Elsevier

The Journal of Pain

Volume 16, Issue 12, December 2015, Pages 1280-1287
The Journal of Pain

Original Report
Expectancies Mediate the Relations Among Pain Catastrophizing, Fear of Movement, and Return to Work Outcomes After Whiplash Injury

https://doi.org/10.1016/j.jpain.2015.09.001Get rights and content
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Highlights

  • Expectancies, pain catastrophizing, and fear of movement predicted return to work at 1-year follow-up.

  • Expectancies partially mediated the relation between pain catastrophizing and return to work.

  • Expectancies fully mediated the relation between fear of pain and return to work.

Abstract

Pain catastrophizing and fear of movement have been identified as key predictors of prolonged work disability after whiplash injury. However, little is known about the processes by which pain catastrophizing and fear of movement affect return to work. This study investigated the mediating role of expectancies on the relations between pain catastrophizing and return to work, and between fear of movement and return to work after whiplash injury. The study sample consisted of 154 individuals with whiplash injury who were enrolled in a multidisciplinary pain rehabilitation program. Participants completed measures of pain catastrophizing, fear of movement, and return-to-work expectancies after admission to a rehabilitation program. A follow-up telephone interview was used to assess work status 1 year after discharge. Consistent with previous research, analyses revealed that expectancies, pain catastrophizing, and fear of movement were significant predictors of return to work at 1-year follow-up. Regression analyses (bootstrapping) revealed that expectancies partially mediated the relation between catastrophizing and return to work. Expectancies completely mediated the relation between fear of movement and return to work. The significant predictive and mediating role of expectancies on return to work argues for the inclusion of expectancies as a specific target of intervention for individuals with whiplash injury.

Perspective

The findings suggest that expectancies might be part of the pathways by which pain catastrophizing and fear of movement affect return-to-work outcomes after whiplash injury. The findings argue for greater attention to return-to-work expectancies as a risk factor for problematic recovery outcomes as well as a target of intervention.

Key words

Catastrophizing
fear of pain
expectancies
return to work
whiplash

Cited by (0)

This research was supported by funds from the Canadian Institutes for Health Research (CIHR), and by the Société de l’assurance automobile du Québec (SAAQ).

The authors declare no conflicts of interest.