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BEHIND THE WHEEL

Road Warfare Takes a Toll on Survivors

Researchers have found post-traumatic stress disorder, long associated with battle, in people who live through highway crashes.

August 20, 2002|LISA LEFF | SPECIAL TO THE TIMES

Robert Pynoos, a nationally recognized child psychiatrist who directs the UCLA trauma center along with Saunders, said it is easy for adults to overlook the traumas that children experience "as if they didn't appraise the threat for what it was."

At the same time, he thinks that, since children do not know how to drive, their sense of helplessness may actually be greater.

Although many psychiatrists believe that the disorder often goes undiagnosed in children and adults, some clinicians believe the number of people at risk of developing it has been overestimated in recent studies. Mark Levy, a forensic psychiatrist who teaches at UC San Francisco, said the promise of multimillion-dollar pain and suffering awards has prompted personal injury lawyers to seek post-traumatic stress diagnoses for their clients.

"It's a fairly new idea that PTSD is in the 25% incidence range, so for auto accidents I would think it is an inflated figure driven by compensation and the plaintiff's bar," Levy said. "The fact that someone was shook up or even had some symptoms doesn't mean they have PTSD."

According to Blanchard, many, or even most of the patients with post-traumatic stress resulting from traffic accidents, will get over it on their own, usually within six months. For the rest, intensive psychological therapy may be required.

Treatment methods include encouraging patients to confront their fears in a safe environment, helping them counteract their catastrophic thoughts with healthier ones and teaching them relaxation techniques.

In the case of people who have been scared off from driving, that might also mean easing them step-by-step into the driver's seat, starting with simply sitting in a car and working their way toward putting the key into the ignition and driving around the block.

"Getting back behind the wheel is a very hard thing, but it is a good thing," Blanchard said.

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