Traffic accidents with children - a source of particular psychological stress

26 Apr 2019 The Human Factor
Experience has shown time and again that traffic accidents trigger strong feelings of fear and helplessness in children – irrespective of whether they simply see them or are directly involved themselves. The subjective danger experienced by the child is of particular significance, while the extend of the injuries suffered plays less of a role.
Both during and in the immediate aftermath of the accident, the child will be in a state of high mental agitation, causing large quantities of stress hormones to be released into their bloodstream. Most children will respond to this by crying, screaming, becoming aggressive, shaking and feeling dizzy. Depending on the severity of the injury, they may also run around or away from the site of the accident in panic. Some children will experience a strong urge to talk, wanting to tell people straight away about what they have experienced, while others will "freeze up", suddenly entering into complete silence, retreating into themselves, and becoming unable to move. The latter reaction may give the impression that the child has not been affected by the accident, but it is actually simply a defense mechanism to prevent them from being completely overwhelmed by what they have experienced.
Children can find seeing dead bodies, blood, injuries, and vomit particularly disturbing, as well as other signs of an accident, such as tire tracks on the road from a braking vehicle. In particular, children experience pungent, acrid and unfamiliar smells more intensively than adults, and may suffer fear, headaches and nausea as a result.
Any child that is hurt in a traffic accident will feel pain accordingly. However, their subjective perception of this pain can vary greatly. For example, young children in particular may see injuries that are actually threatening as harmless while believing trivial injuries such as surface wounds to be extremely threatening. Due to a fear of making the situation worse, having to undergo painful treatment, or being shouted at, young children in particular also tend not to mention pain or disturbing thoughts. This must be taken into account when assessing the condition of the child in question.
Children feel much safer if they are with a familiar person they are close to when the traffic accident happens, while what they experience will be more disturbing to them if they are not accompanied by such a person. The calmer and more relaxed people the child relates to remain during and in the immediate aftermath of an accident, the more confident the child will be in processing the experience.
When children are the victims of an accident, this can be particularly distressing for the other victims and the family and friends – especially the parents. The question of guilt often becomes of central importance to those directly involved in the accident and others affected by it. Any eyewitnesses to the accident may also find it very distressing. However, since they do not have a personal, emotional connection to any of the direct victims, the do not generally need the same amount of psychological help as the family and friends of the victim.

Development of psychological stress in children during the period following the traffic accident

Generally speaking, children and the elderly are the two groups at the greatest risk of becoming pathologically traumatized after experiencing a psychologically stressful event. Younger children are generally affected more severely than older ones, as they are less emotionally secure and have not yet developed coping strategies based on past experience. Traumatized children may suffer impairments to their emotional, social, and psychomotor development. In addition to the acute distress the child experiences, other short-term emotional consequences may include fear, anger, shame, sadness and listlessness. After the accident, their thoughts will often return to what has happened. Just like in adults, memories may resurface and cause sleep disturbances. The child may also find it difficult to concentrate, and their performance at school may begin to suffer. It is also not uncommon for a child's eating habits to change after an accident, and drastic weight loss or gain are often responses to such a traumatic experience.
In a study conducted by the Akademie Bruderhilfe organization, 38 percent of children who had experienced a traffic accident still exhibited symptoms of psychological stress four years after the incident. In turn, 37 percent of these children were scared of traffic on roads. 30 percent of the children in the study complained of sleep disorders, while 16 percent said they often suffered from nightmares and restlessness. Difficulties in concentration were found in 21 percent, and 16 percent exhibited a drop in their school performance. 12 percent of the children experienced aggression and outburst of anger. A number of other consequences were observed, some a long time after the traffic accident itself.

Potential development of anxiety disorders, panic disorders, and depression

In the long term, there is a risk of difficulty fitting in, social isolation, specific compulsions, eczema, headaches, ulcers, digestive problems, and infections. Young people in particular may be susceptible to developing alcohol, nicotine, and drug addictions. There can be a significant delay in when the physical symptoms of experiencing a traffic accident start to manifest, especially in children. Even if a child's behavior does not seem to change in any way at first, this does not guarantee that they have not been psychologically traumatized by the event. Parents and teachers often underestimate the psychological effect that experiencing a traffic accident can have a child, which can lead to the child not receiving the help they need. This type of unprocessed psychological trauma brings with it a risk of developing other psychological disorders later in life.
Generally speaking, however, some children are very much able to process what they have experienced effectively. A stable family life and trust-based attachments to friends and adult figures who are close to the child will reduce the psychological stress and help them to overcome what they have experienced. It is especially helpful if the child feels that they can speak openly about their thoughts and feelings to the adults they are close to and accept help from them. Experiencing an accident and overcoming this experience can also have a number of positive effects, such as making them mentally stronger, improving their social maturity, and increasing their sense of responsibility.
Generally speaking, emergency psychological aid can be provided to help children in the aftermath of a traffic accident. The key to determining the correct approach here is to recognize at an early stage which children are at risk of developing a post-traumatic disorder further down the line. The child should be taken to therapy if their post-traumatic symptoms persist without abating for more than four weeks or if they are suffering particularly badly, if not before.