Pain, perceived injustice and the persistence of post-traumatic stress symptoms during the course of rehabilitation for whiplash injuries.
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.
Sullivan
Michael J L
MJL
Department of Psychology, McGill University, Canada School of Physical and Occupational Therapy, McGill University, Rm D26, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada H3G 1Y5 Clinique d'évaluation et de réadaptation de l'est, 6494 Beaubien est, bureau 102, Montreal, Quebec, Canada H1M 1A9 Clinique de physiothérapie Ste-Anne, 324, boul. Antonio-Barrette N.D.P., Joliette, Quebec, Canada J6E 1G2.
Thibault
Pascal
P
Simmonds
Maureen J
MJ
Milioto
Maria
M
Cantin
André-Philippe
AP
Velly
Ana M
AM
D000328:Adult; D002388:Catastrophic Illness; D003863:Depression / Q000209:etiology; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology* / Q000534:rehabilitation; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D017288:Pain Threshold / Q000502:physiology; D010465:Perception / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000150:complications* / Q000534:rehabilitation*; D055815:Young Adult