Recovery from acute whiplash: the role of coping styles.
METHODS
Prospective cohort study. Victims of car accidents who initiated compensation claim procedures at a Dutch insurance company and presented themselves with neck complaints were sent a questionnaire containing neck-related questions and questions regarding the coping styles used shortly after the accident. An additional two questionnaires were administered 6 and 12 months, respectively, after the accident.


OBJECTIVE
To examine the association between the coping styles used and the development of late whiplash syndrome.


BACKGROUND
Previous research has indicated that neither personality traits nor psychopathologic symptoms can predict the outcome of whiplash. No studies have yet been conducted on the association between coping styles and the development of late whiplash syndrome.


METHODS
The coping styles were determined using the Utrecht Coping List. The duration of neck complaints was measured from the time of the accident and from the time of filling in the first questionnaire. Survival analysis was used to study the association between the duration of neck complaints and the explanatory variables.


RESULTS
Of the 363 eligible claimants, 278 (77%) responded to the questionnaire; 242 (67%) were included in the analysis. After 12 months, 40% of the male and 50% of the female participating claimants still had neck complaints. The duration of the neck complaints was associated with gender, palliative reaction, and the seeking social support coping style.


CONCLUSIONS
The coping style during the first few weeks after the accident and the gender are related to the duration of neck complaints (Cox regression: palliative handling relative risk = 0.91, P = 0.002; seeking social support relative risk = 1.06, P = 0.042; and gender relative risk = 1.50, P = 0.036). Thereafter the intensity of somatic complaints plays a role. Paying attention to the coping style could contribute to the prevention of the development of late whiplash syndrome.
Buitenhuis
J
J
Univé Insurance, Medical Department, P.O. Box 15, 9400 AA Assen, The Netherlands. buitenhuisj@unive.nl
Spanjer
J
J
Fidler
V
V
D000063:Accidents, Traffic; D000208:Acute Disease; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D007346:Insurance, Accident; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care; D016016:Proportional Hazards Models; D012307:Risk Factors; D017678:Sex Distribution; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors; D014911:Whiplash Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*