Department of Psychology, University of Southern Denmark, Odense M, Denmark.
Eur J Psychotraumatol. 2011;2. doi: 10.3402/ejpt.v2i0.5633. Epub 2011 Jan 28.
In more than 90% of whiplash accidents a good explanation regarding the association between trauma mechanism, organic pathology, and persistent symptoms has failed to be provided.
We predicted that the severity of chronic whiplash-associated disorder (WAD), measured as number of whiplash symptoms, pain duration, pain-related disability, and degree of somatisation would be associated with the number of post-traumatic stress disorder symptoms (PTSD). Secondly, we expected attachment-anxiety to be a vulnerability factor in relation to both PTSD and WAD.
Data were collected from 1,349 women and 360 men suffering from WAD from the Danish Society for Polio, Traffic, and Accident Victims. The PTSD symptoms were measured by the Harvard Trauma Questionnaire. All three core PTSD clusters were included: re-experiencing, avoidance, and hyperarousal. Attachment security was measured along the two dimensions, attachment-anxiety and attachment-avoidance, by the Revised Adult Attachment Scale.
PTSD symptoms were significantly related to the severity of WAD. In particular, the PTSD clusters of avoidance and hyperarousal were associated with the number of whiplash symptoms, disability, and somatisation. Attachment-anxiety was significantly related to PTSD symptoms and somatisation but not to pain and disability. A co-morbidity of 38.8% was found between the PTSD diagnosis and WAD, and about 20% of the sample could be characterised as securely attached.
The PTSD clusters of avoidance and hyperarousal were significantly associated with severity of WAD. The study emphasises the importance of assessing PTSD symptomatology after whiplash injury. Furthermore, it highlights that attachment theory may facilitate the understanding of why some people are more prone to develop PTSD and WAD than others.
在超过 90%的挥鞭样损伤事故中，创伤机制、器质性病理和持续症状之间的关联都无法得到很好的解释。
我们预测慢性挥鞭样损伤相关障碍（WAD）的严重程度，以挥鞭样损伤症状的数量、疼痛持续时间、疼痛相关残疾和躯体化程度来衡量，与创伤后应激障碍症状（PTSD）的数量有关。其次，我们期望依恋焦虑是与 PTSD 和 WAD 都相关的易感性因素。
数据来自丹麦脊髓灰质炎、交通和事故受害者协会的 1349 名女性和 360 名男性慢性 WAD 患者。PTSD 症状通过哈佛创伤问卷进行测量。所有三个核心 PTSD 集群都包括在内：再体验、回避和警觉性增高。通过修订后的成人依恋量表，沿着依恋焦虑和依恋回避两个维度来测量依恋安全性。
PTSD 症状与 WAD 的严重程度显著相关。特别是，回避和警觉性增高的 PTSD 集群与挥鞭样损伤症状、残疾和躯体化有关。依恋焦虑与 PTSD 症状和躯体化显著相关，但与疼痛和残疾无关。发现 PTSD 诊断和 WAD 之间存在 38.8%的共病率，大约 20%的样本可以被归类为安全依恋。
回避和警觉性增高的 PTSD 集群与 WAD 的严重程度显著相关。该研究强调了在挥鞭样损伤后评估 PTSD 症状学的重要性。此外，它强调了依恋理论可能有助于理解为什么有些人比其他人更容易发展为 PTSD 和 WAD。
