Perceived injustice in multiple sclerosis: An initial, exploratory study.

Abstract

Purpose/Objective: The current study represents an initial examination of condition-related perceived injustice (PI) in multiple sclerosis (MS) by examining (a) the structural validity and reliability of the Injustice Experience Questionnaire (IEQ) scores and (b) the associations between IEQ scores and scores from measures of anger, pain, depression, anxiety, fatigue, disability, health-related quality of life (HRQOL), physical activity, and sedentary behavior. Research Method/Design: Persons with MS were recruited through the distribution of letters to a random sample of 1,000 persons from the North American Research Committee on MS registry. Participants who completed the IEQ (N = 139) were included in this analysis. Results: Our results support the structural validity of the 2-factor model of Severity/Irreparability and Blame/Unfairness subscales with a Cronbach’s alpha of .917 for the overall scale, and values of .857 and .889 for the subscales, respectively. All measures were meaningfully correlated with IEQ scores. Pain (ρ = .466), fatigue (ρ = .430), disability (ρ = .416), walking impairment (ρ = .446), and physical HRQOL (ρ = .624) were strongly correlated with Severity/Irreparability. Anger; however, was strongly correlated with Blame/Unfairness (ρ = .437). Physical activity and sedentary behavior were similarly correlated with the 2 subscales; however, both moderate-to-vigorous (ρ = −.332) and light physical activity (ρ = −.275) were slightly more correlated with Severity/Irreparability. Conclusions/Implications: The IEQ is a reliable and valid measure of PI in MS. Physical manifestations of MS are primarily associated with PI, and negative associations were observed between physical activity and IEQ scores. Physical activity may increase self-efficacy and counteract cognitions of permanent disability and frustration concerning limitations that are associated with PI.

Perceived Injustice as a Determinant of the Severity of Post-traumatic Stress Symptoms Following Occupational Injury

“…The results of the present study are also consistent with previous research showing significant relations between perceptions of injustice and the severity of pain symptoms [ 18 , 67 – 69 ]. To date, the relation between perceived injustice and adverse pain outcomes has been demonstrated in individuals suffering from a wide range of painful conditions including whiplash injury [ 18 ], low back pain [ 25 ], catastrophic injury [ 70 ], fibromyalgia [ 71 ], sickle cell disease [ 72 ], osteoarthritis [ 73 ], rheumatoid arthritis [ 74 ], traumatic brain injury [ 75 ], and multiple sclerosis [ 76 ]. It has been suggested that perceptions of injustice might trigger a cascade of cognitive (i.e., rumination), emotional (i.e., anger), behavioural (i.e., pain behaviour) and physical (i.e., muscle tension) reactions that impede recovery of pain conditions [ 77 ].…”