title: The role of illness perceptions in predicting outcome after acute whiplash trauma: a multicenter 12-month follow-up study.
abstract: OBJECTIVE
  To examine (1) whether the patients' perceptions of their symptoms immediately after the accident and at 3-month follow-up predict working ability and neck pain at 12-month follow-up and (2) the possible changes in patients' illness perceptions during the follow-up period.
  
  
  METHODS
  A total of 740 consecutive patients exposed to acute whiplash trauma consulting emergency units and general practitioners in 4 Danish counties from 2001 to 2003. The patients completed questionnaires at baseline, 3-, and 12-month follow-up. Illness perceptions were measured using a condensed version of the Illness Perception Questionnaire and a 1-item question concerning return to work expectation. Neck pain was measured using an 11-point box scale, and working ability was measured by self-report at 12-month follow-up. Multiple logistic regression analyses were applied controlling for possible confounders.
  
  
  RESULTS
  Patients with pessimistic illness perceptions at baseline and 3-month follow-up were more likely to experience neck pain and affected working ability at 12 months compared with patients with optimistic illness perceptions. Negative return-to-work expectation predicted affected working ability at 12 months. Furthermore, patients with high neck pain intensity or affected working ability report more changes in their illness perceptions during follow-up than patients with low neck pain intensity or unaffected working ability.
  
  
  CONCLUSIONS
  The findings are in line with the common-sense model of illness and previous research demonstrating that patient's expectations for recovery and illness perceptions might influence the course after whiplash injury. Illness perceptions and expectations may provide a useful starting point for future interventions and be targeted in the prevention of chronicity.
authors.affiliation: *The Research Clinic for Functional Disorders and Psychosomatics †Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Tine B
authors.initials: TB
authors.lastname: Gehrt
authors.forename: Tina Birgitte
authors.initials: TB
authors.lastname: Wisbech Carstensen
authors.forename: Eva
authors.initials: E
authors.lastname: Ørnbøl
authors.forename: Per K
authors.initials: PK
authors.lastname: Fink
authors.forename: Helge
authors.initials: H
authors.lastname: Kasch
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Frostholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003718:Denmark; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology* / Q000209:etiology*; D010147:Pain Measurement; D010465:Perception / Q000502:physiology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013997:Time Factors; D014911:Whiplash Injuries / Q000150:complications / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult