Early Evaluation of Psychological Factors after Traumatic Injury: Insights into Injury Distress, Pain Anxiety, Acceptance, Valued Activity, and Self-Efficacy.

This study evaluated the unique incremental predictive value of brief psychological assessments on pain intensity, pain interference, and physical function after musculoskeletal injury. Participants (N=135) completed baseline assessments during hospitalization following a traumatic injury and follow-up data three months later. Predictive assessments were depression, anxiety, traumatic injury distress and pain anxiety, while concurrent assessments included pain acceptance, valued activity, and pain self-efficacy. Regression analyses determined the added explanatory value (ΔR²) of psychological variables beyond pain intensity and medical/injury factors. Follow-up pain intensity, pain interference and physical function were predicted by traumatic injury distress (ΔR²=0.08, P<0.001; ΔR²=0.16, P<0.001; ΔR2=0.05, P=0.003; respectively), and pain anxiety (ΔR²=0.04, P=0.005; ΔR²=0.06, P<0.001; ΔR2=0.04, P=0.006). Pain acceptance was associated with pain interference at three months (ΔR²=0.03, P=0.036). Both pain intensity and interference were associated with valued activity (ΔR²=0.03, P=0.013; ΔR²=0.02, P=0.035) and pain self-efficacy (ΔR²=0.06, P<0.001; ΔR²=0.06, P<0.001). Greater physical function at follow up was associated with less traumatic injury distress (ΔR2=0.03, P=0.024), and greater pain self-efficacy (ΔR2=0.05, P=0.002). Psychological assessments conducted early in recovery offer additional predictive value beyond medical and injury-related factors. These findings underscore the importance of comprehensive psychological evaluations following traumatic injury.