Motor vehicle collisions  medical, psychosocial, and legal consequences

Tai ngay!!! Ban co the xoa dong chu nay!!! Preface Melanie Duckworth and I go back a long way We met while attending graduate school at the University of Georgia We both had Dr Henry E Adams as a mentor Although he has since passed on, we continue to be indebted to him He significantly influenced us as researchers, clinicians, and as individuals Both Melanie and I completed our internships through the Brown University Internship Consortium Internship was instrumental in my becoming a pain psychologist and in Melanie’s pursuit of research related to trauma After graduate school, we took separate paths She accepted a faculty position at the University of Houston, where she pursued her interest in the study of trauma, and I accepted a position at the London Health Sciences Centre in Ontario, Canada We stayed in touch over the years and we had many conversations about trauma I once made the comment to her that motor vehicle collisions (MVCs) lead to consequences that injured persons experienced as traumatic We then began to think of developing a clinical data set based on psycholegal assessments that I had been conducting We also noticed certain gaps in motor vehicle collision research literature, gaps that might be addressed by our research targeting MVC-related chronic pain and trauma Melanie then accepted a faculty position at the University of Nevada in Reno She set up a laboratory investigating chronic pain and trauma in the MVC context Our shared interest in the physical and psychological consequences of MVCs resulted in increased research collaboration and an increased desire to create a context in which we might bring greater attention to MVCs and the multiple and complex outcomes that are experienced by persons injured in MVCs Through a series of discussions, we identified a number of MVC topics that we considered essential elements of a comprehensive review of the MVC experience William O’Donohue, a colleague of Melanie’s, played an invaluable role in encouraging the creation of a book proposal, in guiding Melanie and I through the book xvii PRE-I045048.indd xvii 4/22/2008 7:51:58 PM xviii Preface proposal submission process, and in working with us throughout the entire writing and editing process The book proposal was accepted by Elsevier Publishing and we were fortunate enough to have a distinguished group of researchers agree to contribute their expertise to the book project We hope that readers of the book are as impressed with their contributions as we are We also hope that persons injured in MVCs benefit most from the information contained in this book In addition to thanking all the contributors, we would like to thank Dan Morgan and Diana Jones at Elsevier for their input in the initial drafts of the book proposal Their contributions certainly resulted in a more refined and focused book We would also like to thank Nikki Levy and Barbara Makinster for their final editorial comments and for their help in bringing this book to completion Tony Iezzi, Ph.D PRE-I045048.indd xviii 4/22/2008 7:51:58 PM List of CONTRIBUTORS Arthur Ameis MultiDisciplinary Assessment Centre, 3200 Dufferin st, suite 500, Toronto, ON M6A 3B2, AA V Lynn Ashton British Columbia Mental Health & Addiction Services, Research Department Administration Building, 2601 Lougheed Highway Coquitlam, BC V3C 4J2, Canada J Gayle Beck Department of Psychology, University at Buffalo – SUNY, Park Hall, Buffalo, NY 14260, U.S.A Brian L Brooks British Columbia Mental Health & Addiction Services, Research Department Administration Building, 2601 Lougheed Highway Coquitlam, BC V3C 4J2, Canada Richard A Bryant School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia Mark Creamer Australian Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, PO Box 5444, West Heidelberg, Victoria, 3081, Australia Matthew O Dolich Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 705, Orange CA 92868-3298, U.S.A Melanie P Duckworth Department of Psychology/MS298, University of Nevada, Reno NV 89557, U.S.A Robert J Gatchel Department of Psychology, College of Science, University of Texas at Arlington, 313 Life Science, Building 501, S Nedderman Drive, Arlington, TX 76019-0528, U.S.A Murray J Girotti Department of Surgery, Rm E1-129, London Health Sciences Centre, Victoria Hospital, 800 Commissioner’s Rd E, London Ont, N6A 5W9 Vithya Gnanakumar c/o Keith A Sequeira, Parkwood Hospital, 801 Commissioners Road East, London, ON N6C 5J1, Canada Edward J Hickling Department of Psychology, University of Albany, State University of New York, 1400 Washington Avenue, Albany, NY 12222, U.S.A xix CTR-I045048.indd xix 4/22/2008 7:54:12 PM xx List of Contributors Graham Hole Department of Psychology, Pevensey Building 2B23, University of Sussex, Falmer, East Sussex BN19QH, England David B Hoyt Department of Surgery, University of California, Irvine, 333 City Boulevard West, Suite 700, Orange CA 92868-3298, U.S.A Tony Iezzi Behavioral Medicine Service, London Health Sciences Centre, 375 South Street, London, ON N6A 4G5, Canada Grant L Iverson Department of Psychiatry, University of British Colombia & British Columbia Mental Health & Addiction Services, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada Sara Jacoby Surgical Intensive Care Unit, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, U.S.A Nancy D Kishino West Coast Spine Restoration Center, Riverside, CA 92507, U.S.A Eric R Kuhn VA Sierra Pacific Mental Illness Research, Education, and Clinical Center, 3801 Miranda Ave, Palo Alto, CA 94306, U.S.A Dara Lambe Lerners LLP Barristers and Solicitors, 80 Dufferin Avenue, P.O Box 2335, London, ON N6A 4G4, Canada Michael Lewandowski Pain Assessment Resources, 4790 Caughlin Parkway, Suite 173, Reno, NV 89519, U.S.A Greta Ludwig Australian Centre for Posttraumatic Mental Health, University of Melbourne, National Trauma Research Institute, P.O Box 5444, West Heidelberg, VIC 3081, Australia Michael F Martelli Concussion Care Centre of Virginia, Ltd, Tree of Life Services, Inc 3721 Westerre Parkway, Suite B, Richmond, VA 23233 Meaghan L O’Donnell Australian Centre for Posttraumatic Mental Health, University of Melbourne, National Trauma Research Institute, P.O Box 5444, West Heidelberg, VIC 3081, Australia William T O’Donohue Department of Psychology/MS298, University of Nevada, Reno, NV 89557-0062, U.S.A Neil G Parry Department of Surgery, University of Western Ontario, Victoria Hospital Room E2-217, London Health Sciences Centre, 800 Commissioners Road, London, ON N6A 5W9, Canada Jason Pretty c/o Keith A Sequeira, Parkwood Hospital, 801 Commissioners Road East London, ON N6C 5J1, Canada Therese S Richmond School of Nursing Research Director, Firearm & Injury Center at Penn, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA 19104-6096, U.S.A James P Robinson University of Washington School of Medicine, UWMC Roosevelt Pain Center, Box 356044, 1959 NE Pacific Street, Seattle, WA 98195, U.S.A CTR-I045048.indd xx 4/22/2008 7:54:12 PM List of Contributors xxi Harpreet Sangha c/o Keith A Sequeira, Parkwood Hospital, 801 Commissioners Road East London, ON N6C 5J1, Canada Stephen Schenke Lerners LLP Barristers and Solicitors, 80 Dufferin Avenue, P.O Box 2335, London, ON N6A 4G4, Canada Keith A.J Sequeira Department of Physical Medicine and Rehabilitation, University of Western Ontario, Parkwood Hospital and St Joseph’s Hospital, 801 Commissioners Road East London, ON N6C 5J1, Canada Joanne E Taylor School of Psychology, Massey University, Private Bag 11222, Palmerston North, North Island, New Zealand Robert Teasell c/o Keith A Sequeira Parkwood Hospital, 801 commissioners Road East London, ON N6C 5J1, Canada Brian R Theodore Department of Psychology, College of Science, University of Texas at Arlington, Arlington, TX 76019, U.S.A Dennis C Turk John and Emma Bonica Professor of Anesthesiology and Pain Research, Department of Anesthesiology, Box 356540, University of Washington, Seattle, WA 98195, U.S.A Nathan D Zasler Concussion Care Centre of Virginia, Ltd, Tree of Life Services, Inc 3721 Westerre Parkway, Suite B, Richmond, VA 23233 CTR-I045048.indd xxi 4/22/2008 7:54:12 PM SECTION I Scope and Significance of Motor Vehicle Collisions In Section I, Duckworth, Iezzi, and O’Donohue use the Introduction chapter to provide an overview of the structure and content of the book The chapters are ordered to provide a chronological account of the assessment and treatment of collision-related physical and psychological injuries, with chapters grouped into sections that address the scope and significance of motor vehicle collisions (MVCs); the immediate physical and psychological aftermath of MVCs; primary care management of acute injury, pain, emotional distress and impairment; specialized management of chronic physical and psychological consequences of MVCs; and those medicolegal issues relevant to determining the extent of physical and psychological injuries and to securing care and compensation for such injuries SEC1-I045048.indd 4/21/2008 12:47:17 PM Motor Vehicle Collisions In Predictors of Motor Vehicle Collisions (Chapter 2), Hole begins his discussion of the predictors of MVCs with a review of those factors that represent some of the more significant challenges to MVC risk estimation Hole provides a review of current data pertaining to a variety of driving behaviors and individual variables that are thought to influence driving risk and the underscores complexity involved in evaluating MVC risk related to the presence of multiple, interacting MVC predictors The predictors of MVCs that are reviewed in Chapter include: alcohol; fatigue; youth, gender, and inexperience; personality; older age; and driving distractions Hole identifies alcohol as the most influential predictor of MVC involvement Fatigue is identified as an MVC risk factor that is particularly problematic for urban drivers and commercial truck drivers Young drivers aged 16 to 20 years experience the highest rate of MVC-related deaths and injuries Hole notes that driving errors are more common among women than men and not decrease with age; driving lapses are equally common among men and women and increase with age; and driving violations are committed more often by men than women, decline with age, and are associated with a two- to four-fold increase in MVC-related injuries Hole reviews research related to sensation-seeking, anger and aggression, and desire for control, and while acknowledging the potential importance of personality characteristics to driving behavior, Hole points to research that examines multiple personality characteristics as holding more promise In discussing the contribution of advanced age to MVC risk, Hole acknowledges the age-related changes in visual acuity that might contribute to increased MVC risk and identifies those visually complex MVC circumstances (e.g., left turn at intersection) that combine with visual acuity changes to result in this age-related increase in MVC risk Driving distractions are gaining research attention due the established association between driving distractions and collisions, with driving distractions accounting for 10–30% of MVCs SEC1-I045048.indd 4/21/2008 12:47:17 PM Introduction Melanie P Duckworth*, Tony Iezzi† and William T O’Donohue* * Department of Psychology/MS298, University of Nevada, Reno, Nevada, U.S.A Behavioral Medicine Service, London Health Sciences Centre, London, Ontario, Canada † INTRODUCTION Most persons are unprepared for their first involvement in a motor vehicle collision (MVC) Fortunately, 86% of persons involved in an MVC will experience only damage to their vehicles (Blincoe et al., 2002) However, the other 14% of persons involved in an MVC will experience, to some degree, pain and injury, medical costs, lost time from work, functional and lifestyle impairment, psychological distress, and systems stress (e.g., insurance and legal) The ripple effect of an MVC will also entail involvement with a number of health professionals, including general practitioners, medical specialists, nurses, physiotherapists, occupational therapists, kinesiologists, speech therapists, rehabilitation consultants, psychologists, psychiatrists, and social workers Persons involved in MVCs will also have to contend with insurance and legal representatives Although MVCs may occur less frequently and may be less traumatic than other events, MVCs may be the single most significant type of traumatic event when frequency and impact are considered together (Norris, 1992) MVCs lead to significant medical, psychosocial, and legal consequences According to the National Highway Traffic Safety Administration (NHTSA; Blincoe et al., 2002), MVCs are the leading cause of death among individuals between the ages of and 34 years and the eight leading cause of death across all ages For every MVC fatality, there are approximately 79 individuals who require medical attention in emergency departments CH01-I045048.indd 4/21/2008 12:48:22 PM Motor Vehicle Collisions The NHTSA reported the total economic cost of MVCs in the United States for the year 2000 to be 230.6 billion dollars (Blincoe et al., 2002), this overwhelming figure accounted for primarily by medical costs ($32.6 billion), workplace productivity losses ($61.0 billion), household productivity losses ($20.2 billion), and insurance and legal costs ($27.7 billion) Although the cost for MVC-related pain and suffering can range from several thousand dollars to many millions (e.g., fatality), the average cost for pain and suffering is approximately $19,000 per injured person The World Health Organization has estimated that by the year 2020 MVCs will rank second only to heart disease and depression in terms of disability (Murray & Lopez, 1996) Across the world, the cost of MVCs has been estimated at 1% of the gross national product regardless of the development or motorization of a country (Elvik, 2000) The insurance industry reports that higher health care costs, more litigious attitudes, and higher awards for pain and suffering account for greater claim costs faced by insurance companies and are leading to significant changes in the laws governing insurance coverage (Connolly, 2004) In addition, there are demographic trends that suggest concerns with the privilege of driving across the world Motor vehicle use on a larger scale in developing countries has been associated with a dramatic increase in MVC-related deaths and injuries (Peden et al., 2001) In developing countries, road users such as pedestrians, bicyclists, and motorcyclists are especially vulnerable when involved in collisions (Nantulya & Reich, 2002) Over the past 10 years there has been a burgeoning of research related to MVCs and the physical and psychological consequences of MVC involvement Accident Analysis and Prevention and Traffic Injury Prevention are peerreviewed journals that focus specifically on injury and damages incurred in vehicle crashes and on efforts related to MVC prevention, epidemiology, and policy-making Other peer-reviewed journals such as The Journal of Trauma and Injury examine trauma and injury in general and in the context of MVCs Among the research publications examining the psychological consequences of MVCs are two well-recognized books that examine psychological trauma in the MVC context (Blanchard & Hickling, 1997, 2004; Hickling & Blanchard, 1999) Blanchard and Hickling’s (1997, 2004) After the Crash: Psychological Assessment and Treatment of Survivors of Motor Vehicle Accidents is a seminal source in this area The book presents findings from a series of MVC studies performed by Blanchard, Hickling and other colleagues, these studies representing one of the earliest programmatic investigations of the psychological repercussions of MVC involvement In The International Handbook of Road Traffic Accidents and Psychological Trauma: Current Understanding, Treatment and Law, Hickling and Blanchard (1999) present an in depth analysis of Posttraumatic Stress Disorder (PTSD) occurring in the MVC context, with 18 of 26 chapters addressing factors related to PTSD In the remaining chapters of the book, the authors expand their examination of MVC consequences to encompass traumatic CH01-I045048.indd 4/21/2008 12:48:22 PM 550 Motor Vehicle Collisions Most countries have designated departments and services for the study of MVCs and sequelae The National Highway Traffic Safety Administration (NHTSA; www.nhsta.dot.gov) is one of the better sources of data gathering and analysis for the study of MVCs The NHTSA has developed comprehensive and sophisticated methodologies and statistics related to assessing costs of fatal and nonfatal injuries, property damage, human capital costs (i.e., medical care and quality of life), and risk factors (e.g., alcohol and speeding) (Blincoe et al., 2002) Other countries have provided large data bases that have yielded interesting results, including Australia (Blows et al., 2005), New Zealand (Alsop & Langley, 2001) Slovenia (Simoncic, 2001), Japan (Mizuno & Kajzer, 1999), and Sweden (Bostrom et al., 2001) A number of studies have also been based on insurance company data sets (Sagberg, 1999; Cassidy et al., 2000; Berglund et al., 2001) Government data sets have the advantage of being based on much larger Ns and greater representation across all demographic levels, while insurance company data sets have the advantage of representing the insurance company perspective and can allow for the evaluation of compensation on various aspects of the MVC experience In the emergency room and the hospital, a number of assessment tools continue to be the gold standard The Glasgow Coma Scale (GCS) is the best tool for assessing depth and duration of impaired consciousness and coma (Teasdale & Jennett, 1974; Gill et al., 2004) The Abbreviated Injury Scale (Association for the Advancement of Automotive Medicine, 1990) and Injury Severity Scale (Baker et al., 1974) appear to be the best measures of injury severity Most recently, the New Injury Severity Score has been developed to improve reliability in scoring accuracy (Osler et al., 1997) In spite of being well-recognized assessment tools, these measures still require more research aimed at identifying sources of error (e.g., differences in GCS scores obtained at the collision site, emergency room, or intensive care unit) Although injury severity has been included in a significant number of studies, the actual measure of pain has not been more formally recognized This is surprising given that pain is now recognized as the 5th vital sign to take during hospitalization It seems that injury severity has been used as a proxy variable of pain, but injury severity and pain is not exactly the same thing Injury severity is determined by an assessor, while pain is determined by the injured person The injured person perspective is likely to be more influential in determining longterm outcomes Thus, a measure of pain intensity is required from hospitalization, to the primary care provider, and to the specialist managing chronic pain conditions and associated sequelae Visual analogue scales of various types for various populations are available (Turk & Melzack, 2001) Item per item, the Multidimensional Pain Inventory is probably the best tool measuring pain severity, affective distress, and quality of life (Kerns et al., 1985) It is easy to complete, it is relatively brief, and is easy to computer score More importantly, it yields a reliable identification of cluster groupings (e.g., adaptive versus dysfunctional copers) that have different functional and treatment outcomes CH19-I045048.indd 550 4/21/2008 8:15:32 PM Conclusions and Future Directions in the Study of MVCs 551 The assessment of traumatic brain injuries and cognitive impairment is also very important Of course, CT-scans and MRIs continue to be the gold standard in identifying brain injuries within the hospital context In terms of neurocognitive impairment, there are a number of different assessment batteries that can be administered (Lezak et al., 2004) Neuropsychology has been especially instrumental in the assessment of poor effort, low motivation, or symptom validity, which is especially important in the medicolegal context (Nicholson & Martelli, 2007) More research is required to identify the psychometric criteria associated with the range of traumatic brain injuries and cognitive impairment Regardless of injuries sustained or permanent residual consequences, an assessment of changes in the quality of life is required The Sickness Impact Profile (Bergner et al., 1981) has been used in medical (Jurkovich et al., 1995; Richmond & Kauder, 2000) and psychological contexts (Duckworth & Iezzi, 2005; Paylo & Beck, 2005) It captures changes in physical (e.g., ambulation) and psychosocial (e.g., social interactions) domains Another measure used in a variety of contexts includes the Short Form-36 Health Survey (Ware et al., 1993) Measures of the quality of life need to be included as part of the routine assessment of MVC sequelae There are a variety of psychological reactions and conditions that occur as a result of MVCs There are general measures of psychological distress and personality (e.g., Minnesota Multiphasic Personality Inventory-II; Butcher et al., 1989) and there are specific measures of emotional states (e.g., Beck Depression Inventory; Beck et al., 1996) Semi-structured clinical interviews have been used extensive and are well-regarded (e.g., Clinician Administered Posttraumatic Stress Disorder Scale; Blake et al., 1995) There has been considerable focus in the MVC literature on posttraumatic stress disorder However, it is clear that other psychological conditions like major depressive disorder are common and require treatment The key issue with regards to psychological reactions and conditions is that measures of psychological status need to be a necessary part of the assessment Administering psychological measures is also made even more important given that psychological variables are strongly associated with impairment and disability Although assessment of physical and psychological impairment and disability may be the most important and contentious issue in the medicolegal and psycholegal context, there is not much available to guide practitioners In part, impairment and disability are complex constructs that are difficult to assess and measure Physical and psychological symptoms that lead to impairment and disability are not pure Physical and psychological symptoms act together and are recursive to some extent Research that combines expertise from both physical and psychological perspectives will likely yield more accurate and representative models of MVCs as they occur in the real world In addition, impairment and disability in the MVC context is highly affected by the litigation process Although much has been published about malingering and compensation, there are no formal measures of litigation stress It is also extremely difficult to CH19-I045048.indd 551 4/21/2008 8:15:32 PM 552 Motor Vehicle Collisions conduct research within the litigation process In spite of all these difficulties, the potential for research and the potential to advance the state of the field are significant TREATMENT OF MVC CONSEQUENCES The treatment of MVC sequelae is probably the most important concern for injured persons Although injured persons are being treated everyday for MVC sequelae, there is a relative paucity of treatment studies specifically involving MVC injuries In the trauma literature, MVCs injuries are often mixed in with slip and falls or intentional injuries like assault Still, there are number of medical and surgical procedures available for the treatment of certain types of MVC injuries (e.g., fractures and soft-tissue) Research examining the influence of demographic and psychological variables on medical outcomes is indicated More recently, there have been a number of studies supporting physical therapy or exercise for the early treatment of whiplash-associated disorder (Rosenfeld et al., 2006; Stewart et al., 2007), but the long-term benefits of this type treatment remains to be determined Another approach found that a psycho-educational video used in the emergency room was successful in reducing pain and medical utilization in whiplash-associated disorder (Oliveira et al., 2006) Treatment studies of MVC-related psychological sequelae have largely focused on posttraumatic stress disorder Blanchard and Bryant and their respective colleagues have been especially instrumental in this area (Blanchard et al., 2003; Bryant et al., 2003) Other promising treatment approaches include group treatment and virtual reality exposure for posttraumatic stress symptoms in MVC cases (Beck & Coffey, 2005; Beck et al., 2007) As noted earlier, more studies evaluating the treatment of other psychological conditions and more studies evaluating the treatment of multifaceted clinical presentations with prominent psychological features (e.g., chronic pain and traumatic brain injury) are needed REFERENCES Aarts, L., & Van Schagen, I (2006) Driving speed and the risk of road crashes: A review Accident Analysis and Prevention, 38, 215–224 Alsop, J., & Langley, J (2001) Under-reporting of motor vehicle traffic crash victims in New Zealand Accident Analysis and Prevention, 33, 353–359 Anstey, K.J., Wood, J., Lord, S., & Walker, J.G (2005) Cognitive, sensory and physical factors enabling driving safety in older adults Clinical Psychology Review, 25, 45–65 Association for the Advancement of Automotive Medicine (1990) The abbreviated injuries scale Des Plains, IL: Association for the Advancement of Automotive Medicine Baker, S.P., O’Neill, B., Haddon, W., & Long, W (1974) The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care Journal of Trauma, 14, 187–196 Beck, A.T., Steer, R.A., & Brown, G.K (1996) The Beck Depression Inventory-II San Antonio, TX: Psychological Corporation CH19-I045048.indd 552 4/21/2008 8:15:32 PM Conclusions and Future Directions in the Study of MVCs 553 Beck, J.G., & Coffey, S.F (2005) Group cognitive behavioural treatment for PTSD: Treatment of motor vehicle accident survivors Cognitive and Behavioral Practice, 12, 267–277 Beck, J.G., Palyo, S.A., Winer, E.H., Schwagler, B.E., & Ang, E.J (2007) Virtual reality exposure therapy for PTSD symptoms after a road accident: An uncontrolled case series Behavior Therapy, 38, 39–48 Bergner, M., Bobbitt, R.A., Carter, W.B., & Gilson, B.S (1981) The Sickness Impact Profile: Development and final revision of a health measure Medical Care, 8, 787–805 Berglund, A., Alfredsson, L., Jensen, I., Cassidy, D., & Nygren, A (2001) The association between exposure to rear-end collision and future health complaints Journal of Clinical Epidemiology, 54, 851–856 Blake, D.D., Weathers, F.W., Nagy, L.M., Kaloupek, D.G., Charney, D.S., & Keane, T.M (1995) The clinician-administered PTSD scale for DSM-IV Journal of Traumatic Stress, 8, 75–90 Blanchard, E.B., Hickling, E.J., Devineni, T., Veazey, C.H., Galovski, T.E., Mundy, E et al (2003) A control evaluation of cognitive behavioral therapy for posttraumatic stress in motor vehicle accident survivors Behaviour Research and Therapy, 41, 79–96 Blincoe, L., Seay, A., Zaloshnja, E., Miller, T., Romano, E., Luchter, S et al (2002) The Economic Impact of Motor Vehicle Crashes 2000 Washington, DC: National Highway Traffic Safety Administration Blows, S., Ameratunga, S., Ivers, R.Q., Lo, S.K., & Norton, R (2005) Risky driving habits in motor vehicle driver injury Accident Analysis and Prevention, 37, 619–624 Bostrom, L., Wladis, A., & Nilsson, B (2001) A review of serious injuries and deaths among car occupants after motor vehicle crashes in Sweden from 1987–1994 Archives of Orthopedics and Trauma Surgery, 121, 1–6 Broyles, R.W., Clarke, S.R., Narine, L., & Baker, D.R (2001) Factors contributing to the amount of vehicular damage resulting from collisions between four-wheel drive vehicles and passenger cars Accident Analysis and Prevention, 33, 673–678 Bryant, R.A., Moulds, M.L., Guthrie, R.M., Dang, S.T., & Nixon, R.D.V (2003) Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder Journal of Consulting and Clinical Psychology, 71, 706–712 Butcher, J.N., Dahlstrom, W.G., Graham, J.R., Tellegen, A., & Kaemmer, B (1989) Minnesota Multiphasic Personality Inventory (MMPI-II) Manual for Administration and Scoring Minneapolis, MN: University of Minnesota Press Cassidy, J.D., Carroll, L.J., Cote, P., Lemstra, M., Berglund, A., & Nygren, A (2000) Effect of eliminating compensation for pain and suffering on the outcome of insurance claims of whiplash injury New England Journal of Medicine, 342, 1179–1186 Duckworth, M.P., & Iezzi, T (2005) Chronic pain and posttraumatic stress symptoms in litigating motor vehicle accident victims Clinical Journal of Pain, 21, 251–261 Ferrando, J., Rodriguez-Sanz, M., Borrell, C., Martinez, V., & Plasencia, A (2005) Individual and contextual effects in injury morbidity in Barcelona (Spain) Accident Analysis and Prevention, 37, 85–92 Fuller, R (2005) Towards a general theory of driver behaviour Accident Analysis and Prevention, 37, 461–472 Gill, M.R., Reiley, D.G., & Green, S.M (2004) Interrater reliability of Glasgow Coma Scale scores in the emergency department Annals of Emergency Medicine, 43, 215–223 Holbrook, T.L., & Hoyt, D.B (2004) The impact of major trauma: Quality-of-life outcomes are worse in women than in men, independent of mechanism and injury severity Journal of Trauma: Injury, Infection, and Critical Care, 56, 284–290 Hole, G (2007) The Psychology of Driving Mahwah, NJ: Lawrence Erlbaum Associates Jurkovich, G., Mock, C., MacKenzie, E., Burgess, A., Cushing, B., deLateur, B et al (1995) The Sickness Impact Profile as a tool to evaluate functional outcome in trauma patients Journal of Trauma: Injury, Infection, and Critical Care, 39, 625–631 Kerns, R.D., Turk, D.C., & Rudy, T.E (1985) The West Haven-Yale Multidimensional Pain Inventory Pain, 23, 345–356 CH19-I045048.indd 553 4/21/2008 8:15:32 PM 554 Motor Vehicle Collisions Kim, H.S., Kim, H.J., & Son, B (2006) Factors associated with automobile accidents and survival Accident Analysis and Prevention, 38, 981–987 Kweon, Y.J., & Kockelman, K.M (2003) Overall injury risk to different drivers: Combining exposure, frequency, and severity models Accident Analysis and Prevention, 35, 441–450 Lagarde, E., Chastang, J.F., Gueguen, A., Coeuret-Pellicer, M., Chiron, M., & Lafont, S (2004) Emotional stress in traffic accidents: The impact of separation and divorce Epidemiology, 15, 762–766 Lezak, M.D., Howieson, D.B., Loring, D.W., Hannay, H.J., & Fischer, J.S (2004) Neuropsychological Assessment (4th ed.) New York, NY: Oxford University Press Mayou, R., & Bryant, B (2003) Consequences of road traffic accidents for different types of road user Injury, International Journal of Care and Injured, 34, 197–202 McEvoy, S.P., Stevenson, M.R., & Woodward, M (2007) Prevalence of, and factors associated with, serious crashed involving a distracting activity Accident Analysis and Prevention, 39, 475–482 McKnight, A.J., & McKnight, A.S (2003) Young novice drivers: Careless or clueless Accident Analysis and Prevention, 35, 921–925 Mizuno, K., & Kajzer, J (1999) Compatibility problems in frontal, side, single car collisions and car-to-pedestrian accidents in Japan Accident Analysis and Prevention, 31, 381–391 Murray, C.J.L., & Lopez, A.D (1996) Global Burden of Disease Cambridge, MA: Harvard University Press Nantulya, D., & Reich, M.R (2002) The neglected epidemic: Road traffic injuries in developing countries British Medical Journal, 324, 1139–1141 National Highway Traffic Safety Administration (2007) Traffic Safety Facts 2005: A Compilation of Motor Vehicle Crash Data from the Fatality Analysis Reporting System and the General Estimates System DOT HS 810 631 National Center for Statistics and Analysis Washington, U.S.: Department of Transportation Nicholson, K., & Martelli, M.M (2007) Malingering: Traumatic brain injury In G Young, A.W Kane, & K Nicholson (Eds.), Causality of Psychological Injury: Presenting Evidence in Court (pp 427–475) New York, NY: Springer Norris, F.H., Matthews, A., & Riad, J.K (2000) Characterological, situational, and behavioural risk factors for motor vehicle accidents: A prospective examination Accident Analysis and Prevention, 32, 505–515 Oliveira, A., Gervirtz, R., & Hubbard, D (2006) A psycho-educational video used in the emergency department provides effective treatment for whiplash injuries Spine, 31, 1652–1657 O’Neill, B., & Mohan, D (2002) Reducing motor vehicle crash deaths and injuries in newly motorizing countries British Medical Journal, 24, 1142–1145 Osler, T., Baker, S.P., & Long, W (1997) A modification to the Injury Severity Score that both improves accuracy and simplifies scoring Journal of Trauma: Injury, Infection, and Critical Care, 43, 922–926 Palyo, S.A., & Beck, J.G (2005) Post-traumatic stress disorder symptoms, pain, and perceived life control: Associations with psychosocial and physical functioning Pain, 117, 121–127 Ramstad, S.M., Russo, J., & Zatzick, D.J (2004) Is it an accident? Recurrent traumatic life events in Level I Trauma Center patients compared to the general population Journal of Traumatic Stress, 17, 529–534 Richmond, T.S., & Kauder, D (2000) Predictors of psychological distress following serious injury Journal of Traumatic Stress, 13, 681–692 Rosenbloom, T., & Wolf, Y (2002) Sensation seeking and detection of risky road signals: A developmental perspective Accident Analysis and Prevention, 34, 569–580 Rosenfeld, M., Seferiadis, A., & Gunnarsson, R (2006) Active involvement and intervention in patients exposed to whiplash trauma in automobile crashes reduces cost Spine, 31, 1799–1804 Sagberg, F (1999) Road accidents caused by driver responding to sleep Accident Analysis and Prevention, 31, 639–649 Siegel, J.H., Loo, G., Dischinger, P.C., Burgess, A.R., Wang, S.C., Schneider, L.W., et al (2001) Factors influencing the patterns of injuries and outcomes in car versus car crashes compared to CH19-I045048.indd 554 4/21/2008 8:15:32 PM Conclusions and Future Directions in the Study of MVCs 555 sport utility, van, or pick-up truck versus car crashes: Crash injury research engineering network study Journal of Trauma: Injury, Infection, and Critical Care, 51, 975–990 Simoncic, M (2001) Road accidents in Slovenia involving pedestrian, cyclist or motorcyclist and a car Accident Analysis and Prevention, 33, 147–156 Simpson, G., Johnston, L., & Richardson, M (2003) An investigation of road crossing in a virtual environment Accident Analysis and Prevention, 35, 787–796 Stewart, M.J., Maher, C.G., Refshauge, K.M., Herbert, R.D., Bogduk, N., & Nicholas, M (2007) Randomized controlled trial of exercise for chronic whiplash-associated disorders Pain, 128, 59–68 Sumer, N (2003) Personality and behavioural predictors of traffic accidents: Testing a contextual mediated model Accident Analysis and Prevention, 35, 949–964 Tavris, D.R., Kuhn, E.M., & Layde, P.M (2001) Age and gender patterns in motor vehicle crash injuries: Importance of type of crash and occupant’s role Accident Analysis and Prevention, 33, 167–172 Teasdale, G., & Jennett, B (1974) Assessment of coma and impaired consciousness: A practical scale Lancet, 304, 81–84 Thiffault, P., & Bergeron, J (2003) Monotony of road environment and driver fatigue: A simulated study Accident Analysis and Prevention, 35, 385–391 Turk, D.C., & Melzack, R (2001) (Eds.) Handbook of Pain Assessment (2nd ed.) New York, NY: Guilford Press Turner, C., McClure, R., & Pirozzo, A (2004) Injury and risk-taking behavior: A systematic review Accident Analysis and Prevention, 36, 93–101 Underwood, G (Ed.) (2005) Traffic & Transport Psychology: Theory and Application New York, NY: Elsevier Ware, J.E., Snow, K.K., Kosinski, M., & Gandek, B (1993) SF-36 Health Survey: Manual and Interpretation Guide Boston, MA: The Health Institute, New England Medical Centre Watson, W.L., & Ozanne-Smith, J (2000) Injury surveillance in Victoria, Australia: Developing comprehensive injury incidence estimates Accident Analysis and Prevention, 32, 277–286 Yee, W.Y., Cameron, P.A., & Bailey, M.J (2006) Road traffic injuries in the elderly Emergency Medical Journal, 23, 42–46 CH19-I045048.indd 555 4/21/2008 8:15:32 PM Index A Abbreviated Injury Scale (AIS), 93–94, 331, 550 ABC See Airway, breathing, and circulation Abdominal compartment syndrome (ACS), 73 Abdominal injury, 72–74 Absent cause, 518 Acceleration-deceleration mechanism, 188 Accident benefits regime, 426–434, 459 Accident neurosis, 335, 382, 523 Accident phobia, 391–392, 395–398, 401, 407–408, 411 ACS See Abdominal compartment syndrome Acupuncture, 149 Acute pain, 58, 61, 65, 69–71, 74–76, 121, 132, 170, 172, 230, 232, 239 Acute stress disorder (ASD), 92, 107–123, 175, 197, 261, 313–316, 321, 353, 366, 545, 557 assessment, 113–115 clinical description, 107–108 cognitive factors, 110–111 diagnostic features, 314 incidence, 108–109 predictors, 113 prevalence, 314–316 PTSD and, 109–110 theoretical basis, 108 treatment, 115–118 Acute Stress Disorder Scale (ASDS), 114 ADHD See Attention-deficit hyperactivity disorder Adjustment disorders, 328 Advanced Trauma Life Support (ATLS), 50, 64 Affidavit of Documents, 456 Aggressive driving, 25 Aging, 273–274 cognitive impairments, 247 driving risk health problems, 30 Airbags, 139 Airway, breathing, and circulation (ABC), 89 airway control, 70f breathing, 52 circulation, 53 definitive airway, 52t AIS See Abbreviated Injury Scale Alcohol, 15–18, 78, 268 Alternative dispute resolutions, 460–461 AMA See American Medical Association AMA Code of Medical Ethics, 479 AMA Ethics Guidelines on PhysicianPatient Relationships, 469 AMA Guides to the Evaluation of Permanent Impairment, 474–478, 526–528 Ambulation, 174 American Academy of Neurology, 481 American College of Surgeons, 143 American Medical Association (AMA), 468, 474–478 AMPLE history, 66 Analgesics, 411 Ancillary diagnostic studies, 204–205 Angular impact, 63 557 index-I045048.indd 557 4/22/2008 6:19:56 PM 558 Anxiety disorders acute stress disorder (ASD), 107–123 disorders of extreme stress not otherwise specified (DESNOS), 313–314, 319–320 driving phobia, 389–412 generalized anxiety disorder (GAD), 322–323 phobic travel anxiety, 393, 395–397 posttraumatic stress disorder (PTSD), 345–358, 365–384 Aortic injuries, 71 Arthropathy, 192 ASD See Acute stress disorder ASDS See Acute Stress Disorder Scale Athey v Leonati, 431 ATLS See Advanced Trauma Life Support Attention-deficit hyperactivity disorder (ADHD), 265–267 B BAC See Blood Alcohol Content BAI See Beck Anxiety Inventory Basilar skull fractures, 68 BAT See Blunt abdominal trauma BDI See Beck Depression Inventory Beck Anxiety Inventory (BAI), 408, 514 Beck Depression Inventory (BDI), 197, 210, 212–213, 514, 551 Benzodiazepines, 272–273 Biofeedback, 409 Biopsychosocial model, 6, 230, 232, 507, 544 Blood Alcohol Content (BAC), 15, 16 Blood pressure (BP), 53 Blunt abdominal trauma (BAT), 72 Botulinum toxin, 156 BP See Blood pressure Brak v Walsh, 442 Brown-Séquard syndrome, 77 C CAGE Questionnaire, 57, 152–153, 208 CAGE-AID Questionnaire, 153t Canadian Charter of Rights and Freedoms, 435 CAPS See Clinician Administered Posttraumatic Stress Disorder Scale index-I045048.indd 558 Index Cardiac arrest, 89 Cardiovascular disease, 271–272 Carroll v Gilbert, 439 Case resolution, 460–463 Causality, 518–519 Causation, 431–434 CBT See Cognitive behavior therapy Center for Epidemiologic Studies Depression (CES-D) scale, 325 Central nervous system sensitization, 195–196 Cervical collar, 544 Chappra v Ohm, 440 Child Trauma Screening Questionnaire, 99 Childs v Desormeaux, 429 Chiropractic treatments, 149–150, 545 Chronic musculoskeletal pain, 237 Chronic pain, 131–160, 187–221, 229–239, 244–280, 312, 321, 331–332, 369, 383, 497–499, 509–512, 514, 520, 522–523, 530 Circadian rhythms, 19 Circulatory assessment, 90 Civilian trauma, 259 Clinical Dementia Rating (CDR), 476 Clinical judgment, 256, 275, 281, 519, 526, 528, 532 Clinician Administered Posttraumatic Stress Disorder Scale (CAPS), 511, 549, 551 Cocaine, 269 Cognitive behavior therapy (CBT), 115, 375–381, 409–410 Cognitive disorder NOS, 246, 251–253 Cognitive impairment, 144–145, 243–285 arising from MVCs, 257–264 classification, 255–256 conceptualization, 249–255 definitions, 244–249 misdiagnosis, 251 Cognitive therapy, 375, 410 Collateral benefits, 447–448 Collision type, 26 angular impact, 63 frontal impact, 55–56, 62 lateral impact, 63 4/22/2008 6:19:56 PM 559 Index offset impact, 63 rear impact, 57, 63 rollover impact, 57 single vehicle, 28 t-bone, 56 Commercial drivers, 20 Compensation neurosis, 523 Complex PTSD, 175, 319–321, 521 Computed tomography (CT), 54, 67, 144, 149, 204, 257, 551 Concannon v Nash, 462 Confirmatory bias, 275 Conflict of interest, 481, 482 Contingency fees, 424, 425 Coping, 172, 219, 521 Cricothyroidotomy, 52 Crumbling skull, 519 CT See Computed tomography D DAS See Driving Anger Scale Daubert Decision, 479, 530–531 DD See Dysthymic disorder Defense medical exams, 458–460 Delayed Onset PTSD, 316, 318–319, 350–351 Dementia, 247 Depressive disorders dysthymic disorder (DD), 327–328 major depressive disorder (MDD), 259–261, 324–327, 346, 348–352, 355, 357, 512, 516 Desbiens v Mordini, 447 Diabetes, 270–271 Diagnosis-Related Estimates (DRE), 492 Diagnostic peritoneal lavage, 72 Diagnostic and Statistical Manual of Mental Disorders (DSM), 93, 107, 109, 113–114, 175, 208t, 245–247, 255, 280, 313, 316–318, 320, 322, 324, 327–329, 346, 351, 368, 396–399, 511, 520, 522 Disclosure of findings, 495 Discovery, 449–455 Disorders of extreme stress, 313–314 Dissociation See also Peritraumatic dissociation, 92, 108, 110, 116, 122, 320–322, 355–356, 409 index-I045048.indd 559 Documentary discovery, 449–450 Documentation review, 493–494 Donoghue v Stevenson, 428 Drivers commercial, 20 drunk, 15, 17, 18 elderly, 33 fearful, 402 high-mileage, 28 middle-aged, 28 young, 21–25 Driving Anger Scale (DAS), 25 Driving Cognitions Questionnaire, 408 Driving phobia, 323–324, 368–369, 403t, 405t assessment, 404–409 clinical description, 390–395 consequent to MVC, 389–412 diagnostic features, 323, 397–401 etiological formulations, 401–402 prevalence following MVCs, 323–324 treatment, 409–410 Driving risk factors alcohol, 15–18 distractions, 33–36 fatigue, 18–21 gender, 21–25 inexperience, 21–25 personality of, 25–26 youth, 21–25 Drug intoxication, 78 Drunk drivers, 15, 17–18 DSM See Diagnostic and Statistical Manual of Mental Disorders Duty of care, 428–429 Dynamic acuity, 31 Dysthymic disorder, 327–328 assessment clinical description diagnostic features, 327 prevalence following MVCs, 327–328 E Ecological validity, 473 ED See Emergency department Ejection from vehicle, 63 Elderly drivers, 19, 27–33, 36, 67, 70, 78, 154, 548 4/22/2008 6:19:56 PM 560 Electrotherapy, 148–149 Emergency department (ED), 49–50, 83, 323, 346, 349 discharge disposition, 96–97 enabling-disabling process model, 84–87 follow-up care, 97–98 functional outcomes, 94–96 inhalation injury, 89 mechanical ventilatory support, 77 resuscitation, 101–102 prognosis, 93–94 psychological assessment, 92–93 trauma, 83–102 Emergency medical service (EMS), 50 EMS See Emergency medical service Endotracheal intubation, 79 Epidural hematoma, 68f Examination for Discovery, 423 Examiner bias, 489–490 Exercise, 147–148 Expert witnesses, 480–481, 483, 487, 505–506, 512, 523, 530–532 expert advice, 430 expert retention, 459–460 expert role, 459–460 expert testimony, 495 Exposure, 54 Exposure-based therapy, 409 F Facet joint injections, 155 Fake Bad Scale, 515 Family Law Act, 445 FAST See Focused assessment with sonography in trauma Fatigue, 18–21 Fenn v City of Peterborough, 435 Ferenczy v M.C.I Medical Clinics, 456 Fibromyalgia, 195, 512 Fibromyalgia Syndrome (FMS), 203 Focused assessment with sonography in trauma (FAST), 67 Foreseeability, 429 Frankfurter v Gibbons, 442 Frontal impact, 55–56, 62 Functional restoration, 236–237 index-I045048.indd 560 Index G GABA See Gamma-aminobutryic acid GAF See Global Assessment of Functioning Gamma-aminobutryic acid (GABA), 154 Gate control theory of pain, 231 General Health Questionnaire (GHQ), 197, 509 Generalized anxiety disorder, 322–323 assessment clinical description diagnostic features, 322 prevalence following MVCs, 322–323 GHQ See General Health Questionnaire Glasgow Coma Scale (GCS), 54t, 64, 65t, 67, 91, 253, 550 Glasgow Outcome Scale, 257 Glaucoma, 30 Global Assessment of Functioning (GAF), 318 H HADS See Hospital Anxiety and Depression Scale Halstead Reitan Neuropsychological Battery (HRNB), 249 Hartwick v Simser, 433 Health Care Expenses, 446–447 Heart-rate recordings, 35 Hemothorax, 66, 70 Heroin, 269 Hospital Anxiety and Depression Scale (HADS), 323 HRNB See Halstead Reitan Neuropsychological Battery Hyperresonance, 53 Hypoperfusion, 79 I ICU See Intensive care unit (ICU) ICIDH-1 See International Classification of Impairments, Disabilities and Handicaps ICIDH-2 See International Classification of Functioning, Disability and Health Imaging, 143–144 4/22/2008 6:19:56 PM 561 Index IME See Independent medical examination Impact of Event Scale, 380 Independent intervening acts, 433–434 Independent medical examination (IME), 468, 484–494 IME exam, 484–487 IME practice, 486–487 IME report, 493 medicolegal exam, 469–472 medicolegal terminology, 472–474 Injuries See also Physical injury abdominal, 72–74 AIS, 93, 550 aortic, 71 by anatomic region, 67–69 life-threatening, 97 ligamentous, 194 major skeletal, 200 mandibular, 69 material contribution, 431–432 maxillofacial, 69 mechanism, 137–138 musculoskeletal, 75–76 neck, 190 severity, 354, 550 spinal cord, 76–78 thoracic, 69–70 traumatic brain, 9, 67–69, 108–109, 118–121, 254 Injury Severity Score (ISS), 331–334, 550 Insurer’s exam, 458–460 Intensive care unit (ICU), 96 Interdisciplinary assessment, 234–235 Interdisciplinary rehabilitation, 235–237 International Classification of Diseases (ICD), 245, 473 International Classification of Impairments, Disabilities and Handicaps (ICIDH-1), 472 International Classification of Functioning, Disability and Health (ICIDH-2), 472, 526 Interscapular pain, 191 Invasive surgery, 155–157 In-vehicle information systems (IVIS), 33 ISS See Injury severity score IVIS See In-vehicle information systems index-I045048.indd 561 J Janiak v Ippolito, 433 K Kinetic energy, 46, 55–56, 62 L Laparotomy, 73f Lateral impact, 56–57, 63 Learning disability, 267–268 Lee v Dawson, 435 Legal fees, 424 Leszcynski v Clark, 438 Life-threatening injuries, 97 Ligamentous injuries, 194 Litigation, 338–339, 381–383, 521–525, 532, 549, 551–552 Litigation stress, 504, 518, 521–525, 532, 549, 551 M Macular degeneration, 30 Magnetic resonance imaging (MRI), 77, 144, 158, 194, 269, 551 Major depressive disorder (MDD), 176, 259–261, 324–327, 346, 348–352, 355, 357, 511, 512, 516 Major skeletal injuries, 200 Malingering, 277–280, 521, 525 Mandibular injury, 69 MAR See Minimum angle of resolution Marijuana, 18, 269 Massage, 150 Maxillofacial injury, 69 Maximum medical improvement (MMI), 475, 477 Mediation, 461 Mesenteric blood supply, 72 Meyer v Bright, 438 Mild traumatic brain injury (MTBI), 108–109, 118–121 Millon Clinical Multiaxial Inventory-III, 514 Minimum angle of resolution (MAR), 30 Minnesota Multiphasic Personality Inventory-II (MMPI-II), 210, 514–515, 551 4/22/2008 6:19:57 PM 562 MMI See Maximum medical improvement MMPI-II See Minnesota Multiphasic Personality Inventory- II Mobilization, 149–150 MODS See Multiple organ dysfunction syndrome Morphine, 152 MPI See Multidimensional Pain Inventory MRI See Magnetic resonance imaging MTBI See Mild traumatic brain injury Multidimensional Pain Inventory (MPI), 210, 515, 550 Multidisciplinary treatment, 150–151 Multiple organ dysfunction syndrome (MODS), 73, 90 Musculoskeletal injury, 75–76 Musculoskeletal pain, 202 N NAN See National Academy of Neuropsychology National Academy of Neuropsychology (NAN), 278, 491 National Comorbidity Study (NCS), 317, 320, 326 National Highway Traffic Safety Administration (NHTSA), 3–4, 14, 174, 187, 550 NCS See National Comorbidity Study NDI See Neck Disability Index Neck Disability Index (NDI), 216 Neck injuries, 190 Neck pain, 191 Negligence, 428 Nervous system sensitization, 195 Neurological disorders, 199–200 Neuropsychological assessment, 217–218 core abilities, 246t deficits, 269 low test scores, 249–255 memory functioning, 266 memory impairment, 247 profile analysis, 276 psychomotor speed, 273 tests, 244 Neuropsychological assessment battery (NAB), 250t, 252, 254 Newton’s First Law, 55 index-I045048.indd 562 Index No-fault regime, 367, 426–427, 503–505, 527, 531 Non-pecuniary general damages, 434–445 Non-steroidal anti-inflammatory drugs (NSAIDS), 76, 152t Notice of Examination, 457 NSAIDS See Non-steroidal antiinflammatory drugs O Obesity, 78 Offset impact, 63 OHIP See Ontario Health Insurance Plan OMPP See Ontario Motorists Protection Plan Ontario Health Insurance Plan (OHIP), 423 Ontario Motorists Protection Plan (OMPP), 437 Ontario’s Insurance Act, 445 Open book pelvic fracture, 75 Open treatment and internal fixation with hardware (OTIF), 76 Opioid seeking behaviors, 209 Oral discovery, 453 Osmotic diuresis, 68 OTIF See Open treatment and internal fixation with hardware Oxygenation, 89 P PADS See Propensity of Anger Driving Scale Pain acute, 58, 61, 65, 69–71, 74–76, 121, 132, 170, 172, 230, 232, 239 adaptation, 217 behaviors, 231 biopsychosocial perspective, 230–231 chronic musculoskeletal, 237 chronic, 131–160, 187–221, 229–239, 244–280, 312, 321, 331–332, 369, 383, 497–499, 509–512, 514, 520, 522–523, 530 coping, 172, 219, 521 gate control theory, 231 generators, 136–137 injury-related impairment, 132–133 4/22/2008 6:19:57 PM Index intensity, 211 location, 201 modifiers, 212 management, 100 musculoskeletal, 202 neck, 191 nociceptors, 133 overt expressions, 216–217 palliate, 194 persistent, 146–147, 189, 218, 220 quality, 212 relief, 172 whiplash, 134 widespread, 146, 201, 530 widespread non-anatomic, 201–202 Pain Disability Questionnaire (PDQ), 477 Partial cause, 518 Patient controlled analgesia (PCA), 70 PCA See Patient controlled analgesia PCP See Primary care provider PDQ See Pain Disability Questionnaire PEEP See Positive and expiratory pressure Peer Review, 483, 484 Pelvic fracture, 74–75 Pecuniary damages, 445–448 Periorbital bruising, 68 Peritrauma factors, 354–355 Peritraumatic dissociation, 126, 176, 316, 320–322, 338, 354, 356–357, 496 Permanent impairment, 474–478 Permanent Partial Disability (PPD), 477 Persistent pain, 146–147, 189, 218, 220 Personal Injury lawyers, 422 Personality disorders, 328–330 PFActS See Pictorial Fear of Activity Scale Pharmacotherapy, 151, 545 Amitriptyline, 154 Analgesics, 411 Benzodiazapines, 272–273 Desipramine, 154 Heroin, 269 Morphine, 152 Non-steroidal anti-inflammatory drugs (NSAIDS), 76, 152t Nortriptyline, 154 Selective serotonin reuptake inhibitors (SSRIs), 154 index-I045048.indd 563 563 Tricyclic antidepressants (TCAs), 153 Phobic travel anxiety, 393, 395–397 Physical examination, 65–66, 142–143, 203–204 Pictorial Fear of Activity Scale (PFActS), 214–216 Pilates, 148 Pinchera v Langille, 442 Plaintiff lawyers, 506 Pneumothorax, 66, 70 Poor effort, 277–280 Positive and expiratory pressure (PEEP), 70 Post-collision records, 517 Posterior longitudinal ligament runs, 136 Posttrauma factors, 352, 355–358 Posttraumatic Stress Disorder (PTSD), 4, 9–10, 87, 96, 107, 119–120, 173, 261–264, 313, 316–320 ASD and, 109–110 assessment, 315, 317, 320 clinical description, 314, 329 complex, 319–320 delayed onset, 316 diagnostic features, 316 dissociation and, 320–322 MDD and, 325, 326–327 prevalence following MVCs, 317–319, 347–348 remission, 317, 318 subsyndromal, 368–369 symptom cluster trajectories, 369–370 theoretical models, 370–375 treatment, 365–384 Pre-collision records, 450, 517 Predictors of motor vehicle collisions, 13–36 alcohol, 15–18 distraction, 33–36 fatigue, 18–21 gender, 21–25 inexperience, 21–25 personality of, 25–26 youth, 21–25 Prentice et al v Coovadia et al., 460 Preponderant cause, 518 Pretrauma factors, 352–354 Pre-trial conferences, 463 4/22/2008 6:19:57 PM 564 Primary care provider (PCP), 7–8, 97, 168, 543, 546, 550 Primary care setting, 131–160 Primary survey, 46, 51f, 51–54, 64–65, 67, 76, 89–91 Primum non nocere, 470 Privilege, 452–453 Proof of damages, 448–455 Propensity of Anger Driving Scale (PADS), 25 Psycholegal assessment, 506–531 practice recommendations, 531–532 psychological testing, 513–515 report, 516–529 Psychological disorders ADHD, 265–267 adjustment, 328 anxiety, 349, 546 extreme stress, 313–314 disability, 332–335 dysthymic, 327–328 generalized anxiety, 322–323 litigation stress and, 335–337 major depressive, 324–327 pain and, 330–332 perceived threat and, 332 personality, 328–330 physical injury and, 330–332 somatoform disorders, 279 substance abuse, 267–270 PTSD See Posttraumatic Stress Disorder Q QTF See Quebec Task Force Quality of life, 87, 232–335, 351–352 Quebec Task Force (QTF), 133, 188t R Radiofrequency neurotomy, 156 Radiographic evaluation, 66–67 Rear impact, 57, 63 Reimbursement, 485 Response Bias, 488–489 Restraining devices, 88 Resuscitation, 87–88 Richardson v Lee, 441 index-I045048.indd 564 Index Rights to Exams, 458–459 Rollover impact, 57 Rotational impact, 57 Rules of civil procedure, 449 Rutherword v Pannunzio, 440 S SABS See Statutory Accident Benefits Schedule Screening Secondary survey, 47, 54–55, 65–66, 69, 75, 91–92 Sickness Impact Profile (SIP), 334 Selective serotonin reuptake inhibitors (SSRIs), 154 Semi-structured interview, 405t, 507–513 Settling offers, 462–363 Sickness Impact Profile (SIP), 174, 334–335, 515, 549 Single vehicle collisions, 28 SIP See Sickness Impact Profile Sleep problems, 264 Snellen eye-chart, 30 Sole cause, 518 Solicitor-client privilege, 452 Somatoform disorders, 279 Special issues, 79–81, 98–99, 270–280, 337–339 Special populations, 118–123 children, 98–99 older adults, 99–100 civilian trauma victims Speeding, 13 Spinal cord injury, 76–78 SSRIs See Selective serotonin reuptake inhibitors Standard of care, 429–431 Standardized pain assessment instruments, 210–212 Statutory Accident Benefits Schedule (SABS), 427 Subjective Units of Distress Scale (SUDS), 407 Substance use and misuse, 101 abuse, 117 alcohol, 15–18, 78, 268 cocaine, 269 dependency, 202 4/22/2008 6:19:57 PM 565 Index heroin, 269 marijuana, 269 opioid-seeking behaviors, 209 Subsyndromal PTSD, 368–369 SUDS See Subjective Units of Distress Scale Supportive psychotherapy, 378–379 Supreme Court of Canada, 441 Surveillance, 455–459 Symptom exaggeration, 277–280, 335, 515, 523 T TBI See Traumatic brain injury T-bone collisions, 56 Temporary tracheotomy, 70f Temporary Total Disability (TTD), 477 Temporomandibular disorders (TMD), 145–146 Temporomandibular joints (TMJs), 142, 145 TENS See Transcutaneous electrical nerve stimulation Terzis v Terzis, 439 Thin skull, 519 Thoracic injury, 69–70 TMD See Temporomandibular disorders TMJs See Temporomandibular joints Tort and accident benefits systems exchange, 459 Tort regime, 426–434 Transcutaneous electrical nerve stimulation (TENS), 148 Trauma Resuscitation Bay, 50, 51f Trauma team leader (TTL), 50 Traumatic brain injury (TBI), 9, 65, 87, 108–109, 118–121, 253–254, 257–259, 354–355, 497 Travel anxiety, 395–396 Triage, 95 Trial, 463–464 Trial Consultant, 483 Tricyclic antidepressants (TCAs), 153 Trigger point injections, 157 TTD See Temporary Total Disability index-I045048.indd 565 U UFOV See Useful Field of View Useful Field of View (UFOV), 32 V Vanderbilt Pain Management Inventory (VPMI), 515 VAS See Visual analog scale Ventilation, 89, 100 Victoria Symptom Validity Test (VSVT), 279 Video surveillance, 424, 457 Virtual reality, 380, 552 Visual analog scale (VAS), 211 Vocational disability, 334 VPMI See Vanderbilt Pain Management Inventory VSVT See Victoria Symptom Validity Test W WADs See Whiplash-associated disorders WAIS-III See Weschler Adult Intelligence Scale-III Walker v Ritchie, 425 Weschler Adult Intelligence Scale-III (WAIS-III), 514 Whiplash associated disorders (WADs), 134, 182 assessment, 191–196 chronicity, 190–191 clinical characterization, 141t contributing factors, 194–196 multidimensional perspective, 194 psychological factors, 196–198 symptom severity, 219–220 Whole Person Impairment (WPI), 447, 473–474, 526–527 Widespread non-anatomic pain, 201–202 Widespread pain, 146, 201, 530 World Health Organization, 170, 472, 511, 526 Y Yoga, 148 Young v Bella, 436 4/22/2008 6:19:57 PM