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While mutual maintenance between pain and <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> has been suggested, knowledge on individual differences in the course of these symptoms is needed. The present study aimed to identify trajectories of <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptoms following whiplash and test predictors and functional outcomes of such trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a prospective cohort design with assessments at baseline (&lt;4\u00a0weeks), 3\u00a0months, and 6\u00a0months post\u2010injury (<jats:italic>n<\/jats:italic>\u00a0=\u00a0229, whiplash grade I\u2010<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>), we identified <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content>\u2010trajectories using Latent Growth Mixture Modeling. Predictors (pain, fear\u2010avoidance\u2010beliefs, pain\u2010catastrophizing, depression, age, and gender) were tested using multinomial logistic regression, and group mean differences in physical and psychosocial pain\u2010related disability at 6\u00a0months were tested as outcomes after controlling for baseline levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three trajectories were identified: \u201cResilient\u201d (75.1%) with little or no <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptoms over time, \u201cRecovering\u201d (10.0%) with high initial <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptom levels, then decreasing substantially, and \u201cChronic\u201d (14.9%) with high initial <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptom levels and a small increase over time. Initial higher pain and depression levels predicted the recovering and chronic trajectories, while the latter had more pain\u2010related disability at 6\u00a0months compared to both other trajectories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Three trajectories were identified, with the chronic trajectory suggesting that a significant subset of people does not recover from <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptoms. This class also reported more pain\u2010related disability. Pain and depression predicted membership, but did, however, not succeed in differentiating between the two high\u2010starting trajectories, suggesting that targeting <jats:styled-content style=\"fixed-case\">PTSD<\/jats:styled-content> symptoms may be important to ensure recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Distinct recovery patterns after whiplash were identified with a significant subgroup reporting elevated and slightly increasing PTSD symptoms over time, highlighting both recovery variability and the presence of PTSD symptoms in a significant subgroup of individuals with whiplash. This subgroup also displayed enhanced pain\u2010related disability over time compared to the recovering and resilient subgroups, thereby linking PTSD symptoms to functional pain outcomes over time. These findings suggest that clinicians should be attentive of potential PTSD symptoms in whiplash patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1325","type":"journal-article","created":{"date-parts":[[2018,10,15]],"date-time":"2018-10-15T05:04:23Z","timestamp":1539579863000},"page":"515-525","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Trajectories of posttraumatic stress symptoms after whiplash: A prospective cohort study"],"prefix":"10.1002","volume":"23","author":[{"given":"Sophie L.","family":"Ravn","sequence":"first","affiliation":[{"name":"Department of Psychology University of Southern Denmark  Odense Denmark"},{"name":"The Specialized Hospital for Polio and Accident Victims  Roedovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen\u2010Inge","family":"Karstoft","sequence":"additional","affiliation":[{"name":"Research and Knowledge Centre The Danish Veteran Centre  Ringsted Denmark"},{"name":"Department of Psychology University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Sterling","sequence":"additional","affiliation":[{"name":"Recover Injury Research Centre NHMRC Centre of Research Excellence in Recovery after Road Traffic Injury The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonny E.","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Southern Denmark  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12,4]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-017-9641-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02294359"},{"key":"e_1_2_8_4_1","volume-title":"Diagnostic and statistical manual of mental disorders, 4th ed., text rev","author":"American Psychiatric Association","year":"2000"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000142221.88111.0f"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3402\/ejpt.v5.23235"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2174\/1745017901309010075"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.848"},{"issue":"1","key":"e_1_2_8_10_1","first-page":"1","article-title":"En empirisk belysning og analyse af \u201cemotional numbing\u201d som eventuelt selvst\u00e6ndig faktor i PTSD","volume":"6","author":"Bach M. 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