Early Evaluation of Psychological Factors After Traumatic Injury: Insights Into Injury Distress, Pain Anxiety,...

This study evaluated the unique incremental predictive value of brief psychological assessments on pain intensity, pain interference, and physical function after musculoskeletal injury.

Participants (N=135) completed baseline assessments during hospitalization following a traumatic injury and follow-up data 3 months later. Predictive assessments were depression, anxiety, traumatic injury distress, and pain anxiety, while concurrent assessments included pain acceptance, valued activity, and pain self-efficacy. Regression analyses determined the added explanatory value (Δ R2 ) of psychological variables beyond pain intensity and medical/injury factors.

Follow-up pain intensity, pain interference, and physical function were predicted by traumatic injury distress (Δ R2 =0.08, P <0.001; Δ R2 =0.16, P <0.001; Δ R2 =0.05, P =0.003, respectively), and pain anxiety (Δ R2 =0.04, P =0.005; Δ R2 =0.06, P <0.001; Δ R2 =0.04, P =0.006). Pain acceptance was associated with pain interference at 3 months (Δ R2 =0.03, P =0.036). Both pain intensity and interference were associated with valued activity (Δ R2 =0.03, P =0.013; Δ R2 =0.02, P =0.035) and pain self-efficacy (Δ R2 =0.06, P <0.001; Δ R2 =0.06, P <0.001). Greater physical function at follow up was associated with less traumatic injury distress (Δ R2 =0.03, P =0.024) and greater pain self-efficacy (Δ R2 =0.05, P =0.002).

Psychological assessments conducted early in recovery offer additional predictive value beyond medical and injury-related factors. These findings underscore the importance of comprehensive psychological evaluations following traumatic injury.