@article{ref1,
title="Whiplash patients' responses on the Impact of Events Scale-R - congruent with pain or PTSD symptoms?",
journal="Clinical journal of pain",
year="2019",
author="Bunzli, Samantha and Maujean, Annick and Andersen, Tonny Elmose and Sterling, Michele",
volume="35",
number="3",
pages="229-237",
abstract="OBJECTIVES: Post-traumatic stress disorder (PTSD) symptoms are common among people with whiplash following a motor vehicle crash. The Impact of Events Scale - Revised (IES-R) screens for PTSD symptoms with psychologist referral recommended for above-threshold scores. Recent data indicate that PTSD symptoms post-whiplash may relate more to pain and disability than the crash itself. This study explored the interpretation of IES-R items by people with whiplash to establish whether responses relate to the crash or to whiplash pain and disability. <br><br>METHODS: Adults with whiplash scoring >24 on the IES-R were eligible. The Three-Step Test-Interview technique was used and responses analysed using content analysis. A coding framework was developed, comprising five categories: &quot;congruent&quot; - responses related to the crash; &quot;incongruent&quot; - responses did not relate to the crash; &quot;ambiguous&quot; - responses were both congruent and incongruent; &quot;confusion&quot; - participants misunderstood the item content; &quot;not applicable&quot; - irrelevancy of items to participants' circumstances. <br><br>RESULTS: The 15 participants (mean IES-R= 37/88) were inclined to respond congruently to specific PTSD items and incongruently to non-specific PTSD items. Participants were more inclined to rate non-specific PTSD items in terms of pain and disability, e.g., >60% responded incongruently to item 2: &quot;I had trouble staying asleep&quot;; item 4: 'I felt irritable and angry&quot;; item 15: &quot;I had trouble falling asleep&quot;; and item 18: &quot;I had trouble concentrating&quot;. <br><br>DISCUSSION: Incongruent responses on non-specific PTSD items may inadvertently inflate levels of PTSD symptoms measured with the IES-R for some whiplash patients, raising implications for the assessment and treatment of the psychological sequelae of whiplash.<p /> <p>Language: en</p>",
language="en",
issn="0749-8047",
doi="10.1097/AJP.0000000000000665",
url="http://dx.doi.org/10.1097/AJP.0000000000000665"
}