Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study

Sophie Lykkegaard Ravn, Karen-Inge Karstoft, Michele Sterling, Tonny Elmose Andersen

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

Resumé

Background: Posttraumatic stress is highly prevalent among whiplash-injured and related to pain-related symptomatology. While mutual maintenance between pain and posttraumatic stress has been suggested, knowledge on individual differences in the course of these symptoms among whiplash-injured is needed. The current study aimed to identify trajectories of posttraumatic stress symptoms following whiplash-injury and test predictors and functional outcomes of such trajectories.

Methods:In a prospective cohort design assessing pain, pain-related disability, fear-avoidance-beliefs, pain-catastrophizing, posttraumatic stress symptoms, and depression at baseline, 3 months, and 6 months post-injury (n=227, whiplash-grade I-III), we identified trajectories of posttraumatic stress symptoms using Latent Growth Mixture Modeling. Predictors were tested using multinomial logistic regression, and group mean difference in pain-related disability (psychosocial and physical) at 6 months was tested as outcome.

Results: Three trajectories were identified:
-“Low-stable” (73.4%) with little or no posttraumatic stress symptoms over
time,
- “High-decreasing” (9.5%) with high initial levls of posttraumatic stress
symptoms decreasing to a substantially lower level, and
- “High-Increasing” (17.1%) with high initial posttraumatic stress symptoms
and a small increase over time.

Initial pain and depression predicted the “High-decreasing”- and “High-increasing”-trajectories, while the “High-increasing”-trajectory had significantly more psychosocial and physical pain-related disability at 6 months compared to both other trajectories.

Conclusions: Three trajectories of recovery related to posttraumatic stress symptoms were identified, with the “High-increasing”-trajectory suggesting that a significant subset of people does not recover over time after a whiplash-trauma. This group showed enhanced levels of psycho-social and physical pain-related disability at 6 months, and initial levels of pain and depression predicted membership, which can be target of intervention.
OriginalsprogEngelsk
Publikationsdato5. sep. 2017
StatusUdgivet - 5. sep. 2017
Begivenhed10th Congress of the European Pain Federation - Copenhagen
Varighed: 6. sep. 20179. sep. 2017

Konference

Konference10th Congress of the European Pain Federation
ByCopenhagen
Periode06/09/201709/09/2017

Citer dette

Ravn, S. L., Karstoft, K-I., Sterling, M., & Andersen, T. E. (2017). Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study. Poster session præsenteret på 10th Congress of the European Pain Federation, Copenhagen, .
Ravn, Sophie Lykkegaard ; Karstoft, Karen-Inge ; Sterling, Michele ; Andersen, Tonny Elmose. / Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study. Poster session præsenteret på 10th Congress of the European Pain Federation, Copenhagen, .
@conference{a9abac7cb4904a8a9d880f51a6a028d9,
title = "Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study",
abstract = "Background: Posttraumatic stress is highly prevalent among whiplash-injured and related to pain-related symptomatology. While mutual maintenance between pain and posttraumatic stress has been suggested, knowledge on individual differences in the course of these symptoms among whiplash-injured is needed. The current study aimed to identify trajectories of posttraumatic stress symptoms following whiplash-injury and test predictors and functional outcomes of such trajectories. Methods:In a prospective cohort design assessing pain, pain-related disability, fear-avoidance-beliefs, pain-catastrophizing, posttraumatic stress symptoms, and depression at baseline, 3 months, and 6 months post-injury (n=227, whiplash-grade I-III), we identified trajectories of posttraumatic stress symptoms using Latent Growth Mixture Modeling. Predictors were tested using multinomial logistic regression, and group mean difference in pain-related disability (psychosocial and physical) at 6 months was tested as outcome. Results: Three trajectories were identified: -“Low-stable” (73.4{\%}) with little or no posttraumatic stress symptoms over time, - “High-decreasing” (9.5{\%}) with high initial levls of posttraumatic stress symptoms decreasing to a substantially lower level, and - “High-Increasing” (17.1{\%}) with high initial posttraumatic stress symptoms and a small increase over time. Initial pain and depression predicted the “High-decreasing”- and “High-increasing”-trajectories, while the “High-increasing”-trajectory had significantly more psychosocial and physical pain-related disability at 6 months compared to both other trajectories. Conclusions: Three trajectories of recovery related to posttraumatic stress symptoms were identified, with the “High-increasing”-trajectory suggesting that a significant subset of people does not recover over time after a whiplash-trauma. This group showed enhanced levels of psycho-social and physical pain-related disability at 6 months, and initial levels of pain and depression predicted membership, which can be target of intervention.",
author = "Ravn, {Sophie Lykkegaard} and Karen-Inge Karstoft and Michele Sterling and Andersen, {Tonny Elmose}",
year = "2017",
month = "9",
day = "5",
language = "English",
note = "10th Congress of the European Pain Federation ; Conference date: 06-09-2017 Through 09-09-2017",

}

Ravn, SL, Karstoft, K-I, Sterling, M & Andersen, TE 2017, 'Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study', 10th Congress of the European Pain Federation, Copenhagen, 06/09/2017 - 09/09/2017.

Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study. / Ravn, Sophie Lykkegaard; Karstoft, Karen-Inge; Sterling, Michele; Andersen, Tonny Elmose.

2017. Poster session præsenteret på 10th Congress of the European Pain Federation, Copenhagen, .

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskning

TY - CONF

T1 - Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study

AU - Ravn, Sophie Lykkegaard

AU - Karstoft, Karen-Inge

AU - Sterling, Michele

AU - Andersen, Tonny Elmose

PY - 2017/9/5

Y1 - 2017/9/5

N2 - Background: Posttraumatic stress is highly prevalent among whiplash-injured and related to pain-related symptomatology. While mutual maintenance between pain and posttraumatic stress has been suggested, knowledge on individual differences in the course of these symptoms among whiplash-injured is needed. The current study aimed to identify trajectories of posttraumatic stress symptoms following whiplash-injury and test predictors and functional outcomes of such trajectories. Methods:In a prospective cohort design assessing pain, pain-related disability, fear-avoidance-beliefs, pain-catastrophizing, posttraumatic stress symptoms, and depression at baseline, 3 months, and 6 months post-injury (n=227, whiplash-grade I-III), we identified trajectories of posttraumatic stress symptoms using Latent Growth Mixture Modeling. Predictors were tested using multinomial logistic regression, and group mean difference in pain-related disability (psychosocial and physical) at 6 months was tested as outcome. Results: Three trajectories were identified: -“Low-stable” (73.4%) with little or no posttraumatic stress symptoms over time, - “High-decreasing” (9.5%) with high initial levls of posttraumatic stress symptoms decreasing to a substantially lower level, and - “High-Increasing” (17.1%) with high initial posttraumatic stress symptoms and a small increase over time. Initial pain and depression predicted the “High-decreasing”- and “High-increasing”-trajectories, while the “High-increasing”-trajectory had significantly more psychosocial and physical pain-related disability at 6 months compared to both other trajectories. Conclusions: Three trajectories of recovery related to posttraumatic stress symptoms were identified, with the “High-increasing”-trajectory suggesting that a significant subset of people does not recover over time after a whiplash-trauma. This group showed enhanced levels of psycho-social and physical pain-related disability at 6 months, and initial levels of pain and depression predicted membership, which can be target of intervention.

AB - Background: Posttraumatic stress is highly prevalent among whiplash-injured and related to pain-related symptomatology. While mutual maintenance between pain and posttraumatic stress has been suggested, knowledge on individual differences in the course of these symptoms among whiplash-injured is needed. The current study aimed to identify trajectories of posttraumatic stress symptoms following whiplash-injury and test predictors and functional outcomes of such trajectories. Methods:In a prospective cohort design assessing pain, pain-related disability, fear-avoidance-beliefs, pain-catastrophizing, posttraumatic stress symptoms, and depression at baseline, 3 months, and 6 months post-injury (n=227, whiplash-grade I-III), we identified trajectories of posttraumatic stress symptoms using Latent Growth Mixture Modeling. Predictors were tested using multinomial logistic regression, and group mean difference in pain-related disability (psychosocial and physical) at 6 months was tested as outcome. Results: Three trajectories were identified: -“Low-stable” (73.4%) with little or no posttraumatic stress symptoms over time, - “High-decreasing” (9.5%) with high initial levls of posttraumatic stress symptoms decreasing to a substantially lower level, and - “High-Increasing” (17.1%) with high initial posttraumatic stress symptoms and a small increase over time. Initial pain and depression predicted the “High-decreasing”- and “High-increasing”-trajectories, while the “High-increasing”-trajectory had significantly more psychosocial and physical pain-related disability at 6 months compared to both other trajectories. Conclusions: Three trajectories of recovery related to posttraumatic stress symptoms were identified, with the “High-increasing”-trajectory suggesting that a significant subset of people does not recover over time after a whiplash-trauma. This group showed enhanced levels of psycho-social and physical pain-related disability at 6 months, and initial levels of pain and depression predicted membership, which can be target of intervention.

M3 - Poster

ER -

Ravn SL, Karstoft K-I, Sterling M, Andersen TE. Trajectories of Posttraumatic Stress Symptoms Following Whiplash-Injury: A Prospective Cohort Study. 2017. Poster session præsenteret på 10th Congress of the European Pain Federation, Copenhagen, .