Skip to main content

Advertisement

SpringerLink
Log in

Reductions in Perceived Injustice Are Associated with Reductions in Posttraumatic Stress Symptoms Among Individuals Receiving Treatment for Whiplash Injury

  • Published:
Psychological Injury and Law Aims and scope Submit manuscript

Abstract

Research has accumulated to suggest that perceived injustice is a risk factor for poor recovery outcomes in individuals with whiplash injuries. The present study examined the relative contributions of treatment-related reductions in perceived injustice and pain severity, in the prediction of reductions in posttraumatic stress symptoms in individuals with whiplash injury. The study sample consisted of 146 individuals (66 women, 80 men) who sustained whiplash injuries in motor vehicle collisions and were enrolled in a multidisciplinary rehabilitation program designed to promote functional recovery following whiplash injury. Participants completed measures of pain severity, disability, posttraumatic stress symptoms, and perceived injustice prior to treatment and after treatment. Pearson correlations revealed that all study variables were significantly correlated. Regression analyses revealed that, at the time of enrollment in the intervention, perceived injustice accounted for a significant proportion of the variance in posttraumatic stress symptom severity, beyond the variance accounted for by pain severity. Paired sample t-tests revealed significant reductions in perceived injustice, pain severity, and posttraumatic stress symptom severity through the course of treatment. For individuals who scored above clinical threshold on a measure of posttraumatic stress symptoms at the time of enrollment in the intervention (N = 71), regression analyses revealed that reductions in perceived injustice accounted for a significant proportion of the variance in reduction of posttraumatic stress symptoms, beyond the variance accounted for by reduced pain severity. Clinical and theoretical implications of the present findings are discussed.

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

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.

  • Andersen, T. E., Brink, O., & Elklit, A. (2013). PTSD symptoms mediate the effect of attachment on pain and somatisation after whiplash injury. Clinical Practice and Epidemiology in Mental Health, 9, 75–83.

    Article  PubMed Central  PubMed  Google Scholar 

  • Andersen, T. E., Karstoft, K. I., Brink, O., & Elklit, A. (2016). Pain-catastrophizing and fear-avoidance beliefs as mediators between post-traumatic stress symptoms and pain following whiplash injury—A prospective cohort study. European Journal of Pain, 20(8), 1241–1252.

    Article  PubMed  Google Scholar 

  • Asmundson, G. J., Coons, M. J., Taylor, S., & Katz, J. (2002). PTSD and the experience of pain: Research and clinical implications of shared vulnerability and mutual maintenance models. Canadian Journal of Psychiatry, 47, 930–937.

    Article  PubMed  Google Scholar 

  • Beck, J. G., Grant, D. M., Read, J. P., Clapp, J. D., Coffey, S. F., Miller, L. M., & Palyo, S. A. (2008). The impact of event scale-revised: Psychometric properties in a sample of motor vehicle accident survivors. Journal of Anxiety Disorders, 22(2), 187–198.

    Article  PubMed  Google Scholar 

  • Bomyea, J., Risbrough, V., & Lang, A. J. (2012). A consideration of select pre-trauma factors as key vulnerabilities in PTSD. Clinical Psychology Review, 32(7), 630–641.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brunet, A., St-Hilaire, A., Jehel, L., & King, S. (2003). Validation of the French version of the Impact of Event Scale-Revised. Canadian Journal of Psychiatry, 48(1), 56–61.

    Article  PubMed  Google Scholar 

  • Carroll, L. J., Holm, L. W., Hogg-Johnson, S., Côté, P., Cassidy, D., Haldeman, S., et al. (2008). Course and prognostic factors for neck pain in whiplash-associated disorders (WAD) results of the Bone and Joint Decade 2000-2010 Task Force on neck pain and its associated disorders. European Spine Journal, 17(1), 83–92.

    Article  PubMed Central  Google Scholar 

  • Clayton, S. D. (2005). The experience of injustice: Some characteristics and correlates. Social Justice Research., 5(1), 71–91.

    Article  Google Scholar 

  • Creamer, M., Bell, R., & Failla, S. (2003). Psychometric properties of the Impact of Event Scale-Revised. Behaviour Research and Therapy, 41(12), 1489–1496.

    Article  PubMed  Google Scholar 

  • D’Souza, R. F., & Rodrigo, A. (2004). Spiritually augmented cognitive behavioural therapy. Australians Psychiatry, 12(2), 148–152.

    Article  Google Scholar 

  • Darley, J. M., & Pitman, T. S. (2003). The psychology of compensatory and retributive justice. Personality and Social Psychology Review, 7(4), 324–336.

    Article  PubMed  Google Scholar 

  • Deffenbacher, J. L. (2011). Cognitive-behavioral conceptualization and treatment of anger. Cognitive and Behavioral Practice, 18(2), 212–221.

    Article  Google Scholar 

  • Dunmore, E., Clark, D. M., & Ehlers, A. (2001). A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault. Behaviour Research and Therapy, 39(9), 1063–1084.

    Article  PubMed  Google Scholar 

  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345.

    Article  PubMed  Google Scholar 

  • Ehlers, A., Mayou, R. A., & Bryant, B. (1998). Psychological predictors of chronic post-traumatic stress disorder after motor vehicle accidents. Journal of Abnormal Psychology, 107(3), 508–519.

    Article  PubMed  Google Scholar 

  • Ezenwa, M. O., Molokie, R. E., Wilkie, D. J., Suarez, M. L., & Yao, Y. (2014). Perceived injustice predicts stress and pain in adults with sickle cell disease. Pain Management Nursing, 16(3), 294–306.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ferrari, R., & Russell, A. S. (2014). Perceived injustice in fibromyalgia and rheumatoid arthritis. Clinical Rheumatology., 33(10), 1501–1507.

    Article  PubMed  Google Scholar 

  • Graham, J. E., Lobel, M., Glass, P., & Lokshina, I. (2008). Effects of written anger expression in chronic pain patients: Making meaning from pain. Journal of Behavioral Medicine, 31(3), 201–212.

    Article  PubMed  Google Scholar 

  • Gun, R. T., & Osti, O. L. (2005). Risk factors for prolonged disability after whiplash injury: A prospective study. Spine, 3(4), 386–391.

    Article  Google Scholar 

  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25.

    Article  PubMed  Google Scholar 

  • Hickling, E. J., Blanchard, E. B., Buckley, T. C., & Taylor, A. E. (1999). Effects of attribution of responsibility for motor vehicle accidents on severity of PTSD symptoms, ways of coping, and recovery over six months. Journal of Traumatic Stress, 12(2), 345–353.

    Article  PubMed  Google Scholar 

  • Keefe, F. J., Lefebvre, J. C., Egert, J. R., Affleck, G., Sullivan, M. J. L., & Caldwell, D. S. (2000). The relationship of gender to pain, pain behavior, and disability in osteoarthritis patients: The role of catastrophizing. Pain, 87(3), 325–334.

    Article  PubMed  Google Scholar 

  • Kongsted, A., Bendix, T., Querama, E., Kasch, H., Bach, F. W., Korsholm, L., & Jensen, T. S. (2008). Acute stress response and recovery after whiplash injuries. A one-year prospective study. European Journal of Pain, 12(4), 455–463.

    Article  PubMed  Google Scholar 

  • Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105.

    Article  PubMed Central  Google Scholar 

  • Lerner, M. J. (1977). Justice motive—Some hypotheses as to its origins and forms. Journal of Personality, 45(1), 3–52.

    Article  Google Scholar 

  • Lind, E. A., & Tyler, T. R. (1988). The social psychology of procedural justice. New York: Plenum.

    Book  Google Scholar 

  • McCracken, L. M., & Eccleston, C. (2003). Coping or acceptance: What to do about chronic pain? Pain, 105(1–2), 197–204.

    Article  PubMed  Google Scholar 

  • Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1(3), 277–299.

    Article  PubMed  Google Scholar 

  • Mikula, G., Scherer, K. R., & Athenstaedt, U. (1998). The role of injustice in the elicitation of differential emotional reactions. Personality and Social Psychology Bulletin, 24(7), 769–783.

    Article  Google Scholar 

  • Miller, D. T. (2001). Disrespect and the experience of injustice. Annual Review of Psychology, 52, 527–553.

    Article  PubMed  Google Scholar 

  • Motor Accidents Authority (2001). Guidelines for the management of whiplash-associated disorders. Retrieved from http://www.whiplashprevention.org/SiteCollectionDocuments/Resea rch%20Arti c l es/Medical%20-%20Whiplash/GuidelinesDiagnosingWhiplash.pdf.

  • Panahi, Y., Moghaddam, B. R., Sahebkar, A., Nazari, M. A., Beiraghdar, F., Karami, G., & Saadat, A. R. (2011). A randomized, double-blind, placebo-controlled trial on the efficacy and tolerability of sertraline in Iranian veterans with post-traumatic stress disorder. Psychological Medicine, 41(10), 2159–2166.

    Article  PubMed  Google Scholar 

  • Powers, M. B., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Foa, E. B. (2010). A meta-analytic review of prolonged exposure for posttraumatic stress disorder. Clinical Psychology Review, 30(6), 635–641.

    Article  PubMed  Google Scholar 

  • Resick, P. A., & Schnicke, M. K. (1993). Cognitive processing therapy for rape victims: A treatment manual. Newbury Park: Sage.

    Google Scholar 

  • Riddle, D., & Stratford, P. (1998). Use of generic versus region-specific functional status measures on patients with cervical spine disorders. Physical Therapy, 78(9), 951–963.

    Article  PubMed  Google Scholar 

  • Ritchie, C., Ehrlich, C., & Sterling, M. (2017). Living with ongoing whiplash associated disorders: A qualitative study of individual perceptions and experiences. BMC Musculoskeletal Disorders, 18(1), 531.

    Article  PubMed Central  PubMed  Google Scholar 

  • Rodero, B., Luciano, J. V., Montero-Marin, J., Casanueva, B., Palacin, J. C., Gili, M., et al. (2012). Perceived injustice in fibromyalgia: Psychometric characteristics of the Injustice Experience Questionnaire and relationship with pain catastrophising and pain acceptance. Journal of Psychosomatic Research, 73(2), 86–91.

    Article  PubMed  Google Scholar 

  • Scott, W., & Sullivan, M. (2012). Perceived injustice moderates the relationship between pain and depressive symptoms among individuals with persistent musculoskeletal pain. Pain Research and Management, 17(5), 335–340.

    Article  PubMed Central  PubMed  Google Scholar 

  • Scott, W., Trost, Z., Milioto, M., & Sullivan, M. J. (2015). Barriers to change in depressive symptoms after multidisciplinary rehabilitation for whiplash: The role of perceived injustice. Clinical Journal of Pain, 31(2), 145–151.

    Article  PubMed  Google Scholar 

  • Scott, W., Trost, Z., Milioto, M., & Sullivan, M. J. L. (2013). Further validation of a measure of injury-related injustice perceptions to identify risk for occupational disability: A prospective study of individuals with whiplash injury. Journal of Occupational Rehabilitation, 23(4), 557–565.

    Article  PubMed  Google Scholar 

  • Sharp, T. J., & Harvey, A. G. (2001). Chronic pain and posttraumatic stress disorder: Mutual maintenance? Clinical Psychology Review, 21, 857–877.

    Article  PubMed  Google Scholar 

  • Spitzer, W. O., Skovron, M. L., Salmi, L. R., Cassidy, J. D., Duranceau, J., Suissa, S., & Zeiss, E. (1995). Scientific monograph of the Quebec Task Force on Whiplash-Associated Disorders: Redefining “whiplash” and its management. Spine, 20(8), 1S–73S.

    PubMed  Google Scholar 

  • Statistical Package for the Social Sciences. (2011). (SPSS, version 20 for Windows). Rel. 09.14. Armonk: IBM.

    Google Scholar 

  • Sterling, M., Hendrikz, J., & Kenardy, F. (2010). Developmental trajectories of pain/disability and PTSD symptoms following whiplash injury. Pain, 150, 22–28.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Adams, H., Horan, S., Maher, D., Boland, D., & Gross, R. (2008). The role of perceived injustice in the experience of chronic pain and disability: Scale development and validation. Journal of Occupational Rehabilitation, 18(3), 249–261.

    Article  PubMed  Google Scholar 

  • Sullivan, M. J. L., Thibault, P., Simmonds, M. J., Milioto, M., Cantin, A. P., & Velly, A. M. (2009). Pain, perceived injustice and the persistence of post-traumatic stress symptoms during the course of rehabilitation for whiplash injuries. Pain, 145(3), 325–331.

    Article  PubMed  Google Scholar 

  • Tolin, D. F., & Foa, E. B. (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132(6), 959–992.

    Article  PubMed  Google Scholar 

  • Trost, Z., Scott, W., Buelow, M. T., Nowlin, L., Turan, B., Boals, A., & Monden, K. R. (2017). The association between injustice perception and psychological outcomes in an inpatient spinal cord injury sample: The mediating effects of anger. Spinal Cord, 55(10), 898–905.

    Article  PubMed  Google Scholar 

  • Trost, Z., Scott, W., Lange, J. M., Manganelli, L., Bernier, E., & Sullivan, M. J. L. (2014). An experimental investigation of the effect of a justice violation on pain experience and expression among individuals with high and low just world beliefs. European Journal of Pain, 18(3), 415–423.

    Article  PubMed  Google Scholar 

  • Turk, D. C., Rudy, T., & Salovey, P. (1985). The McGill Pain Questionnaire: Confirming the factor analysis and examining appropriate uses. Pain, 21(4), 385–397.

    Article  PubMed  Google Scholar 

  • Veilleux, S., Sicard, D., & Bohuon, A. (1989). Traduction de McGill Pain Questionnaire. In R. Melzack & P. Wall (Eds.), Le defi de la douleur. (Troisieme edition. ed.). St-Hyacinthe: Edisem.

  • Vernon, H., & Mior, S. (1991). The neck disability index: A study of reliability and validity. Journal of Manipulative Physiological Therapeutics, 14(7), 409–415.

    PubMed  Google Scholar 

  • Walton, D. M., Pretty, J., MacDermid, J. C., & Teasell, R. W. (2009). Rick factors for persistent problems following whiplash injury: Results of a systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 39(5), 334–350.

    Article  Google Scholar 

  • Weiss, D., & Marmar, C. (1997). The Impact of Events Scale-Revised. In J. Wilson & T. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). New York: Guilford.

    Google Scholar 

  • Wlodyla-Demaille, S., Poiraudeau, S., Catanzarini, J.-F., Rannou, F., Fermanian, J., & Revel, M. (2002). Translation and validation of 3 functional disability scales for neck pain. Archives of Physical Medicine and Rehabilitation, 83(3), 376–382.

    Article  Google Scholar 

  • Yakobov, E., Scott, W., Stanish, W., Dunbar, M., Richardson, G., & Sullivan, M. J. L. (2014). The role of perceived injustice in the prediction of pain and function following total knee arthroplasty. Pain, 155(10), 2040–2046.

    Article  PubMed  Google Scholar 

  • Yakobov, E., Scott, W., Tanzer, M., Stanish, W., Dunbar, M., Richardson, G., & Sullivan, M. J. L. (2014). Validation of the injustice experiences questionnaire adapted for use with patients with severe osteoarthritis of the knee. Journal of Arthritis, 3(1), 130–136.

    Google Scholar 

  • Yehuda, R. (2002). Post-traumatic stress disorder. The New England Journal of Medicine, 346, 108–114.

    Article  PubMed  Google Scholar 

Download references

Funding

This research was supported by funds from the Canadian Institutes for Health Research.

Author information

Authors and Affiliations

  1. Department of Psychology, McGill University, Montreal, QC, H3A 1G1, Canada

    Esther Yakobov & Michael J. L. Sullivan

Authors
  1. Esther Yakobov
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael J. L. Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael J. L. Sullivan.

Ethics declarations

Conflict of Interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yakobov, E., Sullivan, M.J.L. Reductions in Perceived Injustice Are Associated with Reductions in Posttraumatic Stress Symptoms Among Individuals Receiving Treatment for Whiplash Injury. Psychol. Inj. and Law 11, 256–264 (2018). https://doi.org/10.1007/s12207-018-9326-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12207-018-9326-x

Keywords

Search

Navigation