Psychologic processes in daily life with chronic whiplash: relations of posttraumatic stress symptoms and fear-of-pain to hourly pain and uptime

The Clinical Journal of Pain
Michele Sterling, Benjamin J Chadwick

Abstract

Recent models of the relationship between posttraumatic stress and whiplash pain suggest that psychological stress relating to a motor vehicle crash may influence pain perception. The mechanisms of this relationship may be through more direct, psychological pathways, or through factors proposed by the fear-avoidance models of chronic pain. This study sought to investigate the relative contribution of fear-of-pain and trauma symptomatology to daily pain and time spent in an upright posture (uptime) in chronic whiplash-associated disorder (WAD). Hourly electronic-diary reports were used to explore the within-day relationship of psychological trauma symptoms and fear-of-pain to same-hour and next-hour pain reports and next-hour uptime (measured by accelerometers) in 32 individuals with a chronic WAD. Within-person effects were analyzed for 329 diary entries using multilevel modeling with fixed slopes and random intercepts. Reports of trauma-related hyperarousal were associated with greater same-hour pain, and this relationship was mediated by fear-of-pain. Fear-of-pain and uptime were independently associated with reports of increased next-hour pain (controlling for first-order serial autocorrelation). Fear-of-pain was unrelated t...Continue Reading

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Citations

Nov 2, 2012·The Journal of Manual & Manipulative Therapy·Michele Sterling
Apr 20, 2012·Disability and Rehabilitation·Annika BringPernilla Asenlöf
Nov 25, 2011·Disability and Rehabilitation·Lisa C CarlessoJoy C MacDermid
Jul 18, 2017·Journal of Psychosomatic Research·Noga TsurKarni Ginzburg
Jun 25, 2019·Physiotherapy Theory and Practice·Timothy M BenedictAdriaan Louw
Dec 17, 2011·American Journal of Physical Medicine & Rehabilitation·Marie Carmen ValenzaCésar Fernández-de-Las-Peñas
Jan 21, 2020·Journal of Affective Disorders·Noga TsurZahava Solomon

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