I am a
Home I AM A Search Login

Papers of the Week

Papers: 2 Apr 2022 - 8 Apr 2022


Human Studies

2022 Apr 01

Eur J Pain

Values-based Cognitive Behavioral Therapy for the Prevention of Chronic Whiplash Associated Disorders: A Randomized Controlled Trial.


Whiplash is a common traffic-related injury with up to 50% of those affected continuing to experience symptoms one-year post-injury. Unfortunately, treatments have not proven highly effective in preventing and treating chronic symptomatology. The overall aim of this study was to test the effectiveness of an early values-based cognitive-behavioral therapeutic intervention (V-CBT) delivered within 6 months post-injury in preventing chronic symptomatology compared to wait list controls. The study was a two-armed randomized controlled trial. Participants (n=91) experienced pain, disability, and at least one psychological risk factor (e.g., enhanced pain-catastrophizing) after a whiplash trauma no later than 6 months prior. Participants were randomized to 10 sessions of V-CBT starting one week (group A) or three months (group B) post-randomization. The primary outcome was pain-related disability, while secondary outcomes were pain intensity, neck-pain related disability, depression, anxiety, PTSD symptoms, pain-catastrophizing, and kinesiophobia. These were evaluated at baseline and at 3, 6, 9, and 12 months post-randomization. At 3 months, group A demonstrated clinically important effects on all outcomes that were significantly better than group B (waitlist). When group B received the intervention at 6 months, they also demonstrated clinically important effects on all outcomes. However, there was a significant difference at 12 months for the primary outcome, in which group B increased their disability levels, while group A remained stable. While this indicates that an intervention window for early prevention of disability after whiplash injury may exist, this needs to be tested in a truly early intervention.