Catastrophizing and perceived injustice: risk factors for the transition to chronicity after whiplash injury.

STUDY
DESIGN: The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury.
OBJECTIVE: This article focuses on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. SUMMARY OF BACKGROUND DATA: Research has shown that psychological variables play a role in determining the trajectory of recovery after whiplash injury.
METHODS: This article will focus on two psychological variables that have been shown to impact on recovery trajectories after whiplash injury; namely pain catastrophizing and perceived injustice. The article will summarize research that has supported the role of pain catastrophizing and perceived injustice as risk factors for problematic recovery after whiplash injury.
RESULTS: Several investigations have shown that measures of catastrophizing and perceived injustice prospectively predict problematic trajectories of recovery after whiplash injury. Basic research points to the potential roles of expectancies, attention, coping and endogenous opioid dysregulation as possible avenues through which catastrophizing might heighten the probability of the persistence of pain after whiplash injury. Although research has yet to systematically address the mechanisms by which perceived injustice might contribute to prolonged disability in individuals with whiplash injuries, there are grounds for suggesting the potential contributions of catastrophizing, pain behavior and anger.
CONCLUSION: A challenge for future research will be the development and evaluation of risk factor-targeted interventions aimed at reducing catastrophizing and perceived injustice to improve recovery trajectories after whiplash injury.