TY - JOUR
T1 - The development of persistent pain and psychological morbidity after motor vehicle collision
T2 - Integrating the potential role of stress response systems into a biopsychosocial model
AU - McLean, Samuel A.
AU - Clauw, Daniel J.
AU - Abelson, James L.
AU - Liberzon, Israel
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2005
Y1 - 2005
N2 - Objectives: Persistent pain and psychological sequelae are common after motor vehicle collision (MVC), but their etiology remains poorly understood. Such common sequelae include whiplash-associated disorders (WAD), fibromyalgia, and posttraumatic stress disorder (PTSD). Increasing evidence suggests that these disorders share overlapping epidemiologic and clinical features. A model is proposed in which central neurobiological systems, including physiologic systems and neuroanatomical structures involved in the stress response, are an important substrate for the development of all 3 disorders and interact with psychosocial and other factors to influence chronic symptom development. Methods: Epidemiologic and clinical characteristics regarding the development of these disorders after MVC are reviewed. Evidence suggesting a role for stress response systems in the development of these disorders is presented. Results: Contemporary evidence supports a model of chronic symptom development that incorporates the potential for interactions between past experience, acute stress responses to trauma, post-MVC behavior, and cognitive/psychosocial consequences to alter activity within brain regions which process pain and to result in persistent pain, as well as psychological sequelae, after MVC. Such a model incorporates factors identified in prior biopsychosocial theories and places them in the landscape of our rapidly developing understanding of stress systems and CNS pain-modulating pathways. Conclusion: New models are needed to stimulate deeper examination of the interacting influences of initial tissue damage, acute pain, psychosocial contingencies, and central stress pathways during chronic symptom development after MVC. Deeper understanding could contribute to improved treatment approaches to reduce the immense personal and societal burdens of common trauma-related disorders.
AB - Objectives: Persistent pain and psychological sequelae are common after motor vehicle collision (MVC), but their etiology remains poorly understood. Such common sequelae include whiplash-associated disorders (WAD), fibromyalgia, and posttraumatic stress disorder (PTSD). Increasing evidence suggests that these disorders share overlapping epidemiologic and clinical features. A model is proposed in which central neurobiological systems, including physiologic systems and neuroanatomical structures involved in the stress response, are an important substrate for the development of all 3 disorders and interact with psychosocial and other factors to influence chronic symptom development. Methods: Epidemiologic and clinical characteristics regarding the development of these disorders after MVC are reviewed. Evidence suggesting a role for stress response systems in the development of these disorders is presented. Results: Contemporary evidence supports a model of chronic symptom development that incorporates the potential for interactions between past experience, acute stress responses to trauma, post-MVC behavior, and cognitive/psychosocial consequences to alter activity within brain regions which process pain and to result in persistent pain, as well as psychological sequelae, after MVC. Such a model incorporates factors identified in prior biopsychosocial theories and places them in the landscape of our rapidly developing understanding of stress systems and CNS pain-modulating pathways. Conclusion: New models are needed to stimulate deeper examination of the interacting influences of initial tissue damage, acute pain, psychosocial contingencies, and central stress pathways during chronic symptom development after MVC. Deeper understanding could contribute to improved treatment approaches to reduce the immense personal and societal burdens of common trauma-related disorders.
KW - Fibromyalgia
KW - PTSD
KW - Pain
KW - Stress
KW - Trauma
KW - Whiplash-associated disorders
UR - http://www.scopus.com/inward/record.url?scp=25844433594&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=25844433594&partnerID=8YFLogxK
U2 - 10.1097/01.psy.0000181276.49204.bb
DO - 10.1097/01.psy.0000181276.49204.bb
M3 - Review article
C2 - 16204439
AN - SCOPUS:25844433594
SN - 0033-3174
VL - 67
SP - 783
EP - 790
JO - Psychosomatic Medicine
JF - Psychosomatic Medicine
IS - 5
ER -