Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-25T09:41:40.036Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of seeking compensation on the psychological health and recovery of injured patients: the role of stress vulnerability and injury-related disability

Published online by Cambridge University Press:  09 June 2020

I. Pozzato Open the ORCID record for I. Pozzato [Opens in a new window] ,
A. Kifley ,
A. Craig ,
B. Gopinath ,
Y. Tran ,
J. Jagnoor  and
I. D. Cameron
I. Pozzato*
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
A. Kifley
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
A. Craig
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
B. Gopinath
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
Y. Tran
Affiliation:
Centre of Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, NSW, Australia
J. Jagnoor
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
I. D. Cameron
Affiliation:
John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
*
Author for correspondence: Ilaria Pozzato, E-mail: ilaria.pozzato@sydney.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Seeking compensation has been shown to have an adverse effect on the psychological health and recovery of injured patients, however, this effect requires clarification.

Methods

A total of 2019 adults sustaining a traffic injury were recruited. Of these, 709 (35.1%) lodged a compensation claim. Interviews occurred at 1-, 6- and 12-month post-injury. Outcomes were psychological distress (posttraumatic stress (PTS) and depressive symptoms) and health-related functioning (HrF) (quality of life measured by EQ-5D-3L and disability by WHODAS) over 12-months post-injury. Covariates included individual stress vulnerability (preinjury, injury-related factors).

Results

Compared with non-compensation participants, compensation groups had higher stress vulnerability (more severe injuries and negative reactions) and poorer baseline outcomes (psychological health and HrF). After adjustment, we found an effect of compensation on HrF [β-0.09 (−0.11 to −0.07), p < 0.001] and PTS [β = 0.36 (0.16 to 0.56), p = 0.0003], but not on depression [β = −0.07 (−0.42 to 0.28), p = 0.7]. Both groups improved over time. Vulnerable individuals (β = 1.23, p < 0.001) and those with poorer baseline outcomes (PTS: β = 0.06, p = 0.002; HrF: β = −1.07, p < 0.001) were more likely to lodge a claim. In turn, higher stress vulnerability, poor baseline outcomes and claiming compensation were associated with long-term psychological distress and HrF. Nevertheless, concurrent HrF in the model fully accounted for the compensation effect on psychological distress (β = −0.14, p = 0.27), but not vice versa.

Conclusions

This study provides convincing evidence that seeking compensation is not necessarily harmful to psychological health. The person's stress vulnerability and injury-related disability emerge as major risk factors of long-term psychological distress, requiring a whole-systems approach to address the problem.

Keywords

compensationdepressiondisabilityhealth-related functioninginjurypost-traumatic stresspsychological health
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 1 , January 2022 , pp. 68 - 79
Check for updates
Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bickenbach, J. E., Chatterji, S., Badley, E. M., & Üstün, T. B. (1999). Models of disablement, universalism and the international classification of impairments, disabilities and handicaps. Social Science and Medicine, 48(9), 1173–1187.CrossRefGoogle ScholarPubMed
Bradbury, R. C., Golec, J. H., & Steen, P. M. (2001). Comparing uninsured and privately insured hospital patients: Admission severity, health outcomes and resource use. Health Services Management Research, 14(3), 203–210.CrossRefGoogle ScholarPubMed
Cameron, I. D., Rebbeck, T., Sindhusake, D., Rubin, G., Feyer, A.-M., Walsh, J., & Schofield, W. N. (2008). Legislative change is associated with improved health status in people with whiplash. Spine, 33(3), 250–254.CrossRefGoogle ScholarPubMed
Cassidy, J. D., Carroll, L. J., Cote, P., Lemstra, M., Berglund, A., & Nygren, Å. (2000). Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. New England Journal of Medicine, 342(16), 1179–1186.CrossRefGoogle ScholarPubMed
Collie, A. (2018). The mental health impacts of compensation claim assessment processes. Insurance Work and Health Group, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University.Google Scholar
Collie, A., Newnam, S., Keleher, H., Petersen, A., Kosny, A., Vogel, A. P., & Thompson, J. (2019). Recovery within injury compensation schemes: A system mapping study. Journal of Occupational Rehabilitation, 29(1), 52–63.CrossRefGoogle ScholarPubMed
Craig, A., Tran, Y., Guest, R., Gopinath, B., Jagnoor, J., Bryant, R. A., … Middleton, J. W. (2016). Psychological impact of injuries sustained in motor vehicle crashes: Systematic review and meta-analysis. BMJ Open, 6(9), e011993.CrossRefGoogle ScholarPubMed
Duckworth, M. P., & Iezzi, T. (2018). Motor vehicle collisions and their consequences – part II: Predictors of impairment and disability. Psychological Injury and Law, 11(3), 288–306.CrossRefGoogle Scholar
Elbers, N. A., Hulst, L., Cuijpers, P., Akkermans, A. J., & Bruinvels, D. J. (2013). Do compensation processes impair mental health? A meta-analysis. Injury, 44(5), 674–683.CrossRefGoogle ScholarPubMed
The EuroQol Group. (1990). EuroQol-a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.CrossRefGoogle Scholar
Gabbe, B. J., Cameron, P. A., Williamson, O. D., Edwards, E. R., Graves, S. E., & Richardson, M. D. (2007). The relationship between compensable status and long-term patient outcomes following orthopaedic trauma. Medical Journal of Australia, 187(1), 14–17.CrossRefGoogle ScholarPubMed
Giummarra, M. J., Baker, K. S., Ioannou, L., Gwini, S. M., Gibson, S. J., Arnold, C. A., … Cameron, P. (2017a). Associations between compensable injury, perceived fault and pain and disability 1 year after injury: A registry-based Australian cohort study. BMJ Open, 7(10), e017350.CrossRefGoogle Scholar
Giummarra, M. J., Cameron, P. A., Ponsford, J., Ioannou, L., Gibson, S. J., Jennings, P. A., & Georgiou-Karistianis, N. (2017b). Return to work after traumatic injury: Increased work-related disability in injured persons receiving financial compensation is mediated by perceived injustice. Journal of Occupational Rehabilitation, 27(2), 173–185.CrossRefGoogle Scholar
Giummarra, M., Ioannou, L., Gibson, S., Ponsford, J., Fielding, J., Cameron, P., … Georgiou-Karistianis, N. (2013). The relationship between compensation and recovery following a motor vehicle accident: A systematic review. ISCRR and Monash University.Google Scholar
Giummarra, M. J., Ioannou, L., Ponsford, J., Cameron, P. A., Jennings, P. A., Gibson, S. J., & Georgiou-Karistianis, N. (2016). Chronic pain following motor vehicle collision: A systematic review of outcomes associated with seeking or receiving compensation. The Clinical Journal of Pain, 32(9), 817–827.CrossRefGoogle ScholarPubMed
Gopinath, B., Jagnoor, J., Kifley, A., Nicholas, M., Blyth, F., Kenardy, J., … Cameron, I. D. (2019). Differential predictors of pain severity over 12 months following noncatastrophic injury sustained in a road traffic crash. The Journal of Pain, 20(6), 676–684.CrossRefGoogle Scholar
Grant, G. M., O'Donnell, M. L., Spittal, M. J., Creamer, M., & Studdert, D. M. (2014). Relationship between stressfulness of claiming for injury compensation and long-term recovery: A prospective cohort study. JAMA Psychiatry, 71(4), 446–453.CrossRefGoogle ScholarPubMed
Grant, G., & Studdert, D. M. (2009). Poisoned chalice-A critical analysis of the evidence linking personal injury compensation processes with adverse health outcomes. Melbourne University Law Review, 33, 865.Google Scholar
Guest, R., Tran, Y., Gopinath, B., Cameron, I. D., & Craig, A. (2017). Psychological distress following a motor vehicle crash: Evidence from a statewide retrospective study examining settlement times and costs of compensation claims. BMJ Open, 7(9), e017515.CrossRefGoogle ScholarPubMed
Guest, R., Tran, Y., Gopinath, B., Cameron, I. D., & Craig, A. (2018). Prevalence and psychometric screening for the detection of major depressive disorder and post-traumatic stress disorder in adults injured in a motor vehicle crash who are engaged in compensation. BMC Psychology, 6(1), 4.CrossRefGoogle Scholar
Hadler, N. M. (1996). If you have to prove you are ill, you can't get well: The object lesson of fibromyalgia. Spine (Phila Pa 1976) 21(20), 2397–2400.CrossRefGoogle ScholarPubMed
Harris, I., Mulford, J., Solomon, M., van Gelder, J. M., & Young, J. (2005). Association between compensation status and outcome after surgery: A meta-analysis. JAMA, 293(13), 1644–1652.CrossRefGoogle ScholarPubMed
Harris, P. A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., & Conde, J. G. (2009). Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381.CrossRefGoogle ScholarPubMed
Harris, I. A., Young, J. M., Jalaludin, B. B., & Solomon, M. J. (2008). The effect of compensation on general health in patients sustaining fractures in motor vehicle trauma. Journal of Orthopaedic Trauma, 22(4), 216–220.CrossRefGoogle ScholarPubMed
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.CrossRefGoogle Scholar
Jagnoor, J., Blyth, F., Gabbe, B., Derrett, S., Boufous, S., Dinh, M., … Joseph, T. (2014). Factors influencing social and health outcomes after motor vehicle crash injury: An inception cohort study protocol. BMC Public Health, 14(1), 199.CrossRefGoogle ScholarPubMed
Kenardy, J., Edmed, S. L., Shourie, S., Warren, J., Crothers, A., Brown, E. A., … Heron-Delaney, M. (2018). Changing patterns in the prevalence of posttraumatic stress disorder, major depressive episode and generalized anxiety disorder over 24 months following a road traffic crash: Results from the UQ SuPPORT study. Journal of Affective Disorders, 236, 172–179.CrossRefGoogle ScholarPubMed
Kenardy, J., Heron-Delaney, M., Warren, J., & Brown, E. A. (2015). Effect of mental health on long-term disability after a road traffic crash: Results from the UQ SuPPORT study. Archives of Physical Medicine and Rehabilitation, 96(3), 410–417.CrossRefGoogle ScholarPubMed
Lippel, K. (2007). Workers describe the effect of the workers’ compensation process on their health: A Quebec study. International Journal of Law and Psychiatry, 30(4–5), 427–443.CrossRefGoogle ScholarPubMed
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343.CrossRefGoogle ScholarPubMed
MacEachen, E., Kosny, A., Ferrier, S., & Chambers, L. (2010). The “toxic dose” of system problems: Why some injured workers don't return to work as expected. Journal of Occupational Rehabilitation, 20(3), 349–366.CrossRefGoogle ScholarPubMed
Mayou, R., & Bryant, B. (2002). Outcome 3 years after a road traffic accident. Psychological Medicine, 32(4), 671–675.CrossRefGoogle ScholarPubMed
McDougall, J., Wright, V., & Rosenbaum, P. (2010). The ICF model of functioning and disability: Incorporating quality of life and human development. Developmental Neurorehabilitation, 13(3), 204–211.CrossRefGoogle ScholarPubMed
Meadows, D. H. (2008). Thinking in systems: A primer. London, UK: Chelsea Green Publishing.Google Scholar
Murgatroyd, D. F., Casey, P. P., Cameron, I. D., & Harris, I. A. (2015b). The effect of financial compensation on health outcomes following musculoskeletal injury: Systematic review. PloS One, 10(2), e0117597.CrossRefGoogle Scholar
Murgatroyd, D. F., Harris, I. A., Tran, Y., & Cameron, I. D. (2016). The association between seeking financial compensation and injury recovery following motor vehicle related orthopaedic trauma. BMC Musculoskeletal Disorders, 17(1), 282.CrossRefGoogle ScholarPubMed
Murgatroyd, D., Lockwood, K., Garth, B., & Cameron, I. D. (2015a). The perceptions and experiences of people injured in motor vehicle crashes in a compensation scheme setting: A qualitative study. BMC Public Health, 15(1), 423.CrossRefGoogle Scholar
Muthén, B., & Muthén, B. O. (2017). Statistical analysis with latent variables. Mplus user's guide. Eighth Edition. Los Angeles: Muthén & Muthén.Google Scholar
O'Donnell, M. L., Creamer, M. C., McFarlane, A. C., Silove, D., & Bryant, R. A. (2010). Does access to compensation have an impact on recovery outcomes after injury. Medical Journal of Australia, 192(6), 328–333.CrossRefGoogle ScholarPubMed
O'Donnell, M. L., Grant, G., Alkemade, N., Spittal, M., Creamer, M., Silove, D., … Studdert, D. M. (2015). Compensation seeking and disability after injury: The role of compensation-related stress and mental health. The Journal of Clinical Psychiatry, 76(8), e1000–e1005.CrossRefGoogle ScholarPubMed
Reid, M. W., Cooper, D. B., Lu, L. H., Iverson, G. L., & Kennedy, J. E. (2018). Adversity and resilience are associated with outcome after mild traumatic brain injury in military service members. Journal of Neurotrauma, 35(10), 1146–1155.CrossRefGoogle ScholarPubMed
Rochon, P. A., Gurwitz, J. H., Sykora, K., Mamdani, M., Streiner, D. L., Garfinkel, S., … Geoffrey, M. (2005). Reader's guide to critical appraisal of cohort studies: 1. Role and design. BMJ, 330(7496), 895–897.CrossRefGoogle ScholarPubMed
Salvador-Carulla, L., & Garcia-Gutierrez, C. (2011). The WHO construct of health-related functioning (HrF) and its implications for health policy. Paper presented at the BMC Public Health.CrossRefGoogle Scholar
Samoborec, S., Ayton, D., Ruseckaite, R., Winbolt, G., & Evans, S. M. (2019). System complexities affecting recovery after a minor transport-related injury: The need for a person-centred approach. Journal of Rehabilitation Medicine, 51(2), 120–126. doi: 10.2340/16501977-2500.CrossRefGoogle ScholarPubMed
Schaafsma, F. G., Middleton, J., De Wolf, A., Tate, R., & Cameron, I. D. (2013). The association of compensation and long-term health status for people with severe traumatic injuries. Journal of Rehabilitation Medicine, 45(5), 446–451.CrossRefGoogle ScholarPubMed
Spearing, N. M., & Connelly, L. B. (2011). Is compensation “bad for health”? A systematic meta-review. Injury, 42(1), 15–24.CrossRefGoogle ScholarPubMed
Spearing, N. M., Connelly, L. B., Gargett, S., & Sterling, M. (2012a). Does injury compensation lead to worse health after whiplash? A systematic review. Pain, 153(6), 1274–1282.CrossRefGoogle Scholar
Spearing, N. M., Connelly, L. B., Nghiem, H. S., & Pobereskin, L. (2012b). Research on injury compensation and health outcomes: Ignoring the problem of reverse causality led to a biased conclusion. Journal of Clinical Epidemiology, 65(11), 1219–1226.CrossRefGoogle Scholar
Sullivan, M. J., Bishop, S. R., & Pivik, J. (1995). The pain catastrophizing scale: Development and validation. Psychological Assessment, 7(4), 524.CrossRefGoogle Scholar
Thompson, J. (2014). Attributions of responsibility for motor vehicle accidents and post-injury outcomes.CrossRefGoogle Scholar
Thompson, J., Elbers, N., Cameron, I., Craig, A., & Guest, R. (2018). Optimising the health of people in road injury compensation processes: what is the role of regulators and insurers? In A. Craig & R. Guest (Eds), Adversity after the Crash: The Physical, Psychological and Social Burden of Motor Vehicle Accidents. New York, NY: Nova Science.Google Scholar
Twiddy, H., Brown, R. J., & Waheed, H. (2018). The context of litigation in evaluating physical and psychological outcomes from pain management programmes. British Journal of Pain, 13(2), 99–105.CrossRefGoogle ScholarPubMed
Üstün, T. B., Kostanjsek, N., Chatterji, S., & Rehm, J. (2010). Measuring health and disability: Manual for WHO disability assessment schedule WHODAS 2.0. Geneva: WHO Publishing.Google Scholar
Varker, T., Creamer, M., Khatri, J., Fredrickson, J., & O’Donnell, M. L. (2018). Mental health impacts of compensation claims assessment processes on claimants and their families: Final report. Phoenix Australia – Centre for Posttraumatic Mental Health.Google Scholar
Weiss, D., & Marmar, C. (1997). The Impact of Event Scale-revised. Assessing psychological trauma and PTSD. New York, Guilford, 399–411.Google Scholar
World Health Organization. (2001). International classification of functioning, disability and health: ICF. Geneva: WHO Publishing.Google Scholar
World Health Organization. (2008). The global burden of disease: 2004 update. Geneva: WHO Publishing. https://apps.who.int/iris/handle/10665/43942Google Scholar
Supplementary material: File

Pozzato et al. supplementary material

Pozzato et al. supplementary material

Download Pozzato et al. supplementary material(File)
File 32.3 KB