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Published Online:https://doi.org/10.1176/ajp.119.3.237

Thirty alcoholic and 30 non-alcoholic Patients were evaluated to determine past serious suicidal preoccupation or previous suicidal attempts. These data were correlated with the total number of automobile accidents for which the patient was responsible.

The 33 patients deemed to be suicidal averaged 2.70 accidents per patient whereas the 27 non-suicidal patients averaged 1.30 accidents. In the 30-patient alcoholic group, the 17 suicidal patients were responsible for 63 accidents, whereas the 13 non-suicidal patients were responsible for 24 accidents, yielding mean values of 3.70 and 1.77 accidents per person respectively. These differences were statistically significant.

Due to the accepted and real hazards of driving, the automobile constitutes an ideal self-injurious or self-destructive instrument, particularly for persons intent upon camouflaging their suicidal motivation from others–and from themselves. With one exception, all patients believed their traffic accidents were fortuitous.

Alcohol intoxication may be responsible for automobile accidents not only because of the resultant driving impairment, but also because of its potential for reducing the controlling and conforming function of the superego, thus releasing aggressive and self-destructive impulses which find expression in traffic "accidents."

This investigation points toward the possibility that unconscious self-destructive impulses, sometimes abetted by alcohol intoxication, are a major although covert factor in the etiology of certain automobile accidents.

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