Coping and recovery in whiplash-associated disorders: early use of passive coping strategies is associated with slower recovery of neck pain and pain-related disability.

Abstract

OBJECTIVE:

Coping is shown to affect outcomes in chronic pain patients; however, few studies have examined the role of coping in the course of recovery in whiplash-associated disorders (WAD). The purpose of this study was to determine the predictive value of coping style for 2 key aspects of WAD recovery, reductions in neck pain, and in disability.

METHODS:

A population-based prospective cohort study design was used to study 2986 adults with traffic-related WAD. Participants were assessed at baseline, 6 weeks, and 4, 8, and 12 months postinjury. Coping was measured at 6 weeks using the Pain Management Inventory, and neck pain recovery was assessed at each subsequent follow-up, using a 100 mm visual analogue scale (VAS). Disability was assessed at each follow-up using the Pain Disability Index (PDI). Pain recovery was defined as a VAS score of 0 to 10; disability recovery was defined as a PDI score of 0 to 4. Data analysis used multivariable Cox proportional hazards models.

RESULTS:

Those using high versus low levels of passive coping at 6 weeks postinjury experienced 28% slower pain recovery and 43% slower disability recovery. Adjusted hazard rate ratios for pain recovery and disability recovery were 0.72 (95% CI, 0.59-0.88) and 0.57 (95% CI, 0.41-0.78), respectively. Active coping was not associated with recovery of neck pain or disability.

CONCLUSIONS:

Passive coping style predicts neck pain and self-assessed disability recovery. It may be beneficial to assess and improve coping style early in WAD.

• Authors: Linda J Carroll, Robert Ferrari, J David Cassidy, Pierre Côté
• Journal: The Clinical journal of pain (Clin J Pain) Vol. 30 Issue 1 Pg. 1-8 (Jan 2014) ISSN: 1536-5409 [Electronic] United States
• PMID: 23446082 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Accidents, Traffic
• Activities of Daily Living (psychology)
• Adaptation, Psychological
• Adult
• Canada (epidemiology)
• Causality
• Comorbidity
• Disability Evaluation
• Disabled Persons (psychology, rehabilitation, statistics & numerical data)
• Female
• Humans
• Male
• Neck Pain (epidemiology, prevention & control, psychology)
• Pain Management (methods, psychology)
• Prevalence
• Recovery of Function
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Whiplash Injuries (epidemiology, psychology, therapy)