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Chiropractic Research Review

Coping Style Influences Duration of Whiplash Complaints

Evidence suggests that nearly four in 10 whiplash patients experience symptoms one year after the accident. These chronic complaints often cannot be explained by structural or somatic trauma, raising the issue of whether the method in which patients cope psychologically with their initial injury contributes to the duration of their neck pain and perceived symptoms.

This cohort study involved 363 victims of car accidents (18-65 years of age) who had initiated compensation claim procedures at a Dutch insurance company and presented with neck complaints.

Claimants completed a questionnaire that provided data on neck pain and various coping styles using the Utrecht Coping List, which included such factors as avoidance; palliative reaction; seeking social support; and passive reaction patterns.

Additional questionnaires were completed six and 12 months following the date of each claimants original accident. Duration of neck pain was measured from the time of the accident and from the time the initial questionnaire was filed.

After 12 months, 40% of male claimants and 55% of female claimants reported neck complaints related to their original accident. Duration of neck complaints was associated with gender, palliative reaction and the coping style of seeking support.

Palliative reaction included those patients who sought distraction to avoid thinking about their injury and engaged in other behaviors, such as smoking or drinking, as a means to feel better about their injury. Conversely, patients who sought social comfort and understanding, and shared their concern with others, had a shorter duration of neck complaints.

The authors conclude: "The results of this study indicate that the coping style plays a role during the first few weeks of the development of late whiplash syndrome ... in accordance with the idea that nonpalliative treatment and an 'act as usual' attitude help to prevent chronic complaints." They suggest that clinicians pay particular attention to the early emotional aspects and coping styles used during the initial treatment of neck complaints after car accidents as a means to prevent chronic whiplash symptoms.

Note: This study is particularly useful to clinicians, not only because of the quality of research, but because it provides useful information for doctors to use in helping their patients cope with whiplash injuries.

Buitenhuis J, Spanjer J, Fidler V. Recovery from acute whiplash. The role of coping styles. Spine, May 1, 2003:28(9), pp896-901.

Chiropractic Research Review

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