The development of psychological changes following whiplash injury

Sterling, Michele, Kenardy, Justin, Jull, Gwendolen and Vicenzino, Bill (2003) The development of psychological changes following whiplash injury. Pain, 106 3: 481-489. doi:10.1016/j.pain.2003.09.013

Author Sterling, Michele
Kenardy, Justin
Jull, Gwendolen
Vicenzino, Bill
Title The development of psychological changes following whiplash injury
Journal name Pain   Check publisher's open access policy
ISSN 0304-3959
Publication date 2003-12
Sub-type Article (original research)
DOI 10.1016/j.pain.2003.09.013
Volume 106
Issue 3
Start page 481
End page 489
Total pages 9
Editor Allan I. Basbaum
Place of publication Amsterdam, The Netherlands
Publisher Elsevier
Collection year 2003
Language eng
Subject C1
380100 Psychology
730114 Skeletal system and disorders (incl. arthritis)
1701 Psychology
Abstract Psychological distress is a feature of chronic whiplash-associated disorders, but little is known of psychological changes from soon after injury to either recovery or symptom persistence. This study prospectively measured psychological distress (General Health Questionnaire 28 GHQ-28). fear of movement/re-injury (TAMPA Scale of Kinesphobia, TSK), acute post-traumatic stress (Impact of Events Scale, IES) and general health and well being (Short Form 36, SF-36) in 76 whiplash subjects within I month of injury and then 2, 3 and 6 months post-injury. Subjects were classified at 6 months post-injury using scores on the Neck Disability Index: recovered (< 8), mild pain and disability (10-28) or moderate/severe pain and disability (> 30). All whiplash groups demonstrated psychological distress (GHQ-28, SF-36) to some extent at 1 month post-injury. Scores of the recovered group and those with persistent mild symptoms returned to levels regarded as normal by 2 months post-injury, parallelling a decrease in reported pain and disability. Scores on both these tests remained above threshold levels in those with ongoing moderate/severe symptoms. The moderate/severe and mild groups showed elevated TSK scores at 1 month post-injury. TSK scores decreased by 2 months in the group with residual mild symptoms and by 6 months in those with persistent moderate/severe symptoms. Elevated IES scores, indicative of a moderate post-traumatic stress reaction, were unique to the group with moderate/severe symptoms. The results of this study demonstrated that all those experiencing whiplash injury display initial psychological distress that decreased in those whose symptoms subside. Whiplash participants who reported persistent moderate/severe symptoms at 6 months continue to be psychologically distressed and are also characterised by a moderate post-traumatic stress reaction. (C) 2003 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
Keyword Anesthesiology
Clinical Neurology
psychological distress
whiplash-associated disorders
post-traumatic stress
Q-Index Code C1

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Created: Wed, 15 Aug 2007, 02:09:23 EST