Pain, perceived injustice and the persistence of post-traumatic stress symptoms during the course of rehabilitation for whiplash injuries

Pain. 2009 Oct;145(3):325-331. doi: 10.1016/j.pain.2009.06.031. Epub 2009 Jul 29.

Abstract

The present study assessed the role of pain and pain-related psychological variables in the persistence of post-traumatic stress symptoms following whiplash injury. Individuals (N=112) with whiplash injuries who had been admitted to a standardized multidisciplinary rehabilitation program were asked to complete measures of pain, post-traumatic stress symptoms, physical function and pain-related psychological variables at three different points during their treatment program. The findings are consistent with previous research showing that indicators of injury severity such as pain, reduced function and disability, and scores on pain-related psychological were associated with more severe post-traumatic stress symptoms in individuals with whiplash injuries. Contrary to expectations, indicators of pain severity did not contribute to the persistence of post-traumatic stress symptoms. Univariate analyses revealed that self-reported disability, pain catastrophizing and perceived injustice were significant determinants of the persistence of post-traumatic stress symptoms. In multivariate analyses, only perceived injustice emerged as a unique predictor of the persistence of post-traumatic stress symptoms. The results suggest that early adequate management of pain symptoms and disability consequent to whiplash injury might reduce the severity of post-traumatic stress symptoms. The development of effective intervention techniques for targeting perceptions of injustice might be important for promoting recovery of post-traumatic stress symptoms consequent to whiplash injury.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Catastrophic Illness
  • Depression / etiology
  • Disability Evaluation
  • Fear / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / psychology*
  • Pain / rehabilitation
  • Pain Measurement / methods
  • Pain Measurement / psychology*
  • Pain Threshold / physiology
  • Perception / physiology*
  • Range of Motion, Articular / physiology
  • Severity of Illness Index
  • Statistics as Topic
  • Stress Disorders, Post-Traumatic / etiology*
  • Surveys and Questionnaires
  • Whiplash Injuries / complications*
  • Whiplash Injuries / rehabilitation*
  • Young Adult