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挥鞭样损伤相关疾病。机动车事故受害者法医案例中疼痛感知的生物心理社会概况。

Whiplash-Associated Disorders. Biopsychosocial Profiles of Pain Perception in Forensic Cases of Victims of Motor Vehicle Accidents.

作者信息

Pina David, Puente-López Esteban, Ruiz-Hernández José Antonio, Ruiz-Cabello Aurelio Luna, Aguerrevere Luis, Magalhães Teresa

机构信息

Servicio Externo de Ciencias y Técnicas Forenses, Universidad de Murcia, Murcia, Spain.

Facultad de Medicina, Universidad de Murcia, Murcia, Spain.

出版信息

Front Psychol. 2021 Aug 16;12:716513. doi: 10.3389/fpsyg.2021.716513. eCollection 2021.

Abstract

In order to make a complete diagnosis of all the factors influencing whiplash associated disorders (WAD), the evidence suggests that the condition evaluation should follow an integrated biopsychosocial model. This perspective would offer a fuller view of it, recognizing the interplay between the medical, biomechanical, social, and psychological factors. Despite the progress made in the subject, evidence of which psychosocial factors influence the experience of pain in litigant WAD patients is limited. A cross-sectional design and a cluster analysis was used to study the experience of pain and the psychosocial factors included therein in 249 patients with WAD assessed after suffering a motor vehicle accident. Three clusters were obtained: C1, with low scores of pain and a slight-moderate alteration of the Health-Related Quality of Life (HRQoL); C2, with medium scores of pain, alteration of HRQoL and a perception of moderate disability; and C3, with medium-high scores of pain, alteration of the HQoL, perception of moderate disability, presence of anxious-depressive symptomatology, poorer comprehension of the condition suffered, and the belief that it will extend over a long period of time. The results show a heterogeneous experience of pain in WAD, compatible with the biopsychosocial model of disease and the multidimensional approach to pain. The role of the psychologist in the evaluation of the condition could be useful to obtain a complete view of the condition, thus ensuring that the treatment is adapted to the needs of the patient.

摘要

为了全面诊断影响挥鞭样损伤相关疾病(WAD)的所有因素,有证据表明,病情评估应遵循综合生物心理社会模型。这种观点将提供更全面的视角,认识到医学、生物力学、社会和心理因素之间的相互作用。尽管在该领域取得了进展,但关于哪些社会心理因素会影响诉讼WAD患者疼痛体验的证据仍然有限。采用横断面设计和聚类分析,研究了249例机动车事故后接受评估的WAD患者的疼痛体验及其中包含的社会心理因素。得到了三个聚类:C1,疼痛评分低,健康相关生活质量(HRQoL)有轻度至中度改变;C2,疼痛评分中等,HRQoL改变,有中度残疾感;C3,疼痛评分中高,HQoL改变,有中度残疾感,存在焦虑抑郁症状,对所患疾病的理解较差,且认为疾病会持续很长时间。结果显示,WAD患者的疼痛体验具有异质性,这与疾病的生物心理社会模型和疼痛的多维方法相一致。心理学家在病情评估中的作用可能有助于全面了解病情,从而确保治疗能够适应患者的需求。

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