A prospective study of perceived injustice in whiplash victims and its relationship to recovery

Abstract

The objectives of this paper are to to measure levels of perceived injustice in whiplash victims and determine the relationship to recovery at 6-month post-injury. Consecutive acute whiplash patients completed the Injustice Experience Questionnaire, at presentation, and also 3- and 6-month post-injury. At each of these two follow-up points, participants were examined for recovery. Of an initial 134 participants, 130 participants were followed up at 3 months and 124 at 6 months. At the 3-month follow-up, 62 % (80/130) of participants reported recovery from their injuries. At 6 months, 80 % (99/124) reported recovery. The initial Injustice Experience Questionnaire score was low, with a mean score of 6.0 ± 1.0 (range 5–10) out of a maximum of 48. The mean score at 3-month follow-up had increased in the cohort to 7.4 ± 1.6 (range 5–11). At 6-month post-injury, the mean of the Injustice Experience Questionnaire score for the cohort who still reported lack of recovery (25/124 participants) was 15.0 ± 6.0 (range 5–31), while that for the recovered group remained low at 8.2 ± 3.9 (range 5–11). In the primary care setting, a significant proportion of whiplash patients who have not recovered by 3-month post-injury subsequently develop higher levels of perceived injustice by 6-month post-injury. The development of high levels of perceived injustice at 6-month post-injury appears to follow the development of chronic pain and a lack of recovery at 3 months and, at that point, becomes a risk factor for lack of recovery thereafter.