TREATMENTS FOR WHIPLASH-ASSOCIATED DISORDERS (WAD) - BIOBEHAVIORAL APPROACH

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Over 6.1 million police-reported motor vehicle accidents (MVAs) occurred in the United States in 2000. Whiplash injury is the most common form of injury resulting from an MVA. People prone to negative emotional responses are at risk of experiencing elevated levels of fear and anxiety and consequently may be predisposed to develop Whiplash-Associated Disorders (WADs), the clinical manifestations of whiplash injury. Chronic WADs (those that last longer than 6 months) are extremely resistant to treatment. Little is known about the pathophysiology of chronic WADs due to relatively minor neck injury following MVAs. Early interventions in back pain populations that target reduction of fear and subsequent avoidance of activity have been shown to prevent chronic musculoskeletal pain and disability. Preventing chronicity of WADs using similar interventions, however, has not been explored. The purpose of this clinical trial is to test the efficacy of early, biobehavioral interventions to prevent chronic pain and disability associated with whiplash injuries following an MVA. The study compares the efficacy of two interventions in reducing pain and disability at the subacute stage, thus preventing maintenance of WAD symptoms compared to standard care. We hypothesize that (1) intervention subjects will demonstrate significantly greater reduction of anxiety, pain, and functional limitations than standard care subjects, (2) an intervention using exposure-based anxiety reduction will result in significantly better outcomes than an intervention using educational lectures, and (3) subacute WADs subjects will report significantly greater degrees of anxiety and fear-avoidance than subjects whose symptoms remit within 1 month following the MVA.