Abstract
Motor vehicle collisions (MVCs) are very common, and they often result in neck and shoulder injuries that are referred to as whiplash-associated disorders (WAD). The largest percentage of WAD are relatively minor and do not reveal any evidence of objective, structural pathology. However, for a substantial percentage of individuals, WAD evolves into chronic, disabling conditions characterized by pain and other symptoms. A range of pre-morbid, collision-related, biomechanical, and psychosocial responses to the MVC have been investigated to determine the manner in which these responses serve to exacerbate and maintain WAD symptoms. In this article, we review the literature investigating these potential causal, amplifying, and perpetuating factors from a biopsychosocial perspective. We emphasize the range of psychological factors and the post-MVC legal and compensation factors that have been identified as significant contributors to the persistence of symptoms and ensuing disability. We highlight the ways in which psychological and legal factors need to be integrated with biological factors to better understand and prevent WAD and treat individuals who experience WAD to reduce chronicity and disability.