Injuries and being injured. Unvisible wounds after accidental trauma
Summary
Motor vehicle accidents may cause apart from physical also psychological aftermaths.
Despite of posttraumatic psychologic symptoms may remit after 2-3 months, 10-20 %
of the injured persons will develop sustainable psychopathological symptoms. This
report aims at an overview on possible psychopathological disturbances and their perpetuating
conditions. Possible treatments are shown and the necessity of an interdisciplinary
cooperation with the aim of a secondary prevention is emphasized.
Zusammenfassung
Verkehrsunfälle können neben körperlichen auch psychische Folgeschäden verursachen.
Wenngleich posttraumatische psychische Symptome nach 2-3 Monaten remittieren können,
liegt die Zahl derjenigen Unfallverletzten, die eine gravierende psychopathologische
Symptomatik entwickeln, bei ca. 10-20 %. Der vorliegende Artikel zielt auf einen Überblick
der möglichen psychischen Störungsbilder und deren aufrechterhaltende Determinanten
ab. Behandlungsmöglichkeiten werden aufgezeigt und die Notwendigkeit einer interdisziplinären
Zusammenarbeit mit dem Ziel einer Sekundärprävention unterstrichen.
Key words
Accident - psychologic aftermaths - acute stress disorder - posttraumatic stress disorder
- treatment
Schlüsselwörter
Unfall - psychische Folgen - akute Belastungsreaktion - posttraumatische Belastungsstörung
- Behandlung
Literatur
- 1
Acierno R, Hersen M, Hasselt V B, Meuser K T.
Review of the validation and dissemination of eye-movement desensitization and reprocessing:
A scientific and ethical dilemma.
Clinical Psychology Review.
1994;
14
287-299
- 2 American Psychiatric Association .Diagnostic and Statistical Manual of Mental Disorders. (4th
ed), Author, Washington DC 1994
- 3
Awerbuch M.
Whiplash in Australia: Illness or injury.
Med J Australia.
1992;
157
193-196
- 4
Barton K A, Blanchard E B, Hickling E J.
Antecedents and consequences of acute stress disorder among motor vehicle accident
victims.
Behav Res Ther.
1996;
34
805-813
- 5
Blanchard E B, Hickling E J, Vollmer A J, Loos W R, Buckley T C, Jaccard J.
Short-Term follow-up of post-traumatic stress symptoms in motor vehicle accident victims.
Behav Res Ther.
1995;
33
369-377
- 6
Blanchard E B, Hickling E J, Barton K, Taylor A E, Loos W R, Jones-Alexander J.
One-year prospective follow-up of motor vehicle accident victims.
Behav Res Ther.
1996;
34
775-786
- 7
Blanchard E B, Hickling E J, Taylor A E, Loos W R, Foreneris C A, Jaccard J.
Who develops PTSD from motor vehicle accidents.
Behav Res Ther.
1996;
34
1-10
- 8
Blanchard E B, Hickling E J, Taylor A E, Buckley T C, Loos W R, Walsh J.
Effects of litigation settlement on posttraumatic stress symtoms in motor vehicle
accident victims.
J Trauma Stress.
1998;
11
337-355
- 9
Blanchard E B, Buckley T C, Hickling E J, Taylor A E.
Posttraumatic stress disorder and comorbid major depression: is the correlation an
illusion.
J Anxiety Disorders.
1998;
12
21-37
- 10
Bohnen N, Jolles J.
Neurobehavioral aspects of postconcussive symptoms after mild head injury.
J Nerv Ment Dis.
1992;
180
683-692
- 11
Boudewyns P A, Stwertkas L A, Hyer J W, Albrecht X, Sperr E G.
Eye movement desensitization for PTSD of combat: A treatment outcome pilot study.
Behav Therap.
1993;
16
29-33
- 12
Brady K T.
Posttraumatic stress disorder and comorbidität: recognizing the many faces of PTSD.
J Clin Psychiatry.
1997;
58
12-14
- 13
Breslau N, Davis G C, Andreski P, Peterson E L, Schultz L R.
Sex differences in posttraumatic stress disorder archives.
Gen Psychiatry.
1997;
54
1044-1048
- 14
Brom D, Kleber R J, Defares P B.
Brief psychotherapy for posttraumatic stress disorders.
J Consult Clin Psych.
1989;
57
607-612
- 15
Bronisch T.
Posttraumatic Stress Disorder - Posttraumatische Belastungsstörung.
Fortsch Neurol Psychiatrie.
1997;
65
195-207
- 16
Bryant R A, Harvey A G.
Psychological impairment following motor vehicle accidents.
Australian J Public Health.
1995;
19
185-188
- 17
Bryant R A, Harvey A G.
Avoidant coping style and post-traumatic stress following motor vehicle accident.
Behav Res Ther.
1995;
33
631-635
- 18
Bryant R A, Harvey A G.
Initial post-traumatic stress responses following motor vehicle accidents.
Behav Res Ther.
1996;
33
632-636
- 19
Bryant R A, Harvey A G.
Acute stress disorder: a critical review of diagnostic issues.
Clin Psychol Rev.
1997;
17
757-773
- 20
Buckley T C, Blanchard E B, Hickling E J.
A prospective examination of delayed onset of PTSD secondary to motor vehicle accidents.
J Abnormal Psychol.
1996;
105
617-625
- 21 Davidson J RT, Fairbank J A. The epidemiology of posttraumatic stress disorder. In:
Davidson JRT, Foa EB (Eds). Posttraumatic stress disorder: DSM-IV and beyond. American
Psychiatric Press, Washington 1992
- 22 De Girolamo G, McFarlane A C. The epidemiology of PTSD: A comprehensive review
of the international literature. In: Mak FL, Nadelson CC (Eds). International Review
of Psychiatry 2: American Psychiatric Press, Washington DC 1996; 93-119
- 23
Delahanty D L, Herberman H B, Craig K J, Hayward M C, Fullerton C S, Ursano R J.
Acute and chronic distress and posttraumatic stress disorder as a function of responsibility
for serious motor vehicle accidents.
J Consult Clin Psychol.
1997;
65
560-567
- 24
Di Gallo A, Barton J, Parry-Jones W L.
Road traffic accidents: early psychological consequences in children and adolescents.
Br J Psychiatry.
1997;
170
358-362
- 25 Dilling H, Mombour W, Schmidt M H. Internationale Klassifikation psychischer Störungen. Huber,
Bern 1991
- 26
Dressing H, Berger M.
Posttraumatische Streßerkrankungen. Die Entwicklung des gegenwärtigen Krankheitskonzeptes.
Nervenarzt.
1991;
62
16-62
- 27
Ehlers A, Steil R.
Maintenance of intrusive memories in posttraumatic stress disorder: A cognitive approach.
Behav Cognit Psychother.
1995;
23
217-249
- 28
Ehlers A, Mayou R A, Bryant B.
Psychological predictors of chronic PTSD after vehicle accidents.
J Abnormal Psychol.
1998;
107
508-519
- 29
Frank J B, Kosten T R, Giller E L, Dan E.
A randomized clinical trial of phenelzine and imipramine for posttraumatic stress
disorder.
Am J Psych.
1988;
145
1289-1291
- 30 Frey D, Rogner O, Havemann D. Kognitive und psychosoziale Determinanten des Genesungsprozesses
von Unfallpatienten. Universität Kiel 1985
- 31
Foa E B, Rothbaum B O, Riggs D S, Murdock T B.
Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral
procedures and counseling.
J Consult Clin Psychol.
1991;
59
715-723
- 32
Frommberger U, Schlickewei W, Stieglitz R D, Nyberg E, Kuner E, Berger M.
Die psychischen Folgen nach Verkehrsunfällen Teil II: Ergebnisse einer prospektiven
Studie.
Unfallchirurgie.
1998;
24
122-128
- 33 Frommberger U, Käppler C, Stieglitz R D, Schlickewei W, Kuner E, Berger M. Die
Entwicklung von posttraumatischen Belastungsstörungen nach Verkehrsunfällen. Erste
Ergebnisse einer prospektiven Studie. In: Möller H-J, Engel RR, Hoff P (Hrsg). Befunderhebung
in der Psychiatrie: Lebensqualität, Negativsymptomatik und andere aktuelle Entwicklungen.
Springer, Wien 1996; 309-312
- 34
Green M M, McFarlane A C, Hunter C E, Griggs W M.
Undiagnosed posttraumatic stress disorder following motor vehicle accidents.
Med J Australia.
1993;
159
529-534
- 35
Heim E.
Coping und Anpassungsvorgänge in der psychosomatischen Medizin.
Z psychosomatische Med Psychoanalyse.
1979;
25
251-262
- 36
Hickling E J, Blanchard E B, Schwarz S P, Silverman J.
Headaches and motor vehicle accidents: Results of the psychological treatment of post-traumatic
headache.
Headache Quarterly.
1992;
3
285-289
- 37
Hodge J R.
The whiplash neurosis.
Psychosomatics.
1971;
12
245-249
- 38
Jensen J A.
An investigation of eye movement desensitization and reprocessing (EMD/R) as a treatment
for posttraumatic stress disorder (PTSD) symptoms of Vietnam combat veterans.
Behav Ther.
1994;
25
311-325
- 39 Internetseiten des Statistischen Bundesamtes. 23. 08. 1999
- 40
Kessler R, Sonnega A, Bromet E. et al .
Posttraumatic stress disorder in the national comorbidity survey.
Arch Gen Psychiatry.
1995;
52
1048-1060
- 41
Koutsosimou M, McDonald A S, Davey G CL.
Coping and psychopathology in surgery patients: A comparision of accident patients
with other surgery patients.
Br J Health Psychol.
1996;
1
357-364
- 42
Kuch K K, Cox B J, Evans R, Shulman I.
Phobias, panic, and pain in 55 survivors of road vehicle accidents.
J Anxiety Disorders.
1994;
8
181-187
- 43
Kuch K K, Cox B J, Evans R J.
Posttraumatic stress disorder and motor vehicle accident: a multidisciplinary overview.
Canad J Psychiatry.
1996;
41
429-434
- 44 Lauer G. Fahrängste und Fahrphobien. In: Höfling S, Butollo W (Hrsg). Psychologie
für Menschenwürde und Lebensqualität. Deutscher Psychologen-Verlag, München 1989
- 45 Lazarus R S. Streß und Streßbewältigung. In: Filip SH (Hrsg). Kritische Lebensereignisse.
Psychologie-Verlagsunion, Weinheim 1995; 198-232
- 46
Mayou R A, Bryant B, Duthie R.
Psychiatric consequences of road traffic accidents.
Br Med J.
1993;
307
647-651
- 47
Mayou R, Tyndel S, Bryant B.
Long-term outcome of motor vehicle accident injury.
Psychosom Med.
1997;
59
578-584
- 48
Meyer C, Steil R.
Die posttraumatische Belastungsstörung nach Verkehrsunfällen.
Unfallchirurg.
1998;
12
878-894
- 49
Meyer C, Markgraf E.
Die posttraumatische Belastungsstörung nach Verkehrsunfällen. Editorial.
Unfallchirurg.
1998;
12
877
- 50
Norris F H.
Epidemiology of trauma: frequency and impact of different potentially traumatic events
on different demographic groups.
J Consult Clin Psychol.
1992;
60
409-418
- 51
Parker R S.
The spectrum of emotional distress and personality changes after minor head injury
incurred in a motor vehicle accident.
Brain Injury.
1996;
10
287-302
- 52
Pfefferbaum B.
Posttraumatic stress disorder in children: a review of the past 10 years.
J Am Acad Child Adolesc Psychiatry.
1997;
36
1503-1511
- 53
Radanov B P, Di Stefano G, Schnidrig A, Ballinari P.
Role of psychological stress in recovery from common whiplash.
Lancet.
1991;
338
712-715
- 54
Radanov B P, Di Stefano G, Schnidrig A, Sturzenegger M.
Psychosocial stress, cognitive performance and disability after common whiplash.
J Psychosom Res.
1993;
37
1-10
- 55 Ritter G, Kramer J. Unfallneurose, Rentenneurose. Perimed, Erlangen 1991
- 56
Rothbaum B O.
A controlled study of eye movement desensitization and reprocessing in the treatment
of posttraumatic stress disordered sexual assault victims.
Bull Menninger Clin.
1997;
61
317-334
- 57
Shapiro F.
Eye movement desensitization: A new treatment for posttraumatic stress disorder.
J Behav Ther Exp Psychiatry.
1989 a;
20
211-217
- 58
Shapiro F.
Efficiacy of the eye movement desensitization procedure in the treatment of traumatic
memories.
J Traum Stress.
1989 b;
2
199-223
- 59 Shapiro F. Eye movement desensitization and reprocessing: Basic principles, protocols
and procedures. Guilford, New York 1995
- 60
Shestatzky M, Greenberg D, Lerer B A.
A controlled trial of phenelzine in posttraumatic stress disorder.
Psychiatric Res.
1988;
24
149-155
- 61
Solomon S D, Gerrity E T, Muff A M.
Efficiacy of treatments for posttraumatic stress disorder.
1992;
268
633-638
- 62
Solomon S.
Psychosocial treatment of posttraumatic stress disorder.
In Session: Psychotherapy in Practice.
1997;
3
27-41
- 63
Solomon Z, Mikulincer M, Avitzur E.
Coping, locus of control, social support and combat-related posttraumatic stress disorder:
A prospective study.
J Nerv Mental Dis.
1988;
175
277-285
- 64
Steil R, Ehlers A.
Cognitive correlates of intrusive memories after road traffic accidents.
Behav Res Ther (submitted).
- 65 Steil R. Posttraumatische Intrusionen nach Verkehrsunfällen. Faktoren der Aufrechterhaltung. Peter
Lang Verlag, Frankfurt 1996
- 66
Taylor S, Koch W J.
Anxiety disorders due to motor vehicle accidents: Nature and treatment.
Clin Psychol Rev.
1995;
15
721-738
- 67 Winter H. Posttraumatische Belastungsstörung nach Verkehrsunfällen. Peter Lang
Verlag, Frankfurt 1996
Dr. phil. Christina Meyer
Klinik für Unfallchirurgie
Klinikum der Friedrich-Schiller-Universität
Bachstraße 18
D-07743 Jena
