Self-efficacy beliefs mediate the association between pain intensity and pain interference in acute/subacute whiplash-associated disorders

Abstract

Purpose: To evaluate whether a set of pre-accident demographic, accident-related, post-accident treatment and psychosocial factors assessed in people with acute/subacute whiplash-associated disorders (WAD) mediate the association between pain intensity and: (1) pain interference and (2) expectations of recovery, using Bayesian networks (BNs) analyses. This study also explored the potential mediating pathways (if any) between different psychosocial factors.

Methods: This was a cross-sectional study conducted on a sample of 173 participants with acute/subacute WAD. Pain intensity, pain interference, pessimism, expectations of recovery, pain catastrophizing, and self-efficacy beliefs were assessed. BN analyses were conducted to analyse the mediating effects of psychological factors on the association between pain intensity and pain-related outcomes.

Results: The results revealed that self-efficacy beliefs partially mediated the association between pain intensity and pain interference. Kinesiophobia partially mediated the association between self-efficacy and pain catastrophizing. Psychological factors did not mediate the association between pain intensity and expectations of recovery.

Conclusion: These results indicate that individuals with acute/subacute WAD may present with lesser pain interference associated with a determined pain intensity value when they show greater self-efficacy beliefs. As the cross-sectional nature of this study limits firm conclusions on the causal impact, researchers are encouraged to investigate the role that patient's self-efficacy beliefs play in the transition to chronic WAD via longitudinal study designs.

Keywords: Acute; Neck pain; Observational study; Psychological factors; Whiplash.