By Rebecca Guest
Typical Injuries from a Motor Vehicle Crash Cause Psychological Distress
Psychological distress following a motor vehicle crash (MVC) is prevalent and the relationship between physical injury and consequent distress remains unclear. Understanding this relationship may provide an opportunity for promoting improved strategies that could lead to positive health outcomes. Meta-analysis findings have indicated that physical injuries such as traumatic brain injury, whiplash and spinal cord injury following an MVC are associated with significant and long-term psychological distress. However, the extent of the psychological distress requires further investigation to determine characteristics of the development of elevated rates of psychological distress into mental health disorders such as Major Depressive Disorder, Post-Traumatic Stress Disorder, Adjustment Disorder or Driving Phobia. Health professionals, lawyers, compensation scheme regulators and insurers and employers should be mindful of the heightened risks of elevated psychological distress following an MVC as this added factor to the MVC-related physical injury has implications for insurance companies and regulators such as increased costs of the claim and longer timeframes to claim completion, as well as negative health outcomes and reduced quality of life for the MVC survivor.
Brief CBT Can Reduce MVC-Related Distress
Studies investigating psychological distress prevention programs were found to be limited in number and statistical power; however, the review suggests brief cognitive behavior therapy (CBT) approaches are promising at reducing MVC-related distress. The results of the meta-analysis and the systematic review of prevention strategies indicate there is a compelling need for randomised controlled trials designed with adequate statistical power to investigate the efficacy of CBT strategies that can be readily translated into the community for preventing psychological distress following an MVC (see links to the Meta-analysis – BMJ; and Systematic Review – Injury papers). The results of such a trial will identify potential changes to policy and practices for healthcare and MVC compensation systems. Implications include reduced costs of MVC compensation claims and reduced number of days to finalization of compensation claims.
Can Email and Telephone Programs Help to Reduce Distress?
A randomized controlled trial is currently investigating the efficacy of brief email-delivered psychological programs including regular telephone contact for support, encouragement, and normalization replicating face-to-face treatment protocols (CBT vs Lifestyle vs Wait-listed Control) to at least 180 MVC claimants. These programs are delivered soon after lodgement of the MVC survivor’s claim with the aim of preventing the development of psychological distress into more severe disorder such as Depression, Post-Traumatic Stress Disorder or Adjustment Disorder (see link to Trials paper). The results of this RCT should be known in early 2017 and published in a suitable journal.
- Psychological impact of injuries sustained in motor vehicle crashes: Systematic review and meta-analysis – View PDF here.
- Psychological Distress Following a Motor Vehicle Crash: A Systematic Review of Preventative Interventions – DOI: http://dx.doi.org/10.1016/j.injury.2016.09.006
- Prevention of the development of psychological distress following a motor vehicle crash: study protocol for a randomized controlled trial – View PDF here.
Rebecca Guest is a Clinical Psychologist in private practice treating a wide range of clients aged 13 to 80+ years. Rebecca utilizes a cognitive behavior therapy approach to formulate and treat diagnosis such as depressive and anxiety disorders, PTSD and phobias, as well as chronic pain management. Rebecca is also a PhD Candidate at The University of Sydney investigating the development of psychological distress into more severe psychological disorders for MVC survivors with the aim of preventing this negative trajectory for improved health outcomes and quality of life.