Attitude affects recovery from whiplash

For people who suffer whiplash in a car accident; feelings of being wronged may raise their risk of lingering post-traumatic stress.

Post-traumatic stress disorder (PTSD) is an anxiety disorder marked by symptoms such as nightmares or flashbacks of the traumatic event. Studies in the past have pointed to the importance of psychological factors in recovery from whiplash - an injury to the neck's soft tissue, including muscles, ligaments and discs, which typically occur during a car accident that sends the head and neck suddenly forward and back. A recent study found that whiplash patients who were more optimistic about their recovery were less likely than their pessimistic counterparts to have disabilities six months later, even when the severity of the injury was taken into account.

To assess the role of pain and pain-related psychological variables in the persistence of post-traumatic stress symptoms following whiplash injury, researchers followed 112 Canadian patients in rehabilitation for whiplash injuries. Forty-five per cent had symptoms of PTSD when they started treatment.

It was found that those with a greater sense of "perceived injustice" about their situation were more likely than others to still have PTSD symptoms at the end of their rehabilitation programme. Feelings of injustice, in particular, feeling like the victim of someone else's negligence, were the only strong predictor of persistence of PTSD symptoms. Patients with more-severe pain and disability had a higher risk of developing PTSD symptoms in the first place. But those physical symptoms were not related to the risk of lingering post-traumatic stress.

The results raise the possibility that effective treatment of patients' pain early on might prevent serious PTSD symptoms and addressing people's sense of injustice may help keep any symptoms from becoming chronic. These findings link perceived injustice and persistent PTSD; however they do not prove that the former causes the latter.