Sullivan Michael J L, Thibault Pascal, Simmonds Maureen J, Milioto Maria, Cantin André-Philippe, Velly Ana M
Department of Psychology, McGill University, Canada School of Physical and Occupational Therapy, McGill University, Rm D26, 3654 Promenade Sir William Osler, Montreal, Quebec, Canada H3G 1Y5 Clinique d'évaluation et de réadaptation de l'est, 6494 Beaubien est, bureau 102, Montreal, Quebec, Canada H1M 1A9 Clinique de physiothérapie Ste-Anne, 324, boul. Antonio-Barrette N.D.P., Joliette, Quebec, Canada J6E 1G2.
Pain. 2009 Oct;145(3):325-331. doi: 10.1016/j.pain.2009.06.031. Epub 2009 Jul 29.
The present study assessed the role of pain and pain-related psychological variables in the persistence of post-traumatic stress symptoms following whiplash injury. Individuals (N=112) with whiplash injuries who had been admitted to a standardized multidisciplinary rehabilitation program were asked to complete measures of pain, post-traumatic stress symptoms, physical function and pain-related psychological variables at three different points during their treatment program. The findings are consistent with previous research showing that indicators of injury severity such as pain, reduced function and disability, and scores on pain-related psychological were associated with more severe post-traumatic stress symptoms in individuals with whiplash injuries. Contrary to expectations, indicators of pain severity did not contribute to the persistence of post-traumatic stress symptoms. Univariate analyses revealed that self-reported disability, pain catastrophizing and perceived injustice were significant determinants of the persistence of post-traumatic stress symptoms. In multivariate analyses, only perceived injustice emerged as a unique predictor of the persistence of post-traumatic stress symptoms. The results suggest that early adequate management of pain symptoms and disability consequent to whiplash injury might reduce the severity of post-traumatic stress symptoms. The development of effective intervention techniques for targeting perceptions of injustice might be important for promoting recovery of post-traumatic stress symptoms consequent to whiplash injury.
本研究评估了疼痛及与疼痛相关的心理变量在挥鞭伤后创伤后应激症状持续存在中的作用。参与标准化多学科康复项目的112名挥鞭伤患者，被要求在治疗过程中的三个不同时间点完成疼痛、创伤后应激症状、身体功能及与疼痛相关的心理变量的测量。研究结果与先前研究一致，表明疼痛、功能减退和残疾等损伤严重程度指标，以及与疼痛相关的心理评分，与挥鞭伤患者更严重的创伤后应激症状相关。与预期相反，疼痛严重程度指标对创伤后应激症状的持续存在并无影响。单因素分析显示，自我报告的残疾、疼痛灾难化和感知到的不公正，是创伤后应激症状持续存在的显著决定因素。多因素分析中，只有感知到的不公正成为创伤后应激症状持续存在的唯一预测因素。结果表明，对挥鞭伤导致的疼痛症状和残疾进行早期充分管理，可能会减轻创伤后应激症状的严重程度。开发针对不公正感的有效干预技术，对于促进挥鞭伤后创伤后应激症状的恢复可能很重要。
