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

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.