Perfectionism and coping strategies as risk factors for the development of non-specific work-related upper limb disorders (WRULD).

BACKGROUND The incidence of non-specific work-related upper limb disorders (WRULD) is rising throughout western society. Literature and our own WRULD file (>1200 patients) revealed that both physical and psychosocial work-related factors are major causes of non-specific WRULD. It also appeared that non-specific WRULD was more likely to develop in patients with neurotic-perfectionist personalities. AIM To see if, alongside physical and psychosocial work-related factors, personality factors play an important role in developing non-specific WRULD. METHOD This was a case-control study with two control groups, comparing 45 computer workers with non-specific WRULD with 45 computer workers free from upper limb disorder (first control group) and 42 chronic pain patients (second control group). Main questionnaires administered were: the Utrecht Coping List (UCL), measuring coping-styles; the Multidimensional Perfectionism Scale (MPS), measuring neurotic perfectionism; and the Symptom Check List (SCL-90), measuring general psychological complaints (psychoneuroticism). The SCL-90 was added because of its known high correlation with neurotic perfectionism. RESULTS Logistic regression analysis revealed significant differences in SCL-90 scores (chi(2) = 17.2, P < 0.0001), thereby potentially negating the significance of the higher neurotic perfectionism in the non-specific WRULD group. A second control group of chronic pain patients, with prospective high score on the SCL-90, was added. Logistic regression showed that, after controlling for psychoneuroticism, non-specific WRULD patients had more neurotic perfectionist traits (chi(2) = 22.83, P < 0.0001). There were no significant differences in mean UCL scores (P > 0.05). CONCLUSION Alongside physical and psychosocial work-related factors, psychoneuroticism and neurotic perfectionism appear to be important risk factors for developing non-specific WRULD.

[1]  R. Radwin,et al.  Neuromuscular and psychological characteristics in subjects with work-related forearm pain. , 1999, American journal of physical medicine & rehabilitation.

[2]  A. Ellis.  Group rational-emotive and cognitive-behavioral therapy. , 1992, International journal of group psychotherapy.

[3]  R. Frost,et al.  The dimensions of perfectionism , 1990, Cognitive Therapy and Research.

[4]  W. Shaw,et al.  Clinical and workplace factors associated with a return to modified duty in work-related upper extremity disorders , 2003, Pain.

[5]  Arend W A Van Gemmert,et al.  Forearm EMG response activity during motor performance in individuals prone to increased stress reactivity. , 2002, American journal of industrial medicine.

[6]  J. Hardt,et al.  Cross‐validation of the SCL‐27: a short psychometric screening instrument for chronic pain patients , 2001, European journal of pain.

[7]  M.A.E. van Huygevoort,et al.  Error, stress and the role of neuromotor noise in space oriented behaviour , 2000, Biological Psychology.

[8]  J. Sluiter,et al.  Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. , 2001, Scandinavian journal of work, environment & health.

[9]  W S Shaw,et al.  Clinical Tools to Facilitate Workplace Accommodation After Treatment for an Upper Extremity Disorder , 2001, Assistive technology : the official journal of RESNA.

[10]  W. Shaw,et al.  Ergonomic and Psychosocial Factors Affect Daily Function in Workers’ Compensation Claimants With Persistent Upper Extremity Disorders , 2002, Journal of occupational and environmental medicine.

[11]  J. Harrington,et al.  Surveillance case definitions for work related upper limb pain syndromes. , 1998, Occupational and environmental medicine.

[12]  B. Koes,et al.  Repetitive strain injury , 1987, The Lancet.

[13]  D. Hamachek.  Psychodynamics of normal and neurotic perfectionism. , 1978 .

[14]  I. Most.  Psychosocial elements in the work environment of a large call center operation. , 1999, Occupational medicine.

[15]  Most Ig,et al.  Psychosocial elements in the work environment of a large call center operation. , 1999 .

[16]  G. P. van Galen,et al.  Patients suffering from nonspecific work-related upper extremity disorders exhibit insufficient movement strategies. , 2004, Acta psychologica.

[17]  S. G. van den Heuvel,et al.  Work-related neck and upper limb symptoms , 2006 .

[18]  R. Frost,et al.  Perfectionism and evaluative threat , 1990, Cognitive Therapy and Research.

[19]  A. Silman,et al.  Role of mechanical and psychosocial factors in the onset of forearm pain: prospective population based study , 2000, BMJ : British Medical Journal.