Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash: the role of perceived injustice

Whitney Scott; Zina Trost; Maria Milioto; Michael J L Sullivan

doi:10.1097/AJP.0000000000000095

Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash: the role of perceived injustice

Whitney Scott, Zina Trost, Maria Milioto, Michael J L Sullivan

Psychology

Research output: Contribution to journal › Article › peer-review

43 Citations (Scopus)

Abstract

OBJECTIVE: Depressive symptoms complicate patients' recovery after musculoskeletal injury. There is strong evidence to support the utility of multidisciplinary approaches for treating comorbid pain and depressive symptoms. Despite this, a significant proportion of patients may not experience meaningful reductions in depressive symptoms following intervention. The purpose of this study was to identify barriers to change in depressive symptom during multidisciplinary rehabilitation for patients with whiplash injuries.

METHODS: A total of 53 patients with clinically meaningful levels of depressive symptoms before participating in a standardized multidisciplinary rehabilitation program participated in this study. Patients completed self-report measures of depressive symptoms, demographic factors, pain intensity, disability, posttraumatic stress symptoms, pain catastrophizing, perceived injustice, and self-efficacy upon commencement and completion of the rehabilitation program. Analyses examined whether pretreatment variables predicted change in depressive symptoms over treatment and the maintenance of clinically meaningful levels of depressive symptoms at posttreatment.

RESULTS: Duration of work absence and perceived injustice were significant unique predictors of percent change in depressive symptoms in a linear regression analysis. Perceived injustice was the only significant unique predictor of the presence of clinically meaningful levels of depressive symptoms at posttreatment in a logistic regression analysis.

CONCLUSIONS: The results suggest that the identification of patients with high levels of perceived injustice and implementation of targeted interventions for these patients might contribute to greater improvements in their depressive symptomatology.

Original language	English
Pages (from-to)	145-51
Number of pages	7
Journal	The Clinical journal of pain
Volume	31
Issue number	2
DOIs	https://doi.org/10.1097/AJP.0000000000000095
Publication status	Published - Feb 2015

Keywords

Adult
Catastrophization
Depression
Female
Humans
Linear Models
Logistic Models
Male
Neck Pain
Perception
Psychiatric Status Rating Scales
Self Efficacy
Self Report
Severity of Illness Index
Stress Disorders, Post-Traumatic
Treatment Outcome
Whiplash Injuries

Access to Document

10.1097/AJP.0000000000000095

Cite this

@article{6d86d594e8d74e0681aeffc009f255d4,

title = "Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash: the role of perceived injustice",

abstract = "OBJECTIVE: Depressive symptoms complicate patients' recovery after musculoskeletal injury. There is strong evidence to support the utility of multidisciplinary approaches for treating comorbid pain and depressive symptoms. Despite this, a significant proportion of patients may not experience meaningful reductions in depressive symptoms following intervention. The purpose of this study was to identify barriers to change in depressive symptom during multidisciplinary rehabilitation for patients with whiplash injuries.METHODS: A total of 53 patients with clinically meaningful levels of depressive symptoms before participating in a standardized multidisciplinary rehabilitation program participated in this study. Patients completed self-report measures of depressive symptoms, demographic factors, pain intensity, disability, posttraumatic stress symptoms, pain catastrophizing, perceived injustice, and self-efficacy upon commencement and completion of the rehabilitation program. Analyses examined whether pretreatment variables predicted change in depressive symptoms over treatment and the maintenance of clinically meaningful levels of depressive symptoms at posttreatment.RESULTS: Duration of work absence and perceived injustice were significant unique predictors of percent change in depressive symptoms in a linear regression analysis. Perceived injustice was the only significant unique predictor of the presence of clinically meaningful levels of depressive symptoms at posttreatment in a logistic regression analysis.CONCLUSIONS: The results suggest that the identification of patients with high levels of perceived injustice and implementation of targeted interventions for these patients might contribute to greater improvements in their depressive symptomatology.",

keywords = "Adult, Catastrophization, Depression, Female, Humans, Linear Models, Logistic Models, Male, Neck Pain, Perception, Psychiatric Status Rating Scales, Self Efficacy, Self Report, Severity of Illness Index, Stress Disorders, Post-Traumatic, Treatment Outcome, Whiplash Injuries",

author = "Whitney Scott and Zina Trost and Maria Milioto and Sullivan, {Michael J L}",

year = "2015",

month = feb,

doi = "10.1097/AJP.0000000000000095",

language = "English",

volume = "31",

pages = "145--51",

journal = "The Clinical journal of pain",

issn = "0749-8047",

publisher = "Lippincott Williams and Wilkins",

number = "2",

}

TY - JOUR

T1 - Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash

T2 - the role of perceived injustice

AU - Scott, Whitney

AU - Trost, Zina

AU - Milioto, Maria

AU - Sullivan, Michael J L

PY - 2015/2

Y1 - 2015/2

N2 - OBJECTIVE: Depressive symptoms complicate patients' recovery after musculoskeletal injury. There is strong evidence to support the utility of multidisciplinary approaches for treating comorbid pain and depressive symptoms. Despite this, a significant proportion of patients may not experience meaningful reductions in depressive symptoms following intervention. The purpose of this study was to identify barriers to change in depressive symptom during multidisciplinary rehabilitation for patients with whiplash injuries.METHODS: A total of 53 patients with clinically meaningful levels of depressive symptoms before participating in a standardized multidisciplinary rehabilitation program participated in this study. Patients completed self-report measures of depressive symptoms, demographic factors, pain intensity, disability, posttraumatic stress symptoms, pain catastrophizing, perceived injustice, and self-efficacy upon commencement and completion of the rehabilitation program. Analyses examined whether pretreatment variables predicted change in depressive symptoms over treatment and the maintenance of clinically meaningful levels of depressive symptoms at posttreatment.RESULTS: Duration of work absence and perceived injustice were significant unique predictors of percent change in depressive symptoms in a linear regression analysis. Perceived injustice was the only significant unique predictor of the presence of clinically meaningful levels of depressive symptoms at posttreatment in a logistic regression analysis.CONCLUSIONS: The results suggest that the identification of patients with high levels of perceived injustice and implementation of targeted interventions for these patients might contribute to greater improvements in their depressive symptomatology.

AB - OBJECTIVE: Depressive symptoms complicate patients' recovery after musculoskeletal injury. There is strong evidence to support the utility of multidisciplinary approaches for treating comorbid pain and depressive symptoms. Despite this, a significant proportion of patients may not experience meaningful reductions in depressive symptoms following intervention. The purpose of this study was to identify barriers to change in depressive symptom during multidisciplinary rehabilitation for patients with whiplash injuries.METHODS: A total of 53 patients with clinically meaningful levels of depressive symptoms before participating in a standardized multidisciplinary rehabilitation program participated in this study. Patients completed self-report measures of depressive symptoms, demographic factors, pain intensity, disability, posttraumatic stress symptoms, pain catastrophizing, perceived injustice, and self-efficacy upon commencement and completion of the rehabilitation program. Analyses examined whether pretreatment variables predicted change in depressive symptoms over treatment and the maintenance of clinically meaningful levels of depressive symptoms at posttreatment.RESULTS: Duration of work absence and perceived injustice were significant unique predictors of percent change in depressive symptoms in a linear regression analysis. Perceived injustice was the only significant unique predictor of the presence of clinically meaningful levels of depressive symptoms at posttreatment in a logistic regression analysis.CONCLUSIONS: The results suggest that the identification of patients with high levels of perceived injustice and implementation of targeted interventions for these patients might contribute to greater improvements in their depressive symptomatology.

KW - Adult

KW - Catastrophization

KW - Depression

KW - Female

KW - Humans

KW - Linear Models

KW - Logistic Models

KW - Male

KW - Neck Pain

KW - Perception

KW - Psychiatric Status Rating Scales

KW - Self Efficacy

KW - Self Report

KW - Severity of Illness Index

KW - Stress Disorders, Post-Traumatic

KW - Treatment Outcome

KW - Whiplash Injuries

U2 - 10.1097/AJP.0000000000000095

DO - 10.1097/AJP.0000000000000095

M3 - Article

C2 - 24751546

SN - 0749-8047

VL - 31

SP - 145

EP - 151

JO - The Clinical journal of pain

JF - The Clinical journal of pain

IS - 2

ER -

Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash: the role of perceived injustice

Abstract

Keywords

Access to Document

Fingerprint

Cite this