This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Individuals often develop chronic problems after traumatic events. Previous studies have shown that after minor motor vehicle collision (MVC), up to 1/3 of patients will develop psychological sequelae, including posttraumatic stress disorder, depression, and anxiety disorders. In addition, 10-30% of patients develop chronic regional pain (neck or back pain). Despite their common occurrence, the risk factors and processes of disease development for these disorders remain poorly understood. The proposed study seeks to gain important new understanding in these areas, through a comprehensive examination of patient outcomes after minor MVC trauma. 600 women e18 years of age or older will be recruited from 2 local emergency departments. Patients who consent to the ED study will undergo a 30-45 minute ED assessment of crash-related, psychosocial, and biological factors, and complete mail/telephone follow-up at 1 and 6 months. Those who decline participation will be asked if they would be willing to receive 1 follow-up phone call at 6 months to see how they are doing. Patients who complete the ED assessment protocol will be asked if they would be interested in receiving information regarding a separate, related follow-up study conducted in an outpatient clinic. Consenting patients will return to the research clinic 3-7 days after the MVC, and will have a more detailed evaluation, including a more in-depth evaluation of psychosocial and biological factors, and functional MRI assessment of pain and psychological processing. Patients who are symptomatic will continue to return to the outpatient clinic for further evaluations, at 1 month, 3 months, and 6 months. Patients who initially come to the research clinic, but subsequently recover, will complete follow-up at 1 month and/or 6 months via mail/telephone. The wealth of information gained from this study will be used to identify high risk patients, understand mechanisms of disease, and develop secondary pharmacologic and/or behavioral interventions to prevent chronic pain and psychological sequelae after traumatic events.
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