Whiplash Injury

Whiplash and the Effects of Life Stress

This current study1 followed a group of 34 whiplash patients for seven months. The patients were first evaluated within 2 weeks of their injuries, and were given a series of neurological and neuropsychological tests, as well as MRI scans of the brain and spine.

"In 2 patients, small punctate areas of increased signal intensity on T2-weighted and protodensity images were found in the occipital lobes suggesting petecchial hemorrhage; however, both patients had normal MRI at follow-up 7 months later." One of these patients later developed "possible epilepsy."

One of the psychological tests used was the SCL-90-R, which has been shown to be effective at screening out "faked" whiplash profiles (See STR Vol.1, No. 4 & 9).2,3 The study found that whiplash patients had elevated scores on the SCL-90-R, in comparison to levels deemed normal. Only in the "somatization" category, however, was the level considered pathologically high.

When patients with high levels of post-accident stress were compared to patients without stress, however, the researchers found much higher scores on the SCL-90-R. In fact, the stressed patients were found to have pathological scores on 9 of the 11 SCL-90-R measures.

In a closer analysis of this relationship performed in a separate study, the author suggests that this relationship is due to a lowered threshold for stress from the accident itself. "Pain in the neck, which accompanies all whiplash injuries, certainly interferes with daily activities, reminding the sufferer of the accident at every movement." 4

A cycle of stress and pain may also be at work, as those patient who reported a higher level of stressful life events "unrelated to the accident" also reported more chronic symptoms related to their whiplash.

The author suggests that psychological and social issues should be addressed in the long-term treatment of whiplash injuries.

  1. Karlsborg M, Smed A, Jespersen H, et al. A prospective study of 39 patients with whiplash injury. Acta Neurologica Scandinavica 1997;95:65-72.
  2. Wallis BJ, Lord SM, Barnsley L, Bogduk N. Pain and psychologic symptoms of Australian patients with whiplash. Spine 1996;21(7):804-810.
  3. Wallis BJ, Bogduk N. Faking a profile: can naïve subjects simulate whiplash responses? Pain 1996;66:223-227.
  4. Smed A. Cognitive function and distress after common whiplash injury. Acta Neurologica Scandinavica 1997;95:73-80.

 

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