Why soft-tissue damage can be misdiagnosed: Many of the symptoms from a whiplash injury result from soft-tissue damage. The problem is that soft-tissue damage is not revealed on radiological testing. Four most common psychological symptoms According to the research, there are four types of psychological symptoms related to whiplash: Anxiety; Depression; Anger; and Substance abuse. These psychological symptoms seem to come about from... 1. A patient who has been in a whiplash accident, who has experienced soft-tissue damage 2. Combined with the stress of the patient confronting insurance companies, worrying they won't be covered, compensated, etc. 3. Which exacerbates the pain symptoms 4. Resulting in chronic physical and psychological symptoms The most definitive research points to the psychological stress that is caused when someone is experiencing whiplash pain... but has not been treated for it. How chronic pain affects psychological symptoms It makes intuitive sense that a person who experiences chronic pain, is going to experience some psychological effects from that. A study made by Mayou et al found that "the severity of psychological symptoms in whiplash patients were related to the number of medical complications. Radanov et al found that patients which chronic whiplash pain who experienced frequent migraine headaches had increased psychological symptoms. In summary, since soft-tissue often goes misdiagnosed, there can be significant psychological stress... related to the pain and the stress in resolving the financial aspects to get treated. The complex issue is how does one measure and account for this psychological component. To date, the literature provides little in resolving these issues. On the issue of malingering... Malingering is the term used to describe a patient that is perceived to be exaggerating their condition because of the potential for financial gain. Malingering is the second most frequent controversy. The most common research cited in the legal literature about malingering comes from Miller. He suggests that much of a patients "psychoneurotic" symptoms miraculously ceased after receiving a financial settlement. What is interesting to note is that these statements by Miller do not arise from a controlled study. They came from a lecture series he gave and were based on anecdotal experiences. In actual fact, very few clinical studies have found malingering to be a significant factor in recovery. The question then becomes... Is it possible to fake whiplash? Wallis and Bogduk studied this question by asking a group of 40 students to fake a whiplash injury. The authors concluded that, "it is very difficult for an in genuine individual to fake a profile typical of a whiplash patient." In summary, the current literature leads many to believe that malingering is difficult to prove. In fact, to date there has been no conclusive studies to prove malingering. And if a person were to attempt to fake whiplash, it would be extremely difficult to do so if being evaluated by an experienced doctor. There is very little evidence that so-called "compensation neurosis" is real. So my friend, it seems the controversies will continue.