title: Sex Differences in Patients with Chronic Pain Following Whiplash Injury: The Role of Depression, Fear, Somatization, Social Support, and Personality Traits.
abstract: BACKGROUND
  Chronic whiplash-associated disorders (chronic WAD) cover a large variety of clinical manifestations that can occur after a whiplash injury. Women have an increased risk of developing chronic WAD, and it is suggested that psychosocial factors are related to long-term pain and functioning following whiplash injury and persistence of chronic pain. This leads to the question whether there are sex differences in psychosocial factors in chronic WAD.
  
  
  METHODS
  This study included 117 subjects who had experienced a whiplash injury at least 3 months before the start of the study (mean duration of pain: 67.29 ± 63.86 months, range: 297 months). They were selected as chronically symptomatic, by excluding those who had recovered from their whiplash injury. Psychosocial aspects (including depression, fear, somatization, social support, and personality traits) were assessed by validated questionnaires, and sex differences were tested using a univariate analysis of variance (ANCOVA), with age and time from whiplash injury as covariates.
  
  
  RESULTS
  No differences in depression, fear, somatization, discrepancy in social support personality trait, Neck Disability Index scores, physical functioning, bodily pain, or general health were present between women and men with chronic WAD. Women with chronic WAD reported higher levels of emotional support in problem situations and social companionship.
  
  
  CONCLUSIONS
  Except for emotional support in problem situations and social companionship, psychosocial factors do not differ between men and women with chronic WAD. These findings imply little to no risk for sex bias in studies investigating psychosocial issues in patients with chronic WAD.
authors.affiliation: Pain in Motion Research Group, Brussels.|Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.|Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
authors.forename: Anneleen
authors.initials: A
authors.lastname: Malfliet
authors.affiliation: Pain in Motion Research Group, Brussels.|Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.|Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
authors.forename: Margot
authors.initials: M
authors.lastname: De Kooning
authors.affiliation: Human Ecology Department, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.|Medical Sociology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Inghelbrecht
authors.affiliation: Departments of Critical Care Medicine and Cerebral Resuscitation Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Said
authors.initials: S
authors.lastname: Hachimi-Idrissi
authors.affiliation: Faculty of Arts & Architecture, Universiteit Hasselt, Hasselt, Belgium.|Media, Arts & Design, PXL-Hogeschool, Hasselt, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Willems
authors.affiliation: End-of-life Care Research Group, Vrije Universiteit Brussel and Ghent University, Ghent, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Bernheim
authors.affiliation: Pain in Motion Research Group, Brussels.|Departments of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.|Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
authors.forename: Jo
authors.initials: J
authors.lastname: Nijs
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D012737:Sex Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000150:complications*
keywords: biopsychosocial factors; chronic neck pain; psychosocial factors; sex differences; social support; whiplash-associated disorders