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PAPERS: Paul Stallard, Richard Velleman, and Sarah Baldwin Prospective study of post-traumatic stress disorder in children involved in road traffic accidents BMJ 1998; 317: 1619-1623 [Abstract] [Full text]

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Whiplash confounder?

Lawrence M Kelly   (14 December 1998)

Diagnosis

Darren L Weber   (14 November 2002)

Whiplash confounder? 14 December 1998
Lawrence M Kelly, self self Send response to journal: Re: Whiplash confounder?	Stallard et al raise "blow to the head" as a factor, presumably as etiology possibly competing with the "psychological" -- but the numbers reject that organic alternative. Evidence of non-cranial whiplash injury was not addressed, at least in the article. Judging from adult experience, children's road traffic injuries would seem much more likely to involve whiplash than would the "control" childhood sports injuries? Whiplash would of course raise the question of subtle (occult) organic injury (to the lower brain as well as the neighboring cervical spine area) as competition for the presumed purely psychological injury. And, since the child whiplash victim is likely to be free (much more, at least, than the adult?) from either the "malingering" or "compensation neurosis" confounders, PTSD in the child auto victim might give support to the organic genuineness of "psychological" adult whiplash sequelae?
Diagnosis 14 November 2002
Darren L Weber, PhD Student Flinders University of South Australia Send response to journal: Re: Diagnosis	This paper reports a relationship between subjective appraisal of threat to life and the onset of PTSD symptoms in children involved in car accidents. Was there a relationship between severity of the accident and/or injuries and subjective appraisals of threat to life? The capacity to formulate an appraisal would depend largely on the ability to perceive an impending collision, so did you take into account distraction or inattention in those people who did not develop PTSD? Without any perception of an impending incident, but just the immediate physical impact, there would be no content for appraisal, unless their appraisal involves cognition after the impact. In this vien, it would be interesting to know the percentage of accident victims who have recollections about the events leading up to the accident vs the events just after the accident. Competing interests:   None declared