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Car Accidents Are Leading Cause For Post-traumatic Stress Disorder In The General Population, Says New Book
Psychological Disorders, Like Depression, Predispose Accident Victims to Developing PTSD; Women Suffer More Than Men
WASHINGTON -- Over three million people a year are involved in automobile accidents which cause serious bodily injury and psychological distress. Between 10 and 45 percent of those injured later suffer from Post-traumatic Stress Disorder (PTSD) which can interfere with their daily functioning, according to the first book that comprehensively examines the psychological effect of motor vehicle accidents on the survivors of a crash. Car accidents are also the most frequent kind of trauma experienced by American men and the second most frequent trauma experienced by American women.
''Besides this being a national public health problem,'' say psychologists Edward B. Blanchard, Ph.D., and Edward J. Hickling, Psy.D., authors of After The Crash: Assessment and Treatment of Motor Vehicle Accident Survivors, which is published by the American Psychological Association (APA), ''it is also taking a psychological toll. Not only are almost half of those in car accidents at a noticeable risk for developing PTSD, but there are other non symptomatic signs that affect them, like having trouble on the job and in school, maintaining friendships and not being able to enjoy leisure time.''
Since broken bones and soft tissue injuries are the first things taken care of after a car accident, the emergency room and primary care medical doctors along with the physical therapist end up becoming the gatekeepers to other caretakers, says Dr. Blanchard. ''Knowing about PTSD symptoms would be very important in making an appropriate referral. This is similar to what primary care physicians went through 15 years ago when they were being sensitized to symptoms of depression'
''Also, because of the debilitating effect car accidents can have and the necessity of daily driving in many people's lives, it is crucial to have services available to those suffering from the repercussions of an accident. One has to be able to drive a car or be a passenger without experiencing severe anxiety,'' says Dr. Blanchard.
The book examines the current research on PTSD and describes the experiences and symptoms of survivors of motor vehicle accidents and effective treatments used in a five-year study of 158 motor vehicle accident survivors in Albany, NY. The study, the Albany MVA Project, was funded by a grant from the National Institute of Mental Health.
A control group of 93 individuals who matched the accident victims demographically but had not been in an accident were compared on the same measures of PTSD, depression and other psychological disorders and psycho social functioning (performance at work, quality of relationships with significant others and friends and participation and enjoyment of recreational activities).
''Among the 158 survivors of serious motor vehicle accidents (defined as those who required medical attention), 39.2 percent developed PTSD initially after the accident or within a year of it,'' says Dr. Blanchard. ''Of that group, 10.4 percent of the women compared with only 5.0 percent of the men developed PTSD. The main symptoms of PTSD are reexperiencing the traumatic event, persistent avoidance of stimuli associated with the trauma and/or numbing or decrease in general responsiveness and persistent symptoms of increased arousal that were not present prior to the trauma'.
''We found that fear of dying in an accident, waiting for a court decision and the seriousness of an injury increased one's risk for developing PTSD. Also, a large proportion of the car accident survivors who suffered from PTSD were more likely to have been in a previous motor vehicle accident or experienced prior trauma than the sample that had not been in an accident. This,'' Dr. Blanchard says, ''supports the fact that prior PTSD sensitizes individuals to develop PTSD when confronted with a new trauma'" .
''Furthermore, car accident survivors were found to suffer from depression more than the control sample. Fifty-three percent of those with PTSD suffered from major depression. Almost 10 percent of the survivors who developed PTSD were clinically depressed at the time of the accident and 43.5 percent of the survivors with PTSD developed major depression after the accident,'' say the authors. ''It appears that psychological disorders, like depression, predispose accident victims to developing PTSD'.
Other problems also plagued the survivors from the Albany study who suffered from PTSD, say the authors. At least 15.3 percent of them developed a driving phobia (stopped driving or severely restricted their driving) and 93.2 percent of the survivors developed driving reluctance (avoided the site of the accident and weather conditions and certain road and traffic conditions that were similar to conditions the day of the accident, and did not want to be a passenger).
''After treating these survivors, our results suggests that we can help these people get beyond their very traumatic experience,'' says Dr. Blanchard. Cognitive-behavioral treatments that involve learning how to think about the traumatic experience in healthier ways appear to be the most effective in reducing the accident survivors' PTSD symptoms and other psychological problems that resulted from the accident, concluded the authors.
Book: After the Crash: Assessment and Treatment of Motor Vehicle Accident Survivors by Edward B. Blanchard, Ph.D., University of Albany at SUNY and Edward J. Hickling, Psy.D., Russell Sage College and Albany Medical College. $39.95, published by the APA, 1-800-374-2721.
(Review copies of the Book are available from the APA Public Affairs Office.) The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 151,000 researchers, educators, clinicians, consultants and students. Through its divisions in 50 subfields of psychology and affiliations with 58 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.
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