車禍致長期頸痛潮流 (Whip-lash)是社會制度群眾形成的個人病

http://www.bcmj.org/article/whiplash-social-disorder%E2%80%94how-so

Whiplash is a social disorder—How so!

Issue: BCMJ, Vol. 44, No. 6, July, August 2002, page(s) 307-311 Articles
Robert Ferrari, MD, FRCPC

How could whiplash be a social disorder? It brings the people together: accident victims of all walks of life—the guilty, the innocent, the upwardly mobile, the downtrodden, and the woebegone all take the stage. The industry that copes with epidemic proportions of chronic pain following acute whiplash injuries includes physicians of many specialities, nurses, paramedics, physiotherapists, occupational therapists, massage therapists, dentists, oral surgeons, chiropractors, osteopaths, pharmacists, acupuncturists, psychologists, lawyers, judges, historians, philosophers, herbal remedists, and the occasional psychic.

Lithuania

Lithuania is a country in which there is little or no awareness or experience among the general population of the notion that a whiplash injury may cause chronic pain and disability. Collision victims view it as a benign injury not requiring medical attention. Possibilities for secondary gains are minima

Greece

Chronic whiplash syndrome also appears to be rare in Greece

Despite having differing insurance systems, different cultures, different cars, and different compensation systems, Lithuanians, Greeks, and Germans behave remarkably the same; and yet very differently from people in Canada, the United States, and the United Kingdom

 

 

Symptom expectation and amplification

In Canada and the US, as in many other western countries, there is widespread public information regarding the potential for chronic pain following whiplash injury, as well as knowledge of the expected symptoms—even among individuals with no experience of having a collision.[8,9] This expectation can lead to an individual becoming hypervigilant for symptoms, registering normal bodily sensations as abnormal, and reacting to bodily sensations with affect and cognitions that intensify them and make them more alarming, ominous, and disturbing—which is known as symptom amplification. In Lithuania, Germany, and Greece, recent studies (using the methodology of Aubrey8 and Mittenberg9) find a lack of expectation of chronic symptoms, and the whiplash injury is viewed as benign.[10,11]

宣傳病得病。

 

Symptom attribution

The final facet of this social symptom triad is symptom attribution. As a collision victim becomes hypervigilant for symptoms, and as one comes to expect chronic symptoms, the problem of symptom attribution is a natural result. In the setting of amplification, previously unintrusive symptoms, largely ignored in daily life, become far more intrusive after the collision. The patient regards them as new (they are now being registered), and attributes them to the collision

Effect of Eliminating Compensation for Pain and Suffering on the Outcome of Insurance Claims for Whiplash Injury

J. David Cassidy, D.C., Ph.D., Linda J. Carroll, Ph.D., Pierre Côté, D.C., Mark Lemstra, M.Sc., Anita Berglund, B.Sc., and Åke Nygren, M.D., Ph.D.

N Engl J Med 2000; 342:1179-1186April 20, 2000

http://www.nejm.org/doi/full/10.1056/NEJM200004203421606#t=articleDiscussion