The present paper aims to elucidate under what conditions victims of injustice who seek revenge feel satisfied and perceive that everybody got what he or she deserved. Two hypotheses are discussed: The comparative suffering hypothesis states that seeing the offender suffer from fate is sufficient for evoking satisfaction and perceptions of deservingness among victims. The understanding hypothesis states that revenge can only be satisfactory when the offender understands it as a response to his or her prior behavior. These hypotheses were tested in three experimental studies. The comparative suffering hypothesis received only weak support. The understanding hypothesis, on the other hand, received much stronger support: When the offender understood revenge as punishment, revenge led to satisfaction and deservingness among victims. These findings are discussed with regard to the question why people take revenge.

BackgroundNumerous studies document the influence of psychosocial variables on the course of coronary heart disease. This study examines the influence of personality traits (trait anger, cynicism) and aspects of the physician-patient relationship (promoting patient participation by the physician, active communication behavior of the patient, trust in the physician) on the health related quality of life (HRQOL) of cardiac patients after rehabilitation.MethodsN = 331 patients with chronic ischemic heart disease were surveyed using questionnaires at two time points (beginning and end of 3-weeks inpatient rehabilitation). In addition, characteristics of the disease and cardiac risk factors were provided by the physician. HRQOL was measured using a total of six scales and three instruments: SF-12, MacNew questionnaire, and SAQ. Hierarchical regression analyses were carried out to predict HRQOL after rehabilitation, in which the baseline values of HRQOL, sociodemographic variables, characteristics of the disease and risk factors, personality traits, and finally the aspects of the physician-patient relationship were included stepwise. As a number of variables were used for the regression models, multiple imputation was conducted.ResultsThe baseline values explain most of the variance (42%-60%). After controlling the baseline values, the sociodemographic variables explain up to 5% incremental variance of HRQOL, with income being the most important predictor. The characteristics of the disease and cardiac risk factors explain between 0.4% and 3.8% incremental variance, however, variance increase is often not significant. The personality traits added in the fourth step explain up to 2% additional variance; trait anger is a significant predictor of HRQOL in three of the six scales. The features of the physician-patient relationship included in the last step lead to a significant increase in explained variance (between 1.3% and 3.9%) for all six scales. In particular, the physician's promotion of patient participation has a significant influence. The overall explanation of variance for HRQOL is between 50% and 64%.ConclusionsLow income, a high level of trait anger, and low patient participation are significant risk factors, even if a number of potential confounders are adjusted. Research is needed that shows which causal pathway low income functions on and what therapies in rehabilitation can mitigate the disadvantage of persons with a high level of trait anger. The providers should implement measures to actively integrate rehabilitation patients in treatment (e.g. encourage them to ask questions).

The health dimensions examined are assessed quite differently by the patients. The most significant factor of influence is the HRQOL. In the subgroup of patients with a higher level of education, the predictive strength of the variables examined is considerably higher in comparison with the total sample. Since the health valuations can be predicted to a limited extent only using other data arising during routine care, it is necessary to implement special methods for compiling health valuations.

With respect to understandability and acceptance, VAS questions appear to be better suited for reflecting patient preferences than WTP questions. The rating scale for assessing the personally estimated importance was understandable, but had poor distribution properties and was considered by patients to be superfluous.