Cognitive impairments, psychological dysfunction, and coping styles in patients with chronic whiplash syndrome

To investigate underlying mechanisms of cognitive dysfunction in whiplash syndrome, focusing on psychologic factors and coping mechanisms.

Patients with whiplash often experience cognitive-functioning impairments, although neurologic and neuropsychologic test results do not always support this. Psychologic factors are also hypothesized to influence the existence of whiplash-related cognitive impairments. This has led to a controversy about the etiology of these experiences.

In this retrospective study, 31 patients with whiplash were compared with 30 neurologic patients and a non-neurologic control group (i.e., subjects with "nonorganic" psychologic symptoms) on memory, attention, and cognitive flexibility. In addition, psychologic questionnaires (Minnesota Multiphasic Personality Inventory, Symptom Checklist, and Utrecht Coping List) were used to investigate psychologic functioning and coping in these patient groups.

Patients with whiplash performed similarly to neurologic patients on the cognitive tasks and performed worse on memory and attention tasks compared with the control group. Furthermore, patients with whiplash had high scores on subscales measuring somatization and displayed a predominantly active and palliative coping style.

Somatization, in combination with inadequate coping, might play a role in the development, persistence, or aggravation of whiplash-related symptoms, such as pain or cognitive dysfunction.