{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:19:34Z","timestamp":1768342774272,"version":"3.49.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T00:00:00Z","timestamp":1582675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Posttraumatic stress disorder (PTSD) symptoms are common in chronic Whiplash associated disorders (WAD) and have been found to be associated with higher levels of pain and disability. Theoretical frameworks have suggested that PTSD and pain not only coexist, but also mutually maintain one another. Although the comorbidity has been subject to increasing quantitative research, patients\u2019 experiences of the comorbidity and symptom interaction remain largely uninvestigated using qualitative methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The present study set out to explore the potential relationship of PTSD and pain in people with WAD and properly assessed PTSD after motor vehicle accidents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A qualitative explorative study of eight individual face-to-face semistructured interviews were conducted. Interviews were recorded and transcribed verbatim and analyzed using framework analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Through the analysis, we developed three overarching themes. The first theme illustrated the complex and burdensome comorbidity with overlapping and transdiagnostic symptoms, whereas the second theme highlighted how several circumstances, some related to the health care system, could extend and amplify the traumatic response. The final theme illustrated symptom associations and interactions, particularly between pain and PTSD, both supporting and rejecting parts of the mutual maintenance framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings underlined the great complexity and variability of the comorbidity and the traumatic event, but also emphasized how experiences of psyche and soma seem closely connected in these patients. The results provide support for the importance of thorough assessment by multidisciplinary teams, minimizing distress post-injury, and a critical approach to the idea of mutual maintenance between pain and PTSD.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pm\/pnz369","type":"journal-article","created":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T12:15:19Z","timestamp":1576757719000},"page":"1676-1689","source":"Crossref","is-referenced-by-count":9,"title":["There\u2019s Nothing Broken. You\u2019ve Had a Whiplash, That\u2019s It: A Qualitative Study of Comorbid Posttraumatic Stress Disorder and Whiplash Associated Disorders"],"prefix":"10.1093","volume":"21","author":[{"given":"Sophie Lykkegaard","family":"Ravn","sequence":"first","affiliation":[{"name":"Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark"},{"name":"InCoRE"},{"name":"ThRIVE"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanna Bjerg","family":"Eskildsen","sequence":"additional","affiliation":[{"name":"INSIDE, Department of Psychology, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Thit","family":"Johnsen","sequence":"additional","affiliation":[{"name":"INSIDE, Department of Psychology, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Sterling","sequence":"additional","affiliation":[{"name":"RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tonny Elmose","family":"Andersen","sequence":"additional","affiliation":[{"name":"InCoRE"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,2,26]]},"reference":[{"issue":"8","key":"2020081623465630000_pnz369-B1","first-page":"1","article-title":"Scientific monograph of Quebec task force on whiplash associated disorders: Redefining \u2018whiplash\u2019 and its management","volume":"20","author":"Spitzer","year":"1995","journal-title":"Spine"},{"key":"2020081623465630000_pnz369-B2","first-page":"9","volume-title":"Whiplash \u2013 Evidence Base for Clinical Practice.","author":"Sterling"},{"issue":"2","key":"2020081623465630000_pnz369-B3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jmpt.2008.11.014","article-title":"Course and prognostic factors for neck pain in whiplash-associated disorders (WAD): Results of the Bone and Joint Decade 2000\u20132010 Task Force on Neck Pain and Its Associated Disorders","volume":"32","author":"Carroll","year":"2009","journal-title":"J Manipulative Physiol Ther"},{"key":"2020081623465630000_pnz369-B4","doi-asserted-by":"crossref","first-page":"S52","DOI":"10.1097\/BRS.0b013e3181643ece","article-title":"The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: Results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders","volume":"33(Suppl 4","author":"Holm","year":"2008","journal-title":"Spine"},{"issue":"11","key":"2020081623465630000_pnz369-B5","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1016\/j.injury.2013.07.011","article-title":"A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors","volume":"44","author":"Heron-Delaney","year":"2013","journal-title":"Injury"},{"key":"2020081623465630000_pnz369-B6","volume-title":"Diagnostic and Statistical Manual of Mental Disorders.","year":"2013","edition":"5th ed"},{"issue":"1","key":"2020081623465630000_pnz369-B7","doi-asserted-by":"crossref","first-page":"75","DOI":"10.2174\/1745017901309010075","article-title":"PTSD symptoms mediate the effect of attachment on pain and somatization after whiplash injury","volume":"9","author":"Andersen","year":"2013","journal-title":"Clin Pract Epidemiol Ment Health"},{"issue":"7","key":"2020081623465630000_pnz369-B8","doi-asserted-by":"crossref","first-page":"1527","DOI":"10.3899\/jrheum.091321","article-title":"The course of symptoms for whiplash-associated disorders in Sweden: 6-month follow-up study","volume":"37","author":"Crutebo","year":"2010","journal-title":"J Rheumatol"},{"issue":"4","key":"2020081623465630000_pnz369-B9","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.ejpain.2007.07.008","article-title":"Acute stress response and recovery after whiplash injuries. 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