A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash

Dunne, Rachael Louise, Kenardy, Justin and Sterling, Michele (2012) A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash. Clinical Journal of Pain, 28 9: 755-765.


Author Dunne, Rachael Louise
Kenardy, Justin
Sterling, Michele
Title A randomized controlled trial of cognitive-behavioral therapy for the treatment of PTSD in the context of chronic whiplash
Journal name Clinical Journal of Pain  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-11
Sub-type Article
DOI 10.1097/AJP.0b013e318243e16b
Volume number 28
Issue number 9
ISSN 0749-8047; 1536-5409
Start page 755
End page 765
Total pages 11
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Formatted abstract Objectives: Whiplash-associated disorders (WAD) are common and involve both physical and psychological impairments. Research has shown that persistent posttraumatic stress symptoms are associated with poorer functional recovery and physical therapy outcomes. Trauma-focused cognitive-behavioral therapy (TF-CBT) has shown moderate effectiveness in chronic pain samples. However, to date, there have been no clinical trials within WAD. Thus, this study will report on the effectiveness of TF-CBT in individuals meeting the criteria for current chronic WAD and posttraumatic stress disorder (PTSD).

Method: Twenty-six participants were randomly assigned to either TF-CBT or a waitlist control, and treatment effects were evaluated at posttreatment and 6-month follow-up using a structured clinical interview, self-report questionnaires, and measures of physiological arousal and sensory pain thresholds.

Results: Clinically significant reductions in PTSD symptoms were found in the TF-CBT group compared with the waitlist at postassessment, with further gains noted at the follow-up. The treatment of PTSD was also associated with clinically significant improvements in neck disability, physical, emotional, and social functioning and physiological reactivity to trauma cues, whereas limited changes were found in sensory pain thresholds.

Discussion: This study provides support for the effectiveness of TF-CBT to target PTSD symptoms within chronic WAD. The finding that treatment of PTSD resulted in improvements in neck disability and quality of life and changes in cold pain thresholds highlights the complex and interrelating mechanisms that underlie both WAD and PTSD. Clinical implications of the findings and future research directions are discussed.
Keyword Whiplash
Posttraumatic stress
MVC
Pain
Randomized control trial
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

 
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