PTSD Not Just for War Survivors

Auto accident victims increasingly diagnosed with it

MONDAY, Dec. 8, 2003 (HealthDayNews) -- People who have survived serious car accidents have a lot in common with soldiers, a new book says: They can both develop posttraumatic stress disorder (PTSD).

The book, After the Crash: Psychological Assessment and Treatment of Survivors of Motor Vehicle Accidents says car accidents are a leading cause of PTSD in the general population.

PTSD is a common psychological ailment, affecting as many as 5 million Americans every year, according to the National Institute of Mental Health. During times of war that number is even higher. Symptoms of PTSD include reliving the traumatic incident often through flashbacks or nightmares. Other symptoms include sleep problems, depression, anxiety, irritability and anger.

In this updated version of the book, psychologists Edward Blanchard, from the University of Albany, and Edward Hickling, in private practice in Albany, N.Y., add information from a new study of motor vehicle accident survivors and PTSD.

For the latest study, the researchers followed 161 car crash survivors for five years after the accident. All of the study participants were at least slightly injured and sought medical treatment after their accident.

In this group, 110 were diagnosed with PTSD, and of those with PTSD, the researchers report that 60 percent also were diagnosed with major depression.

Almost all -- 95 percent -- of the crash survivors were anxious when driving and many avoided certain driving situations, such as night or highway driving, after their accidents.

J. Gayle Beck, a professor of psychology at the University at Buffalo who specializes in treating PTSD after a motor vehicle accident, says that's common behavior for people who have lived through a serious accident.

"These people tend to refuse to drive or are unbelievably nervous drivers," Beck says.

And, she says, a serious accident doesn't necessarily have to be one where someone is seriously injured. Any accident that really scares someone or makes them believe they might die has the potential to cause PTSD, she says, recalling a patient whose car rolled over numerous times. Remarkably, he wasn't seriously injured, but during the accident, he had truly believed he was going to die, and those memories haunted him.

"There's a perception that automobile accidents aren't extraordinary events," says Beck. "These studies [in the book] are drawing attention to the fact that many times in a crash you see incredibly horrifying things and people are convinced they are going to die. These things can easily set the stage for PTSD."

PTSD, says Beck, is not always easy to diagnose. Many of the symptoms aren't easily seen by outsiders. The most common, she says, is having recurrent and intrusive thoughts about the accident. This may make you appear to others as distracted or not able to concentrate. She says people suffering from PTSD often are clearly hyperactive and have trouble sleeping.

One clear sign that someone may need help is a refusal to drive, or if they must drive, very nervous or altered driving behavior.

While some of these things are common right after an accident, Beck says if any of these symptoms last more than six months, it's definitely time to get treatment. Ideally, though, treatment should begin earlier, somewhere between one and six months, Beck recommends.

According to the book, and to Beck, cognitive behavioral therapy is helpful, as is supportive psychotherapy. Beck says researchers are experimenting with new ways to treat PTSD, and in her lab, she is currently using virtual reality driving simulations as a safe way to get people with PTSD driving again.

More information

To learn more about posttraumatic stress disorder, go to the National Institute of Mental Health or to the National Center for PTSD.

SOURCES: J. Gayle Beck, professor, psychology, University at Buffalo, N.Y.; After the Crash: Psychological Assessment and Treatment of Survivors of Motor Vehicle Accidents
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