The Mediating Role of Pain Acceptance in the Relation Between Perceived Injustice and Chronic Pain Outcomes in a Community Sample.

Abstract

Perceived injustice has been defined as an appraisal regarding the severity and irreparability of loss associated with pain, blame, and a sense of unfairness. Recent findings suggest that perceived injustice is an important risk factor for elevated disability associated with chronic pain. However, the mechanisms by which this perception leads to disability are not well understood. Therefore, the current study aimed to examine the mediating role of pain acceptance on the relation between perceived injustice and chronic pain outcomes (pain intensity, pain-related disability, and psychological distress). This cross-sectional study used a sample of 475 individuals from the community who report chronic pain. Participants completed the Injustice Experience Questionnaire, the Chronic Pain Acceptance Questionnaire, a pain rating intensity scale, the Modified Brief Pain Inventory, and the Hospital Anxiety and Depression Scale. Results revealed significant direct links from perceived injustice to pain intensity (c'=0.416, P<0.001), disability (c'=0.891, P<0.001), and distress (c'=0.261, P<0.001), as well as indirect links from perceived injustice through acceptance of pain to pain disability (ab=0.512, P<0.001, confidence interval, 0.390-0.635) and psychological distress (ab=0.106, P<0.001, confidence interval, 0.077-0.136). Clinical and theoretical implications are discussed along with future research directions.