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ArticlesPosttraumatic Stress Disorder, Automobile Collisions and other Injury Causing Incidents Author: Richard H. Adler Posttraumatic stress disorder (PTSD) is a greatly misunderstood diagnosis frequently made with individuals who have been traumatized physically and emotionally. There is no doubt physical trauma caused by motor vehicle collisions, trip and falls, pedestrian or bicycle collisions, head injuries as well as the violent wartime or criminal incident contexts can and often does lead one to develop post traumatic stress disorder. Scientific evidence has established that Post Traumatic Stress Disorder is a debilitating condition of both the body and the mind. As stated by the Surgeon General of the United States in his Report on Mental Health issued in 1999, the distinction between mental and physical is no longer tenable in this area: One reason the public continues to this day to emphasize the difference between mental and physical health is embedded in language. Common parlance continues to use the term“physical” to distinguish some forms of health and illness from“mental” health and illness. People continue to see mental and physical as separate functions when, in fact, mental functions (e.g., memory) are physical as well (American Psychiatric Association, 1994). Mental functions are carried out by the brain. Likewise, mental disorders are reflected in physical changes in the brain (Kandel, 1998). It is now accepted in the health care community based on a growing body of scientific literature that persistent and profound changes in some of the body’s physiologic systems occur in individuals with Post Traumatic Stress Disorder. Researchers have found evidence of damage to the physical systems associated with Post Traumatic Stress Disorder such as increased sympathetic nervous system activity, alterations in stress hormones secretion, memory processing and limbic system abnormalities in brain imaging studies of traumatized patients The mere presence of psychological distress related to traumatic injury does not in and of itself mean the patient has posttraumatic stress disorder (PTSD). In order for psychological injuries to rise to the level of a diagnosis of PTSD, it must meet all of the specific diagnostic criteria of the DSM-IV (Diagnostic and Statistical Manual) published by the American Psychological Association:
Clearly, the diagnosis of PTSD is detailed and specific. Oftentimes, when PTSD is suspected, the actual psychological dysfunction may be of a lesser nature, commonly diagnosed as "stress disorder" or "phobic reaction." Regardless of the diagnosis or label attached, healthcare providers need to be aware of the significant risk posed to patients with traumatic injuries of developing PTSD or one of the lesser-included conditions of psychological distress. In the area of motor vehicle , pedestrian motor vehicle and bicycle automobile collision injuries, there are characteristics that make for a greater risk of PTSD or related psychological problems, such as:
Treatment and therapy for PTSD will most likely include "desensitizing" techniques. In the case of those with fear of driving, travel or the location of the accident, therapy will likely include repeated exposure to the phobic stimuli, including the "imagining" of the traumatic event. These techniques result in desensitizing the patient to the impact of the provocative stimuli and thereby lessen or eliminate the victim's fear. Cognitive behavior therapy and relaxation training employed in the treatment of chronic pain have also been found to be effective in the treatment of PTSD symptoms. In certain situations, medications are needed and can include antidepressant drugs. Should your patient exhibit all or some of PTSD-like symptoms listed in the DSM-IV criteria stated above, it may be wise to refer that person to a competent mental health professional experienced with trauma-related issues for diagnosis and treatment. As this is an area fraught with medical/legal and insurance claim issues, a referral to an experienced personal injury attorney well versed in post traumatic stress disorder early on is recommended as well. |
