to wait to deal with the physical pain.
- Jaspers JPC. Whiplash
and post-traumatic stress disorder. Disability and Rehabilitation, 1998;20(11),197-404.
- Radanov BP, Di
Stefano G, Schnidrig A. Common whiplash: psychosomatic or somatopsychic? Journal
of Neurology, Neurosurgery, and Psychiatry 1997;57:486-490.
- Mayou RA, Simkin
S, Threlfall J. The effects of road traffic accidents on driving behavior.
Injury 1994;24: 457-460.
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