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Type: Journal article
Title: Compensation seeking and disability after injury: the role of compensation-related stress and mental health
Author: O’Donnell, M.
Grant, G.
Alkemade, N.
Spittal, M.
Creamer, M.
Silove, D.
McFarlane, A.
Bryant, R.
Forbes, D.
Studdert, D.
Citation: The Journal of Clinical Psychiatry, 2015; 76(8):e1000-e1005
Publisher: Physicians Postgraduate Press
Issue Date: 2015
ISSN: 0160-6689
Statement of
Meaghan L. O’Donnell, Genevieve Grant, Nathan Alkemade, Matthew Spittal, Mark Creamer, Derrick Silove, Alexander McFarlane, Richard A. Bryant, David Forbes, and David M. Studdert
Abstract: Claiming for compensation after injury is associated with poor health outcomes. This study examined the degree to which compensation-related stress predicts long-term disability and the mental health factors that contribute to this relationship.In a longitudinal, multisite cohort study, 332 injury patients (who claimed for compensation) recruited from April 2004 to February 2006 were assessed during hospitalization and at 3 and 72 months after injury. Posttraumatic stress, depression, and anxiety symptoms (using the Mini-International Neuropsychiatric Interview) were assessed at 3 months; compensation-related stress and disability levels (using the World Health Organization Disability Assessment Schedule II) were assessed at 72 months.A significant direct relationship was found between levels of compensation-related stress and levels of long-term disability (β = 0.35, P < .001). Three-month posttraumatic stress symptoms had a significant relationship with compensation-related stress (β = 0.29, P < .001) as did 3-month depression symptoms (β = 0.39, P < .001), but 3-month anxiety symptoms did not. A significant indirect relationship was found for posttraumatic stress symptoms and disability via compensation stress (β = 0.099, P = .001) and for depression and disability via compensation stress (β = 0.136, P < .001).Stress associated with seeking compensation is significantly related to long-term disability. Posttraumatic stress and depression symptoms increase the perception of stress associated with the claims process, which in turn is related to higher levels of long-term disability. Early interventions targeting those at risk for compensation-related stress may decrease long-term costs for compensation schemes.
Keywords: Humans; Wounds and Injuries; Disability Evaluation; Longitudinal Studies; Depression; Stress, Psychological; Anxiety; Stress Disorders, Post-Traumatic; Compensation and Redress; Adult; Middle Aged; Disabled Persons; Female; Male
Rights: © Copyright 2015 Physicians Postgraduate Press, Inc.
RMID: 0030042169
DOI: 10.4088/JCP.14m09211
Grant ID:
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