Neuropsychological Services Following Motor Vehicle Collisions

Motor vehicle collisions (MVCs) are the second leading cause of traumatic brain injury (TBI), accounting for between 17 and 28 % of all TBIs. Although about 86 % of those who are involved in MVCs sustain no injuries, the remaining 14 % commonly experiences temporary or permanent cognitive, physical, and emotional problems; decreased functioning; and adverse lifestyle changes, which often result in litigation or pursuit of disability benefits. Although by far the most common severity of brain trauma resulting from MVCs falls at the mild end of the spectrum, many patients sustain moderate and severe brain injuries. Because of differing neuropathology, clinical presentations, recovery courses, and treatment and care needs, the neuropsychological conceptualization of, and services provided to, those who have sustained mild traumatic brain injuries typically differ from the conceptualization and services needed for those who sustained moderate–severe TBIs. Physical pain, emotional distress, effects of medications, and various motivations to seek services often contribute to the complexity of issues experienced by patients and confronted by clinicians. The purpose of this article is to review the assessment and treatment of cognitive, emotional, and behavioral problems experienced by persons who have been involved in MVCs, with a primary focus on outpatient settings and TBIs that fall at the mild end of the severity spectrum.