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Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000085
Original Articles

The Role of Illness Perceptions in Predicting Outcome After Acute Whiplash Trauma: A Multicenter 12-month Follow-up Study

Gehrt, Tine B. BSc*; Wisbech Carstensen, Tina Birgitte PhD*; Ørnbøl, Eva MSc*; Fink, Per K. PhD*; Kasch, Helge PhD; Frostholm, Lisbeth PhD*

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Objectives: To examine (1) whether the patients’ perceptions of their symptoms immediately after the accident and at 3-month follow-up predict working ability and neck pain at 12-month follow-up and (2) the possible changes in patients’ illness perceptions during the follow-up period.

Materials and Methods: A total of 740 consecutive patients exposed to acute whiplash trauma consulting emergency units and general practitioners in 4 Danish counties from 2001 to 2003. The patients completed questionnaires at baseline, 3-, and 12-month follow-up. Illness perceptions were measured using a condensed version of the Illness Perception Questionnaire and a 1-item question concerning return to work expectation. Neck pain was measured using an 11-point box scale, and working ability was measured by self-report at 12-month follow-up. Multiple logistic regression analyses were applied controlling for possible confounders.

Results: Patients with pessimistic illness perceptions at baseline and 3-month follow-up were more likely to experience neck pain and affected working ability at 12 months compared with patients with optimistic illness perceptions. Negative return-to-work expectation predicted affected working ability at 12 months. Furthermore, patients with high neck pain intensity or affected working ability report more changes in their illness perceptions during follow-up than patients with low neck pain intensity or unaffected working ability.

Discussion: The findings are in line with the common-sense model of illness and previous research demonstrating that patient’s expectations for recovery and illness perceptions might influence the course after whiplash injury. Illness perceptions and expectations may provide a useful starting point for future interventions and be targeted in the prevention of chronicity.

© 2015 by Lippincott Williams & Wilkins

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