Factors associated with recovery expectations following vehicle collision: A population-based study

Abstract

Positive expectations predict better outcomes for a variety of health conditions including recovery from whiplash-associated disorders, but we know little about which individuals have negative expectations, and therefore may be at risk for poor whiplash-associated disorders recovery. We assessed expectations for global recovery in a population-based cohort of 6015 individuals with traffic-related whiplash-associated disorders. We used multinomial logistic regression analysis to model factors associated with expecting to recover slowly, or not recover at all, as opposed to expecting to recover quickly. Depressive symptomatology, lower education, lower income, male gender, younger age, being a passenger in the vehicle, history of neck pain, and greater initial pain (greater percentage of body in pain, greater intensity of neck pain and presence of low back and/or headache pain) were associated with poor expectations for recovery. A number of demographic, socioeconomic and injury-related factors were associated with expectations for recovery in whiplash-associated disorders. Two of the strongest associated factors were depressive symptomatology and initial neck pain intensity. These results support using a biopsychosocial approach to evaluate expectancies and their influence on important health outcomes.