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

Abstract

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 (χ2 = 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 (χ2 = 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. © Society of Occupational Medicine 2004; all rights reserved.