Psychological Factors and the Development of Chronic Whiplash-associated Disorder(s): A Systematic Review.

OBJECTIVES: To assess which psychological factors are important in the development of chronic whiplash symptoms.

METHODS: Searches were conducted across PubMed, CINAHL, Scopus, and PsychINFO up until March 2017. Studies were included if they investigated psychological prognostic factors in association with recovery from a whiplash injury. Studies also had to be prospective, cohort, follow-up or observational studies, have a 6 month follow-up and published in English. Quality assessments were conducted by 2 independent reviewers. Thirty-one articles were included investigating 34 psychological factors.

RESULTS: Poor expectations of recovery, posttraumatic stress symptoms and passive coping emerged as the most consistent prognostic factors of chronic neck pain and/or disability after a whiplash injury. Anxiety, travel anxiety, depression, personality, precollision distress, general psychological distress, and avoidance behavior were not associated with chronic whiplash problems.