Post Traumatic Stress Disorders
We’re accustomed to dealing with clients who have been seriously injured, or lost a loved one, as a result of being involved in a motor vehicle crash. Many people’s tendency is often to focus on the physical injuries (broken bones, lumbar injuries, cervical injuries, shoulder injuries, chronic pain, etc.), but what about the silent injury of Post-traumatic Stress Disorder (PTSD).
Many people do not realize that PTSD is recognized as a mental health condition people can develop after experiencing, or witnessing, a life-threatening event. Whether you can recover for PTSD will depend on your situation, and the laws of the state where the injured derived. With that said, the American Psychiatric Association revised the PTSD diagnostic criteria and included PTSD in a new category: Trauma- and Stressor-Related Conditions. The diagnostic criterion for all of the conditions included in this new classification require exposure to a traumatic or stressful event. Below are the criteria that must be met.
Criterion A (one required) –The person was exposed to death or actual serious injury in the following way(s): (1) Directly experiencing the traumatic event; (2) Witnessing the event as it occurred to others; (3) Learning the traumatic event occurred to a relative or close friend and; (4) Indirect exposure to aversive details of the trauma.
Criterion B (one required)– The traumatic event is persistently re-experienced in the following way(s): (1) Unwanted upsetting memories; (2) Nightmares; (3) Flashbacks; (4) Emotional distress after exposure to traumatic reminders and; (5) Physical reactivity after exposure to traumatic reminders.
Criterion C (one required)– Avoidance of trauma-related stimuli after the trauma in the following way(s): (1) Trauma-related thoughts or feelings and (2) Trauma related reminders.
Criterion D (two required) –Negative thoughts or feelings that began or worsened after the trauma in the following ways: (1) Inability to recall key features of the trauma; (2) Overly negative thoughts and assumptions about oneself or the world; (3) Exaggerated blame of self or others for causing the trauma; (4) Negative affect; (5) Decreased interest in activities; (6) Feeling isolated and; (7) Difficulty experiencing positive affect.
Criterion E (two required) –Trauma-related arousal and reactivity that began or worsened after the trauma in the following ways: (1) Irritability or aggression; (2) Risky or destructive behavior; (3) Hypervigilance; (4) Heightened startled reaction; (5) Difficulty concentrating and; (6) Difficulty sleeping.
Criterion F (required)– Symptoms last for more than 1 month.
Criterion G (required) –Symptoms create distress or functional impairment.
Criterion H (required) –Symptoms are not because of medication, substance abuse or other illness.
Symptoms of PTSD usually begin within the first three months after the trauma, although there may be a delay of months, or even years, before criteria for the diagnosis are met. Often a person’s reaction to trauma initially meets criteria for Acute Stress Disorder, but Acute Stress Disorder is distinguished from PTSD because the symptoms are restricted to a duration of three days to one month. The duration of PTSD symptoms varies with complete recovery within three months occurring in approximately 50 percent of adults. However, some individuals remain symptomatic for more than 12 months and some for many years.
Research indicates PTSD is more prevalent in females and they experience PTSD for a longer duration on average than males. PTSD is associated with high levels of social, occupational and physical disability as well as considerable economic costs and high levels of medical utilization.
Most people hurt in car or truck wrecks do not have PTSD. They may have some short-term anxiety, but nothing that rises to the level of PTSD. We have all had stressful conditions we endured, but sucked it up and went on with life. However, there are vehicles crashes in which PTSD is a realistic issue.
While we are careful to avoid exaggeration of minor degrees of PTSD symptoms in auto and truck crash cases, we are alert to the need to have clients evaluated when appropriate for more serious and long-term PTSD symptoms.
Whether mild or severe, credible PTSD symptoms can be presented as part of mental pain and suffering in car and truck crash cases.
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