Children and Adolescents: Psychological Impact of Motor Vehicle Crashes

By Apple, Roger W. | International Journal of Child and Adolescent Health, April 1, 2018 | Go to article overview

Children and Adolescents: Psychological Impact of Motor Vehicle Crashes


Apple, Roger W., International Journal of Child and Adolescent Health


Introduction

Motor vehicle crashes have become so commonplace in United States culture that many within the culture do not consider the psychological ramifications, particularly the development of post-traumatic stress disorder (PTSD). Motor vehicle crashes (MVC) can cause long-term mental health problems for children and adolescents. Such problems include Acute Stress Disorder (ASD), post-traumatic stress disorder (PTSD), depressive symptoms, and numerous behavior problems that often are unrecognized and that consequently receive no form of treatment or intervention (1). Many children who experience traumatic events will experience signs of distress soon after the event, usually within the first few weeks. Such signs of distress include avoidance behaviors, concentration and attention difficulties, withdrawal behaviors, and a loss of interest in activities (2, 3). Up to 35% of children injured in motor vehicle crashes have symptoms of PTSD months or even years after motor vehicle crashes (1), making it crucial that our medical and mental health systems increase their awareness of the prevalence of PTSD related to motor vehicle crashes as well as improve their ability to identify traumatic symptoms in children and adolescents subsequent to motor vehicle crashes.

The psychological impact of motor vehicle crashes on children and adolescents is a concept that has failed to resonate with many health care and mental health care providers. It may be that motor vehicle crashes have become such a common occurrence in our daily lives that we have forgotten about the potential traumatic impact of such events. Fortunately, the general issue of trauma and children is currently receiving a significant amount of attention in the literature and in clinical practice. This review will use existing literature to help bridge the gap between general trauma literature and the literature on trauma and motor vehicle crashes involving children and adolescents in order to illuminate the psychological impact of motor vehicle crashes. Interestingly, when work began on this review it was assumed that there would be very little literature on the specific topic on traumatic stress reactions for children and adolescents related to MVC; however, that assumption was completely wrong (4-17)! While the research seems to be paying attention to this phenomenon, clinical providers and United States culture as a whole does not seem to be connecting PTSD with motor vehicle crashes nearly as well.

Trauma can be an invisible condition tht debilitates the lives of countless children and adolescents who often lack the skills necessary to communicate such complex symptoms to caregivers or healthcare providers. This makes it essential to explicitly assess the psychological functioning of each child and adolescent that has been in a motor vehicle crash. This review will focus primarily on the psychological impact on children and adolescents resulting from motor vehicle crashes and other chapters will discuss historical background as well as specific assessment and treatment options.

General impact of trauma on children

The impact of trauma on children and adolescents in general, or after accidental injury, has received much and growing attention in the literature (8, 18-21); however, the literature regarding the impact of trauma subsequent to motor vehicle crashes is varied often using different terminology such as road traffic accidents, road accidents, motor vehicle accidents, or motor vehicle crashes (5, 9, 10). This review will use the term motor vehicle crashes rather than motor vehicle accidents, because the term accident suggests a random act that was not intended to be harmful. This review will use current literature to draw parallels between trauma in general and trauma caused by motor vehicle crashes in order to provider a greater understanding of MVC and the traumatic impact on children and adolescents. This section will briefly review the DSM 5 narrative description of post-traumatic stress disorder, and provide a discussion regarding intrusive memories and rumination, social support, acceptance, and thought control strategies. …

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