Posttraumatic Stress Disorder and Motor Vehicle Accidents: A Multidisciplinary Overview

Objective: Motor vehicle accidents (MVA) may result in intractable disability. This paper investigates posttrau-matic stress disorder (PTSD) as a potential cause. Method: The literature was reviewed for recent studies on prevalence, symptom profile, and outcome of PTSD. Results: PTSD is prevalent in roughly 10 % of survivors of MVAs during the first year. Comorbid depression and pain are common. Medical complications, psychophysiological reactivity, and possibly litigation may slow remission. Phobic symptoms can persist for years. Mood disturbance may augment the impact of pain on daily living and on self-perceived disability. Conclusion: Recently developed screening instruments, structured interviews, and behavioural approach tests yield quantitative and reliable assessments of symptom severity. Cognitive–behavioural intervention and antide-pressants may improve coping, ease fear, and reduce the impact of pain. (Can J Psychiatry 1996;41:429–434) Key Words: accidents, phobias, pain, assessment, disability, treatment An MVA is a human-made calamity. It angers and it raisesquestions of blame. It can turn survivors into white-knuckled drivers who live in fear of another accident (1). Medical help is more likely to be sought for physical com