Psychosocial factors related to return to work following rehabilitation of whiplash injuries

Abstract Introduction The present study examined the effects of pain chronicity on the responsiveness of psychosocial variables to intervention for whiplash injuries. Methods Participants (N = 75) were work disabled patients with a diagnosis of Whiplash Grade II and were clients in a 10-week community-based, psychosocial intervention aimed at facilitating return to work. Individuals were classified as subacute (4-12 weeks; N = 25), early chronic (3-6 months; N = 25), and chronic (6-18 months; N = 25). Patients in the three groups were matched on sex (13 men, 12 women) and age (±2 years). Patients completed measures of pain severity, self-reported disability, pain catastrophizing and fear of movement at pre-treatment, mid-treatment and post-treatment. Results Return to work rates were 80, 72 and 32% for the subacute, early chronic and chronic groups, respectively. Individuals in the chronic group, compared to individuals in the subacute or early chronic groups, had significantly more elevated pre-treatment scores on measures of pain catastrophizing, F(2, 74) = 9.6, P < .001, and fear of movement, F(2, 74) = 3.4, P < .05. The magnitude of treatment-related reductions i