The role of symptoms of post-traumatic stress disorders and anxiety on pain catastrophizing, disability, and illness perceptions in patients with chronic whiplash-associated disorders: a cross-sectional study.

Abstract

Whiplash is an injury caused by a sudden acceleration-deceleration of the head, transferring energy to the spine. The clinical symptoms after the injury are known as whiplash-associated disorders (WAD), and the mechanisms of its chronicity and recovery remain unclear. We aimed to explore the relationship between post-traumatic stress disorder (PTSD) symptoms and anxiety with disability, pain catastrophizing, and illness perceptions in patients with chronic whiplash-associated disorders (cWAD). We carried out a multi-center cross-sectional study in which 120 participants with cWAD were recruited. Main outcomes included sociodemographic, PTSD symptoms, anxiety, pain catastrophizing, illness perceptions, and disability. A correlation and a multiple linear regression analysis were performed. In cWAD, PTSD symptoms correlated positively with anxiety (r = 0.667; p = 0.01). Anxiety also shows positive associations with the illness perceptions questionnaire (IPQ-R) identity subscale (r = 0.378; p = 0.01). In regression analyses, pain-related anxiety (PASS) was significantly associated with PTSD symptoms (IES-R), neck disability (NDI), and illness identity (IPQ-R Identity), explaining 58.5% of the variance (R² = 0.585, p < 0.001). These findings highlight the relevance of PTSD symptoms and anxiety in relation to pain-related disability and illness perceptions in patients with cWAD.