Posttraumatic Stress Disorder and Whiplash After Motor Vehicle Accidents

Overall Conclusions

Although the presence of whiplash might be relevant in the recovery of PTSD, the importance of this relationship is still not well understood. In the above research, we have assumed a causal direction—that after accidents physical injury in the accidents and its healing influences individuals’ psychological state. It is equally possible that the survivor’s psychological state influences his/her perception of (1) degree of healing and (2) present physical state.

This topic area is in need of more extensive collaborative research among orthopedists, physical therapists, and mental health professionals. As if to answer our 1997 call for more research on this topic, Sharp and Harvey (2001) published a theoretical paper in which they speculate about the possible mutual maintenance between PTSD and chronic pain (Blanchard & Hickling, 2004; Otis et al., 2003). They noted the scattered reports of high levels of comorbidity between PTSD and chronic pain and went on to speculate on possible mechanisms by which these two problems reinforce one another. Chief among these are (1) that the pain serves as a reminder of the trauma, (2) that chronic levels of anxiety and arousal (from PTSD) make the sufferer more sensitive to painful stimuli, and (3) that both problems lead to efforts at avoidance of situations that remind sufferers of the source of the pain and situations that involve actual pain from any source. We certainly agree with this formulation. Given that our data did not permit a fine-grained analysis that would allow one to draw strong causal inferences, future research examining each of the above-mentioned mechanisms is warranted.