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A recent issue of the British Medical Journal examined the incidence of Post Traumatic Stress Disorder among children involved in automobile accidents. Increasing data demonstrating that emotional symptoms caused by experiencing trauma or the impact of living with physical problems secondary to trauma complicates neuropsychological assessment and often exerts a negative impact on daily functioning is being generated.
Psychologists at the Royal United Hospital in England followed 119 children who had been in auto accidents in 1997. These children were evaluated for Post Traumatic Stress Disorder. Although there has been some controversy in the past concerning the validity and reliability of this diagnosis, there is increasing research data demonstrating that it is a valid diagnosis and that stress often precipitates a constellation of life disrupting symptoms that fall under this diagnosis.
Six weeks after being in an automobile accident, forty-one of the children showed signs of Post Traumatic Stress Disorder symptoms, including sleep disturbance and nightmares, separation anxiety from parents, difficulty concentrating, intrusive thoughts about accidents, difficulty communicating with others, mood disturbance and a decline in school performance. Interestingly in a control group of 66 children involved in sports related injuries, only 2 showed any signs of Post Traumatic Stress Disorder.
Neither the type of accident nor severity of physical injuries was related to the presence of Post Traumatic Stress Disorder. However, the more a child perceived the accident as life threatening, the more likely the child was to experience Post Traumatic Stress Disorder symptoms. In fact, the experience of a perceived life threatening event is the first criteria that must be met for a Post Traumatic Stress Disorder diagnosis.
In this study females were more likely to develop the disorder than males. Clearly the psychological needs of children involved in automobile accidents are largely unrecognized. Future research will need to examine the potential benefits of ph.armacologic as well as behavioral treatments to reduce symptom severity and bring individuals back to their pre-accident level of functioning. It is hoped that future research will also examine the relationship between severity of Post Traumatic Stress symptoms, traumatic brain injury and the impact of both upon neuropsychological testing and everyday functioning. Interested readers are referred to this article in the British Medical Journal, Volume 317, pages 1619-1623.
