Epidemiology of whiplash: an international dilemma

In countries with a very low or non-existent prevalence of late whiplash syndrome, accident victims do not routinely hear reports of acute whiplash injury leading to chronic symptoms or disability. They do not witness such behaviour in others, and do not thereby have any expectation of such possibilities. They do not engage in a process that encourages hypervigilance for and attention to symptoms, thus eliminating many factors that promote symptom amplification. They also do not engage in a process that engenders anxiety, frustration, and resentment (that is, battling with insurance companies and proving that your pain is real). They do not change their activity in response to what they, after all, view as a minor injury. They will not amplify pre-accident symptoms, or symptoms or amplify daily life's aches and pains. They will not attribute all these different sources of symptoms to chronic damage they believe the accident caused. There is no cultural information to encourage this chronic pain behaviour being seen in other cultures.