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Temperament and character: prognostic factors in whiplash patients?

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Abstract

We studied the relationship between whiplash injury and personality in 40 whiplash patients who admitted the hospital within 8 h from the car accident and 80 age- and gender-matched controls. For this purpose we used the Temperament and Character Inventory (TCI). We found that personality dimensions in whiplash patients both in the acute phase and at follow-up 2 years later showed the same results, i.e., significantly less Harm Avoidant (less anxious; low HA) than controls, but when dividing patients into groups depending on severity of outcome from whiplash injury 2 years after, no differences were found. According to our results personality symptoms related to whiplash injury is probably not a secondary phenomenon. Whiplash patients were normally developed in character, i.e., self-directedness (SD), and CO (cooperativeness) and therefore in general are capable of coping with their somatic problems.

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References

  1. Anderberg UM, Forsgren T, Ekselius L, Marteinsdottir I, Hallman J (1999) Personality traits on the basis of the temperament and character inventory in female fibromyalgia syndrome patients. Nord J Psychiatry 53:353–359

    Article  Google Scholar 

  2. Berry H (2000) Chronic whiplash syndrome as a functional disorder. Arch Neurol 57:592–594

    Article  CAS  PubMed  Google Scholar 

  3. Berstad JR, Baerum B, Lochen EA, Mogstad TE, Sjaastad O (1975) Whiplash: chronic organic brain syndrome without hydrocephalus ex vacuo. Acta Neurol Scand 51:268–284

    CAS  PubMed  Google Scholar 

  4. Borchgrevink G, Stiles T, Borchgrevink P, Lereim I (1997) Personality profile among symptomatic and recovered patients with neck sprain injury, measured by MCMI-I acutely and 6 months after car accidents. J Psychosom Res 42:357–367

    Article  CAS  PubMed  Google Scholar 

  5. Bosma FK, Kessels RPC (2002) Cognitive impairments, psychological dysfunction, and coping styles in patients with chronic whiplash syndrome. NNBN 15:56–65

    Google Scholar 

  6. Brändström S, Richter J, Przybeck T (2001) Distributions by age and sex of the dimensions of temperament and character inventory in a cross-cultural perspective among Sweden, Germany and the USA. Psychol Rep 89:747–758

    PubMed  Google Scholar 

  7. Buitenhuis J, Spanjer J, Fidler V (2003) Recovery from acute whiplash: the role of coping styles. Spine 28:896–901

    Article  CAS  PubMed  Google Scholar 

  8. Cassidy JD, Carroll LJ, Coté P, Lemstra M, Berglund A, Nygren Å (2000) Effect of eliminating compensation for pain and suffering on the outcome of insurance for whiplash injury. N Engl J Med 342:1179–1186

    PubMed  Google Scholar 

  9. Castro WH, Meyer SJ, Becke ME, Nentwig CG, Hein MF, Ercan BI, Thomann S, Wessels U, Du Chesne AE (2001) No stress-no whiplash? Prevalence of “whiplash” symptoms following exposure to a placebo rear-end collision. Int J Legal Med 114:316–322

    CAS  PubMed  Google Scholar 

  10. Cloninger CR (1987) A systemathic method for clinical description and classification of personality variants. Arch Gen Psychiatry 44:573–588

    CAS  PubMed  Google Scholar 

  11. Cloninger CR, Svrakic DM, Przybeck TR (1993) A psychobiological model of temperament and character. Arch Gen Psychiatry 50:975–990

    CAS  PubMed  Google Scholar 

  12. Cloninger CR, Przybeck TR, Svrakic DM, Wetzel RD (1994) Applications to mood disorders. In: Cloninger CR (ed) The temperament and character inventory (TCI): a guide to its development and use. Center for Psychobiology of Personality, Washington University, St. Louis, Missouri

  13. Côté P, Hogg-Johnson S, Cassidy D, Carroll L, Frank JW (2001) The association between neck pain intensity, physical functioning, depressive symptomatology and time-to-claim-closure after whiplash. J Clin Epidemiol 54:275–286

    Article  PubMed  Google Scholar 

  14. Davis S, Teresi L, Bradley W, Ziemba M, Bloze E (1991) Cervical spine hyperextension injuries: MR findings. Radiology 180:245–251

    CAS  PubMed  Google Scholar 

  15. Ferrari R, Schrader H (2001) The late whiplash syndrome: a biopsychosocial approach. J Neurol Neurosurg Psychiatry 70:722–726

    Article  CAS  PubMed  Google Scholar 

  16. Gargan MF, Bannister GC, Main CJ (1992) Behavioral response to whiplash injury. Presented at the British Cervival Spine Society, Bowness-on-Windermere

  17. Gozzard C, Bannister G, Langkamer G, Khan S, Gargan M, Foy C (2001) Factors affecting employment after whiplash injury. J Bone Joint Surg (Br) 83-B:506–509

    Google Scholar 

  18. Haynes SG, Feinlieb M (1982) Type A behavior and the incidence of coronary heart disease in the Framingham Heart Study. Adv Cardiol 29:85–95

    CAS  PubMed  Google Scholar 

  19. Henry GK, Gross HS, Herndon CA, Furst CJ (2000) Nonimpact brain injury: neuropsychological and behavioural correlates with consideration of physiological findings. Appl Neuropsychol 7:65–75

    Article  CAS  PubMed  Google Scholar 

  20. Joyce PR, Mulder RT, Cloninger CR (1994) Temperament and hypercortisolemia in depression. Am J Psychiatry 151:195–198

    CAS  PubMed  Google Scholar 

  21. Karlsborg M, Smed A, Jespersen H, Stephensen S, Cortsen M, Jennum P, Herning M, Korfitsen E, Werdelin L (1997) A prospective study of 39 patients with whiplash injury. Acta Neurol Scand 95:65–72

    CAS  PubMed  Google Scholar 

  22. Keller M, Hiltbrunner B, Dill C, Kesselring J (2000) Reversible neuropsychological deficits after mild traumatic brain injury. J Neurol Neurosurg Psychiatry 68:761–764

    Article  CAS  PubMed  Google Scholar 

  23. Kessels RPC, Aleman A, Verhagen WIM, van Luijtelaar ELJM (2000) Cognitive functioning after whiplash injury: a meta analysis. JINS 6:271–278

    Article  CAS  PubMed  Google Scholar 

  24. Kischka U, Ettlin T, Heim S, Schmid G (1991) Cerebral symptoms following whiplash injury. Eur Neurol 31:136–140

    CAS  PubMed  Google Scholar 

  25. Lee J, Giles K, Drummond P (1993) Psychological disturbances and an exaggerated response to pain in patients with whiplash injury. J Psychosom Res 37:105–110

    Article  CAS  PubMed  Google Scholar 

  26. Lorberboym M, Gilad R, Gorin V, Sadeh M, Lampl Y (2002) Late whiplash syndrome: Correlation of brain SPECT with neuropsychological tests and P300 Event-Related Potential. J Trauma 52:521–526

    PubMed  Google Scholar 

  27. Mandel S, Esposito J, Gordon JE, Maitz EA, Massari DJ, Mandel H (2002) Handicap after acute whiplash injury. Neurology 58:157–159

    Article  PubMed  Google Scholar 

  28. Mayou R, Bryant B, Duthie R (1993) Psychiatric consequences of road traffic accidents. Br Med J 307:647–651

    CAS  Google Scholar 

  29. Mayou R, Bryant B(1996) Outcome of whiplash neck injury. Injury 27:617–623

    CAS  PubMed  Google Scholar 

  30. Merskey H (1993) Psychological consequences of whiplash. Spine: state of the art reviews 7:471–480

  31. Norris SH, Watt I (1983) The prognosis of neck injuries resulting from rear-end vehicle collisions. J Bone Joint Surg (Br) 65:608–611

    Google Scholar 

  32. Nylander PO, Schlette P, Brändström S, Nilsson M, Forsgren T, Forsgren L, Adolfsson R (1996) Migraine: temperament and character. J Psychiatr Res 30:359–368

    Article  CAS  PubMed  Google Scholar 

  33. Obelieniene D, Schrader H, Bovim G, Misevičiene I, Sand T (1999) Pain after whiplash: a prospective controlled cohort study. J Neurol Neurosurg Psychiatry 66:279–283

    PubMed  Google Scholar 

  34. Olivegren H, Jerkvall N, Hagstrom Y, Carlsson J (1999) The long-term prognosis of whiplash-associated disorders (WAD). Eur Spine J 8:366–370

    Article  CAS  PubMed  Google Scholar 

  35. Peebles JE, McWilliams LA, MacLennan (2001) A comparison of symptom checklist 90-revised profiles from patients with chronic pain from whiplash and patients with other musculoskeletal injuries. Spine 26:766–770

    CAS  PubMed  Google Scholar 

  36. Radanov BP, Stefano G di, Schnidrig A, Ballinari P (1991) Role of psychosocial stress in recovery from common whiplash. Lancet 338:712–715

    CAS  PubMed  Google Scholar 

  37. Radanov BP, Dvorak J, Valach L (1992) Cognitive deficits in patients after soft tissue injury of the cervical spine. Spine 17:127–131

    CAS  PubMed  Google Scholar 

  38. Radanov BP, Bicik I, Dvorak J, Antinnes J, Schulthess GK von, Buck A (1999) Relation between neuropsychological and neuroimaging findings in patients with late whiplash syndrome. J Neurol Neurosurg Psychiatry 66:485–489

    CAS  PubMed  Google Scholar 

  39. Richter J, Brändström S, Przybeck T (1999) Assessing personality: the temperament and character in a cross-cultural comparison between Germany, Sweden and the USA. Psychol Rep 84:1315–1330

    Google Scholar 

  40. Russel IJ (1993) A metabolic basis for fibromyalgia syndrome. In: (Vaeroy H, Merskey H (eds) Progress in fibromyalgia and myofascial pain. Elsevier, Amsterdam

  41. Sapir DA, Group JM (2001) Radiofrequency medial branch neurotomy in litigant and nonlitigant patients with cervical whiplash. A prospective study. Spine 26:E268–E273

    Article  CAS  PubMed  Google Scholar 

  42. Schlesinger I, Hering-Hanit R, Dagan Y (2001) Sleep disturbances after whiplash injury: objective and subjective findings. Headache 41:586–589

    Article  CAS  PubMed  Google Scholar 

  43. Schwartz D, Barth J, Dane J, Drenan S, DeGood D, Rowlingson J (1987) Cognitive deficits in chronic pain patients with and without history of head/neck injury: development of a brief screening battery. Clin J Pain 3:94–101

    Google Scholar 

  44. Smed A (1997) Cognitive function and distress after common whiplash injury. Acta Neurol Scand 95:73–80

    CAS  PubMed  Google Scholar 

  45. Spitzer W, Skovron ML, Salmi R, Cassidy D, Duranceau J, Suissa S, Zeiss E (1995) Scientific monograph of the Quebec Task Force on whiplash-associated disorders: redefining whiplash and its management. Spine 20 (Suppl 8)

  46. Squires B, Gargan MF, Bannister GC (1996) Soft-tissue injuries of the cervical spine. J Bone Joint Surg (Br) 78:955–957

    Article  Google Scholar 

  47. Sternbach RA (1968) Pain: a psychophysiological analysis. Academic Press, New York

  48. Suissa S, Harder S, Veilleux M (2001) The relation between initial symptoms and signs and the prognosis of whiplash. Eur Spine J 10:44–49

    CAS  PubMed  Google Scholar 

  49. Sullivan MJ, Hall E, Bartolacci R, Sullivan ME, Adams H (2002) Perceived cognitive deficits, emotional distress and disability following whiplash injury. Pain Res Manag 7:120–126

    PubMed  Google Scholar 

  50. Taylor AE, Cox CA, Mailis A (1996) Persistent neuropsychological deficits following whiplash: evidence for chronic mild traumatic brain injury? Arch Phys Med Rehab 77:529–535

    CAS  Google Scholar 

  51. Wallis B, Lord S, Barnsley L, Bogduk N (1996) Pain and psychologic symptoms of Australian patients with whiplash. Spine 21:804–810

    Article  CAS  PubMed  Google Scholar 

  52. Wallis BJ, Lord SM, Bogduk N (1997) Resolution of psychological distress of whiplash patients following treatment by radiofrequency neurotomy: a randomised, double-blind, placebo-controlled trial. Pain 73:15–22

    Article  CAS  PubMed  Google Scholar 

  53. Van Balen HGG, de Mey HRA, van Limbeek J (1999) A neurocorrective approach for MMPI-2 use with brain-damage patients. Int J Rehab Res 22:249–259

    Google Scholar 

  54. Versteegen GJ, Dijkstra PU, Jaspers JP, Meijler WJ, ten Duis HJ, Klip EC (2003) Sprain of the neck: quality of life and psychological functioning. A 4 year retrospective study. Qual Life Res 12:335–343

    Article  CAS  PubMed  Google Scholar 

  55. Yanell PR, Rossie GV (1988) Minor whiplash head injury with major debilitation. Brain Injury 3:255–258

    Google Scholar 

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Acknowledgements

The generous cooperation of the patients in this study is gratefully acknowledged. We thank H. Stenlund, Department of Epidemiology and Public Health, Umeå University, for statistical support. This study was supported by the National Societies for Aiding Traffic Accident Victims and Polio Victims, the Swedish Association for Persons Disabled by Traffic Accidents or Cancer, Medical Research Council (B93-21X-10412, B94-21X 03921), Joint Committee Northern Health Region (Sweden), Stiftelsen Söderström-Königska, Svenska Läkarsällskapet, and Swedish Society of Medical Research.

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  1. Kurt Pettersson

    Present address: Department of Hand Surgery, Örebro University Hospital, 701 85, Örebro, Sweden

Authors and Affiliations

  1. Department of Orthopedics, Umeå University, Umeå, Sweden

    Kurt Pettersson, Göran Toolanen & Christer Hildingsson

  2. Division of Psychiatry, Department of Neuroscience and Locomotion, Linköping University, Linköping, Sweden

    Sven Brändström & Per-Olof Nylander

  3. Department of Psychiatry, Kalmar, Sweden

    Per-Olof Nylander

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  1. Kurt Pettersson
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Correspondence to Kurt Pettersson.

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Pettersson, K., Brändström, S., Toolanen, G. et al. Temperament and character: prognostic factors in whiplash patients?. Eur Spine J 13, 408–414 (2004). https://doi.org/10.1007/s00586-004-0681-9

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  • DOI: https://doi.org/10.1007/s00586-004-0681-9

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