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The Development of Persistent Pain and Psychological Morbidity After Motor Vehicle Collision: Integrating the Potential Role of Stress Response Systems Into a Biopsychosocial Model

From the Departments of Emergency Medicine (S.A.M.), Medicine (Rheumatology) (D.J.C.), and Psychiatry (I.L., J.L.A.) and the Chronic Pain and Fatigue Research Center (S.A.M., D.J.C.), University of Michigan Medical Center, Ann Arbor, Michigan.

View larger version (19K): [in a new window]   Figure 1. Vlaeyen’s cognitive-behavioral model of chronic pain pathogenesis (Source: Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317–332.)

View larger version (53K): [in a new window]   Figure 2. Amendment to Vlaeyen’s cognitive-behavioral model of chronic pain pathogenesis, incorporating the hypothesized role of the stress response system in the development of aberrant pain and/or emotional processing after motor vehicle collision.