TY  - JOUR
PY  - 2018//
TI  - Reciprocal associations of pain and post-traumatic stress symptoms after whiplash injury: a longitudinal, cross-lagged study
JO  - European journal of pain
A1  - Ravn, S. L.
A1  - Sterling, M.
A1  - Lahav, Y.
A1  - Andersen, T. E.
SP  - 926
EP  - 934
VL  - 22
IS  - 5
N2  - BACKGROUND: The objectives of the current study were to investigate (1) the longitudinal, reciprocal associations between pain and post-traumatic stress symptoms as proposed by the mutual maintenance model, and (2)  to assess the predictive value of the three clusters of post-traumatic stress, where the model revealed that post-traumatic stress symptoms maintained pain in a consecutive cohort of whiplash-injured. <br><br>METHODS: Participants (n = 253; 66.4% women) were people with WAD grades I-III following motor vehicle crashes in Australia. Pain and post-traumatic stress symptoms were assessed by questionnaires over the course of a year (at baseline (<4 weeks), 3, 6 and 12 months post-injury). The objectives were tested using auto-regressive cross-lagged modelling and two additional structural equation models. <br><br>RESULTS: The analyses revealed that post-traumatic stress symptoms at baseline predicted an increase in pain between baseline and 3 months and that post-traumatic stress symptoms at 6 months predicted an increase in pain between 6 and 12 months, beyond the stability of pain over time. Furthermore, hyperarousal at baseline significantly predicted pain at 3 months and hyperarousal at 6 months significantly predicted pain at 12 months with 16 and 30% explained variance, respectively. <br><br>CONCLUSIONS: The results point to a temporal main effect of post-traumatic stress symptoms on pain over and above the stability of pain itself within the first 3 months post-injury and again in the chronic phase from 6 to 12 months with hyperarousal symptoms driving these effects. From 3 to 6 months, there was a slip in the maintenance patterns with no cross-lagged effects. SIGNIFICANCE: Investigating mutual maintenance of pain and PTSS in whiplash, the present study found evidence suggesting a maintaining effect of PTSS on pain within the first 3 months post-injury and from 6 to 12 months driven by hyperarousal, highlighting the importance of addressing PTSS.<br><br>© 2018 European Pain Federation - EFIC®.<p />  <p>Language: en</p>
LA  - en
SN  - 1090-3801
UR  - http://dx.doi.org/10.1002/ejp.1178
ID  - ref1
ER  -