Symptom Attribution After a Car Wreck

Determining what symptoms were caused, or made worse, by a car wreck seems like it would be super straightforward.

But it can be a struggle for the injured person.

Why is it so difficult?

There are a number of reasons:

Attribution Bias

Car wrecks are memorable. They provide a simple explanation for symptoms.

But I don’t think “causal attribution” is a stand-alone explanation. There are other factors.

Heightened Awareness/Worsened Symptoms

Before a wreck people may have symptoms that they ignored or minimized. Maybe they didn’t treat for those symptoms and never really discussed them.

Let’s say someone has limited range of motion in their shoulder. They get into a wreck and really hurt their neck. During a doctor’s visit the doctor has the person go through range of motion testing.

The range of motion testing gets the attention of both the person with the neck injury and the doctor.

This heightened awareness can create the perception that the symptoms were caused by the event.

And, of course, there’s the most likely explanation that there was pain or some other symptoms before the collision and the collision made it worse.

Recency Effect

This is similar to Heightened Awareness.

Symptoms from an older condition may not have been top of mind until the collision occurred.

After the collision, current pain is more immediately noticeable and tends to overshadow memory of prior pain. This creates the perception that the accident "caused" the pain.

Imperfect Memory

People often struggle to accurately recall the details of the symptoms they had before an event (like a collision). Over time their memory may change and minimize the severity of pre-existing conditions. This is sometimes referred to as “retrospective bias.”

The defense loves spinning the narrative that the injured person is blaming everything on the collision. Even problems they clearly had before the wreck.

It’s true that all sorts of psychological factors bias people toward that attribution.

But I think the most common explanation is that pre-existing symptoms sure aren’t helped—directly or indirectly—by a car wreck.

Body parts that weren’t working very well before the wreck aren’t going to work better after it. And the opportunity to adapt or work around a limitation is frequently compromised when other parts of the body are injured.