The impact of perceived injustice on pain and psychological outcomes after traumatic injury: a longitudinal analysis

Author:

Trost Zina1,Sturgeon John2,Agtarap Stephanie3,McMinn Kenleigh4,McShan Evan5,Boals Adriel6,Arewasikporn Anne2,Foreman Michael4,Warren Ann Marie4

Affiliation:

1. Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States

2. Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States

3. Craig Hospital, Denver, CO, United States

4. Division of Trauma, Baylor University of Medical Center, Dallas, TX, United States

5. Baylor Scott & White Institute for Rehabilitation Dallas, TX, United States,

6. Department of Psychology, University of North Texas, Denton, TX, United States

Abstract

Abstract Individuals' appraisals regarding the injustice of their pain or physical injury have emerged as a significant risk factor for worse physical and psychological outcomes. Injustice appraisals are defined by perceptions of external blame for pain or injury and viewing pain or injury as a source of irreparable loss. To date, research on the impact of injustice appraisal has been primarily cross sectional, and existing longitudinal studies have examined injustice appraisals at only 2 time points in the context of rehabilitation treatment. This study examined the trajectory of injustice appraisals in 171 patients admitted for traumatic injury at admission, as well as 3, 6, and 12 months after discharge and examined injustice appraisals as a potential moderator of recovery after injury. Findings can be summarized as follows: First, injustice perception was largely stable in the 12 months after hospital discharge. Second, elevated injustice perception was associated with decreased recovery in pain intensity and depressive symptomatology over the study period but did not moderate changes in pain catastrophizing or posttraumatic stress symptomatology over time. This study is the first naturalistic prospective analysis of injustice appraisal following trauma admission within the American healthcare system. Findings indicate that injustice appraisals do not naturally decrease in the aftermath of traumatic injury and may be a risk factor for poorer physical and psychological recovery. Future research should examine additional sociodemographic and psychosocial factors that may contribute to elevated injustice appraisal, as well as ways of addressing the potential deleterious impact of injustice appraisals in treatment settings.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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