Pain avoidance predicts disability and depressive symptoms three years later in individuals with whiplash complaints
Abstract
BACKGROUND: Longstanding symptoms due to whiplash are commonly associated with decreased levels of emotional and physical functioning. To date, there is strong empirical support for the relationship between psychological in/flexibility and pain-related functioning, but the predictive role for future health is largely unknown. Hence, the aim of this study was to investigate if psychological in/flexibility (i.e. avoidance and cognitive fusion) predicted pain disability and depressive symptoms 3 years later in individuals with whiplash complaints. METHODS: Data were collected at baseline and at a 3 year follow-up from 368 members of a national patient organization for people with whiplash-associated disorder. In a series of hierarchical regression analyses, background variables, pain related variables, psychological distress and psychological inflexibility at baseline were evaluated as predictors of levels of pain disability and depressive symptoms at follow-up. RESULTS: Results showed that psychological inflexibility, and more specifically avoidance, was a unique predictor of pain disability and depressive symptoms, also when controlling for background variables, pain related variables and psychological distress. Level of education was also found to predict both pain disability and symptoms of depression. Lastly, pain variability predicted pain disability, and anxiety predicted depressive symptoms. CONCLUSION: Pain avoidance significantly predicted pain disability and depressive symptoms 3 years later. Although tentative, results warrant more studies to further explore the importance of pain avoidance for future health.
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This type of avoidance was recently shown to predict pain disability and depressive symptoms three years later.
“This type of avoidance was recently shown to predict pain disability and depressive symptoms three years later [17].”
From Baseline Pro-Inflammatory Cytokine Levels Moderate Psychological Inflexibility in Behavioral Treatment for Chronic Pain (2022) · cites this paper as [17]
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“This type of avoidance was recently shown to predict pain disability and depressive symptoms three years later [17].”
BackgroundSelf-citation
- Authors
- Zetterqvist, V., Holmström, L., Maathz, P., & Wicksell, R. K.
- Affiliations
- Uppsala University (SE)
- Karolinska University Hospital (SE)
- Corresponding author
- Zetterqvist, V.
- Venue
- Acta Anaesthesiologica Scandinavica
- Publisher
- Wiley
- Published
- 2017-02-23
- Volume
- 61
- Issue
- 4
- Pages
- 445-455
- ISSN
- 0001-5172 (ISSN-L)
- 1399-6576
- OpenAlex
- W2590945555
- Cited by
- 13
- References
- 45
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 2 · 2020: 1 · 2019: 5
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Acta Anaesthesiologica Scandinavica (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Kommunfullmäktige, Stockholms Stad
- Karolinska Institutet
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- whiplash-associated disorders, pain avoidance, psychological inflexibility, cognitive fusion, pain-related disability, depressive symptoms, long-term outcomes, pain variability, anxiety, educational attainment, psychological distress
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Cognition, Depression, Disability Evaluation, Educational Status, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Pain, Pain Measurement, Predictive Value of Tests, Stress, Psychological, Whiplash Injuries, Young Adult
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