Skip to main content
SpringerLink
Log in

The Role of Perceived Injustice in the Experience of Chronic Pain and Disability: Scale Development and Validation

  • Published:
Journal of Occupational Rehabilitation Aims and scope Submit manuscript

Abstract

Introduction The primary objective of this research was to evaluate the psychometric properties of a questionnaire designed to assess perceive injustice associated with injury. Methods In Study 1, the 12-item Injustice Experience Questionnaire (IEQ) was administered to 226 individuals with musculoskeletal conditions. A subsample of 85 individuals were interviewed 1-year later about their ongoing symptoms and return to work status. In Study 2, the IEQ and other pain-related measures were administered on two separate occasions to 70 pain patients participating in a functional restoration rehabilitation program. Results—Study 1 Principal components analysis yielded a two-component solution with eigenvalues greater 1. Item content of the two components reflected elements of blame and irreparability of loss. In cross sectional analyses, the IEQ was significantly correlated with measures of catastrophic thinking, r = .75, P < .01, fear of movement/re-injury, r = .58, P < .01, depression, r = .66, P < .01, and pain severity, r = .54, P < .01. Cross-sectional regression analyses revealed that the IEQ, β = .44, P < .01, and the PCS, β = .18, P < .05, each contributed significant unique variance to the prediction of pain severity. The IEQ prospectively predicted return to work status, OR = .75, 95% CI = .58–.99, but not pain severity. Results—Study 2 Analyses supported the test re-test reliability of the IEQ, r = .90, P < .01. Treatment-related changes in the IEQ were significantly correlated with an objective index of improved physical function, r = .51, P < .01. Conclusions The findings of these two studies support the construct validity of the IEQ and suggest that this measure might be a useful complement to psychosocial assessment of individuals with persistent pain conditions. Discussion addresses the processes through which perceived injustice might impact on disability and rehabilitation outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Keogh JP, Nuwayhid I, Gordon JL, Gucer PW. The impact of occupational injury on the injured worker and family. Am J Ind Med. 2000;38:498–506. doi:10.1002/1097-0274(200011)38:5<498::AID-AJIM2>3.0.CO;2-I.

    Article  PubMed  CAS  Google Scholar 

  2. Chapman CR, Gavrin J. Suffering: the contributions of persistent pain. Lancet. 1999;353:2233–37. doi:10.1016/S0140-6736(99)01308-2.

    Article  PubMed  CAS  Google Scholar 

  3. Berglund A, Bodin L, Jensen I, Wiklund A, Alfredsson L. The influence of prognostic factors on neck pain intensity, disability, anxiety and depression over a 2-year period in subjects with acute whiplash injury. Pain. 2006;125(3):244–56. doi:10.1016/j.pain.2006.05.026.

    Article  PubMed  Google Scholar 

  4. Nederhand MJ, Hermens HJ, Ijzerman MJ, Turk DC, Zilvold G. Chronic pain disabillity due to an acute whiplash injury. Pain. 2003;102:63–71. doi:10.1016/s0304-3959(02)00340-8.

    Article  PubMed  Google Scholar 

  5. Sullivan MJ, Sullivan ME, Adams H. Stage of chronicity and cognitive correlates of pain-related disability. Cogn Behav Ther. 2002;31:111–8. doi:10.1080/165060702320337988.

    Article  Google Scholar 

  6. Lyons R, Sullivan M. Curbing loss in illness and disability. In: Harvey J, editor. Perspectives on personal and interpersonal loss. New York: Taylor & Francis; 1998.

    Google Scholar 

  7. Harris S, Morley S, Barton SB. Role loss and emotional adjustment in chronic pain. Pain. 2003;105:363–70. doi:10.1016/S0304-3959(03)00251-3.

    Article  PubMed  Google Scholar 

  8. Suissa S. Risk factors for poor prognosis after whiplash injury. Pain Res Manag. 2003;8:69–75.

    PubMed  Google Scholar 

  9. Watson PJ, Booker CK, Moores L, Main C. Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004;8:359–69. doi:10.1016/j.ejpain.2003.11.003.

    Article  PubMed  Google Scholar 

  10. Evans TH, Mayer TG, Gatchel RJ. Recurrent disabling work-related spinal disorders after prior injury claims in a chronic low back pain population. Spine J. 2001;1:183–9. doi:10.1016/S1529-9430(01)00079-1.

    Article  PubMed  CAS  Google Scholar 

  11. Miller DT. Disrespect and the experience of injustice. Annu Rev Psychol. 2001;52:527–53. doi:10.1146/annurev.psych.52.1.527.

    Article  PubMed  CAS  Google Scholar 

  12. Hamilton VL, Hagiwara S. Roles, responsibility and accounts across cultures. Int J Psychol. 1992;27:157–79. doi:10.1080/00207599208246873.

    Article  Google Scholar 

  13. Lind EA, Tyler TR. The social psychology of procedural justice. New York: Plenum; 1988.

    Google Scholar 

  14. Mohiyeddini C, Schmitt MJ. Sensitivity to befallen injustice and reactions to unfair treatment in a laboratory situation. Soc Justice Res. 1997;10:333–53. doi:10.1007/BF02683307.

    Article  Google Scholar 

  15. Fetchenhauer D, Huang X. Justice sensitivity and distributive decisions in experimental games. Personality Individ Differ. 2004;36:1015–29. doi:10.1016/S0191-8869(03)00197-1.

    Article  Google Scholar 

  16. Hafer CL, Begue L. Experimental research on Just-World Theory: problems, developments and future challenges. Psychol Bull. 2005;131:128–67. doi:10.1037/0033-2909.131.1.128.

    Article  PubMed  Google Scholar 

  17. Strang H, Braithwaite J. Restorative justice: from philosophy to practice. Dartmouth, CT: Aldershot Press; 2000.

    Google Scholar 

  18. Blyth FM, March LM, Nicholas MK, Cousins MJ. Chronic pain, work performance and litigation. Pain. 2003;103:41–7. doi:10.1016/S0304-3959(02)00380-9.

    Article  PubMed  Google Scholar 

  19. Ferrari R, Russell A. Why blame is factor in recovery from whiplash injury. Med Hyp. 2001;56:372–75. doi:10.1054/mehy.2000.1215.

    Article  CAS  Google Scholar 

  20. Gun RT, Osti OL. Risk factors for prolonged disability after whiplash injury: a prospective study. Spine. 2005;30:386–91. doi:10.1097/01.brs.0000153399.24457.ee.

    Article  PubMed  Google Scholar 

  21. Turk DC, Okifuji A. Perception of traumatic onset, compensation status, and physical findings: impact on pain severity, emotional distress, and disability in chronic pain patients. J Behav Med. 1996;19(5):435–53. doi:10.1007/BF01857677.

    Article  PubMed  CAS  Google Scholar 

  22. Mikula G, Scherer KR, Athenstaedt U. The role of injustice in the elicitation of differential emotional reactions. Pers Soc Psychol Bull. 1998;24:769–83. doi:10.1177/0146167298247009.

    Article  Google Scholar 

  23. Sullivan M, Bishop S, Pivik J. The pain catastrophizing scale: development and validation. Psychol Assess. 1995;7:524–32. doi:10.1037/1040-3590.7.4.524.

    Article  Google Scholar 

  24. Beugre CD. Reacting aggressively to injustice at work: a cognitive stage model. J Bus Psychol. 2006;20:291–301. doi:10.1007/s10869-005-8265-1.

    Article  Google Scholar 

  25. Sullivan MJ, Stanish WD. Psychologically based occupational rehabilitation: the Pain-Disability Prevention Program. Clin J Pain. 2003;19(2):97–104. doi:10.1097/00002508-200303000-00004.

    Article  PubMed  Google Scholar 

  26. Sullivan MJ, Stanish W, Waite H, Sullivan M, Tripp DA. Catastrophizing, pain, and disability in patients with soft-tissue injuries. Pain. 1998;77(3):253–60. doi:10.1016/S0304-3959(98)00097-9.

    Article  PubMed  CAS  Google Scholar 

  27. Kori S, Miller R, Todd D. Kinesiophobia: a new view of chronic pain behavior. Pain Manag. 1990;Jan/Feb:35–43.

  28. Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H. Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363–72. doi:10.1016/0304-3959(94)00279-N.

    Article  PubMed  CAS  Google Scholar 

  29. Crombez G, Vlaeyen JW, Heuts PH, Lysens R. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1–2):329–39. doi:10.1016/S0304-3959(98)00229-2.

    Article  PubMed  CAS  Google Scholar 

  30. Picavet HS, Vlaeyen JW, Schouten JS. Pain catastrophizing and kinesiophobia: predictors of chronic low back pain. Am J Epidemiol. 2002;156(11):1028–34. doi:10.1093/aje/kwf136.

    Article  PubMed  Google Scholar 

  31. Beck A, Steer R, Brown GK. Manual for the Beck Depression Inventory-II. San Antonio TX: Psychological Corporation; 1996.

    Google Scholar 

  32. Vowles KE, Gross RT, Sorrell JT. Predicting work status following interdisciplinary treatment for chronic pain. Eur J Pain. 2004;8(4):351–58. doi:10.1016/j.ejpain.2003.10.009.

    Article  PubMed  Google Scholar 

  33. Poole H, Bramwell R, Murphy P. Factor structure of the Beck Depression Inventory-II in patients with chronic pain. Clin J Pain. 2006;22(9):790–98. doi:10.1097/01.ajp.0000210930.20322.93.

    Article  PubMed  Google Scholar 

  34. Pollard CA. Preliminary validity study of the pain disability index. Percept Mot Skills. 1984;59(3):974.

    PubMed  CAS  Google Scholar 

  35. Tait RC, Chibnall JT, Krause S. The Pain Disability Index: psychometric properties. Pain. 1990;40(2):171–82. doi:10.1016/0304-3959(90)90068-O.

    Article  PubMed  CAS  Google Scholar 

  36. Tait RC, Pollard CA, Margolis RB, Duckro PN, Krause SJ. The Pain Disability Index: psychometric and validity data. Arch Phys Med Rehabil. 1987;68(7):438–41.

    PubMed  CAS  Google Scholar 

  37. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975;1:277–99. doi:10.1016/0304-3959(75)90044-5.

    Article  PubMed  CAS  Google Scholar 

  38. Turk DC, Rudy T, Salovey P. The McGill Pain Questionnaire: confirming the factor analysis and examining appropriate uses. Pain. 1985;21:385–97. doi:10.1016/0304-3959(85)90167-8.

    Article  PubMed  CAS  Google Scholar 

  39. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334. doi:10.1007/BF02310555.

    Article  Google Scholar 

  40. Sullivan M, Adams A, Rhodenizer T, Stanish W. A psychosocial risk factor targeted intervention for the prevention of chronic pain and disability following whiplash injury. Phys Ther. 2006;86:8–18.

    PubMed  Google Scholar 

  41. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17(1):52–64. doi:10.1097/00002508-200103000-00008.

    Article  PubMed  CAS  Google Scholar 

  42. Simmonds M, Olson S, Novy D, Jones S, Hussein T, Lee C, et al. Physical performance tests: are they psychometrically sound and clinically useful for patients with low back pain? Spine.. 1999;23:2412–21. doi:10.1097/00007632-199811150-00011.

    Article  Google Scholar 

  43. Simmonds MN, Soval R. The influence of pain and fatigue on physical performance and health status in ambulatory patients with HIV. Clin J Pain. 2005;21(3):200–6. doi:10.1097/00002508-200505000-00002.

    Article  PubMed  Google Scholar 

  44. Annes J. An introduction to Plato’s republic. Oxford, UK: Oxford University Press; 1982.

    Google Scholar 

  45. Marenbon J. Early medieval philosophy. Oxford, UK: Oxford University Press; 1997.

    Google Scholar 

  46. Hart HLA. Punishment and responsibility: essays in the philosophy of law. Oxford, UK: Oxford University Press; 1995.

    Google Scholar 

  47. Shavell S. The fundamental divergence between the private and the social motive to use the legal system. J Legal Stud. 1997;26:575–612. doi:10.1086/468008.

    Article  Google Scholar 

  48. DeGood DE, Kiernan B. Perception of fault in patients with chronic pain. Pain. 1996;64:153–9. doi:10.1016/0304-3959(95)00090-9.

    Article  PubMed  CAS  Google Scholar 

  49. Aceves-Avila FJ, Ferrari R, Ramos-Remus C. New insights into culture driven disorders. Best Pract Res Clin Rheumatol. 2004;18:155–71. doi:10.1016/j.berh.2004.02.004.

    Article  PubMed  Google Scholar 

  50. Bigos SJ, Battie MC. Acute care to prevent back disability. Clin Orthop. 1987;221:212–30.

    Google Scholar 

  51. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000;85(3):317–32. doi:10.1016/S0304-3959(99)00242-0.

    Article  PubMed  CAS  Google Scholar 

  52. Sullivan MJL, Rouse D, Bishop SR, Johnston S. Thought suppression, catastrophizing and pain. Cognit Ther Res. 1997;21:555–68. doi:10.1023/A:1021809519002.

    Article  Google Scholar 

  53. Van Damme S, Crombez G, Eccleston C. Disengagement from pain: the role of catastrophic thinking about pain. Pain. 2004;107(1–2):70–6. doi:10.1016/j.pain.2003.09.023.

    PubMed  Google Scholar 

  54. Aquino K, Tripp TM, Bies RJ. How employees respond to personal offense: the effects of blame attribution, victim status, and offender status on revenge and reconciliation in the workplace. J Appl Psychol. 2001;86:52–9. doi:10.1037/0021-9010.86.1.52.

    Article  PubMed  CAS  Google Scholar 

  55. Ferguson TJ, Rule BG. An attributional perspective on anger and aggression. In: Green RG, Donnerstein E, editors. Aggression: theoretical and empirical perspectives. New York: Acedemic Press; 1983. p. 41–74.

  56. Aquino K, Douglas S, Martinko MJ. Overt anger in response to victimization: attributional style and organizational norms as moderators. J Occup Health Psychol. 2004;9:152–64. doi:10.1037/1076-8998.9.2.152.

    Article  PubMed  Google Scholar 

  57. Anderson CA, Bushman BJ. Human aggression. Annu Rev Psychol. 2002;53:27–51. doi:10.1146/annurev.psych.53.100901.135231.

    Article  PubMed  Google Scholar 

  58. Clayton SD. The experince of injustice: some characteristics and correlates. Soc Justice Res. 2005;5:71–91. doi:10.1007/BF01048378.

    Article  Google Scholar 

  59. Arrmstrong-Stassen M. The effect of gender and organizational level on how survivors appraise and cope with organizational downsizing. J Appl Behav Sci. 1998;34:125–42. doi:10.1177/0021886398342001.

    Article  Google Scholar 

  60. Berkowitz L. Pain and aggression: some findings and implications. Motiv Emot. 1993;17:277–93. doi:10.1007/BF00992223.

    Article  Google Scholar 

  61. Kerns RD, Rosenberg R, Jacob MC. Anger expression and chronic pain. J Behav Med. 1994;17(1):57–67. doi:10.1007/BF01856882.

    Article  PubMed  CAS  Google Scholar 

  62. Burns JW, Bruehl S. Anger management style, opioid analgesic use, and chronic pain severity: a test of the opioid-deficit hypothesis. J Behav Med. 2005;28(6):555–63. doi:10.1007/s10865-005-9020-9.

    Article  PubMed  Google Scholar 

  63. Bruehl S, Chung OY, Burns JW, Biridepalli S. The association between anger expression and chronic pain intensity: evidence for partial mediation by endogenous opioid dysfunction. Pain. 2003;106(3):317–24. doi:10.1016/S0304-3959(03)00319-1.

    Article  PubMed  CAS  Google Scholar 

  64. Orth U, Montada L, Maercker A. Feelings of revenge, retaliation motive, and post-traumatic stress reactions in crime victims. J Interpers Violence. 2006;21:229–43. doi:10.1177/0886260505282286.

    Article  PubMed  Google Scholar 

  65. Bruehl S, Chung OY, Burns JW. Differential effects of expressive anger regulation on chronic pain intensity in CRPS and non-CRPS limb pain patients. Pain. 2003;104(3):647–54. doi:10.1016/S0304-3959(03)00135-0.

    Article  PubMed  Google Scholar 

  66. McCracken LM, Eccleston C. Coping or acceptance: what to do about chronic pain? Pain. 2003;105:197–204. doi:10.1016/S0304-3959(03)00202-1.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

The authors thank Jesse Bouvier for his assistance in data entry. This work was supported by a grant from the Canadian Institutes of Health Research.

Author information

Authors and Affiliations

  1. Department of Psychology, McGill University, 1205 Docteur Penfield Avenue, Montreal, QC, Canada, H3A 1B1

    Michael J. L. Sullivan

  2. Faculty of Medicine, McGill University Health Centre, Montreal, QC, Canada

    Heather Adams

  3. Fit for Work Inc., St. Johns, NL, Canada

    Sharon Horan

  4. Fit for Work Inc., St. Johns, NL, Canada

    Denise Maher

  5. Eastern Rehabilitation Inc., CBI Health, Halifax, NS, Canada

    Dan Boland

  6. LifeMark Health Center, Dartmouth, NS, Canada

    Richard Gross

Authors
  1. Michael J. L. Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Heather Adams
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sharon Horan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Denise Maher
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dan Boland
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Richard Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael J. L. Sullivan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sullivan, M.J.L., Adams, H., Horan, S. et al. The Role of Perceived Injustice in the Experience of Chronic Pain and Disability: Scale Development and Validation. J Occup Rehabil 18, 249–261 (2008). https://doi.org/10.1007/s10926-008-9140-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10926-008-9140-5

Keywords

Search

Navigation