Department of Psychology, McGill University, Montreal, QC, Canada.
Clin J Pain. 2012 Jul;28(6):484-8. doi: 10.1097/AJP.0b013e3182527d13.
Emerging research suggests that perceptions of injustice after musculoskeletal injury can have a significant impact on a number of pain-related outcomes.
The purpose of this paper is to review evidence linking perceptions of injustice to adverse pain outcomes. For the purposes of this paper, perceived injustice is defined as an appraisal cognition comprising elements of the severity of loss consequent to injury ("Most people don't understand how severe my condition is"), blame ("I am suffering because of someone else's negligence"), a sense of unfairness ("It all seems so unfair"), and irreparability of loss ("My life will never be the same").
Cross-sectional studies show that high scores on perceptions of injustice are correlated with pain catastrophizing, fear of movement, and depression. Prospective studies show that high scores on perceived injustice are a prognostic indicator of poor rehabilitation outcomes and prolonged work disability. Research shows that perceptions of injustice interfere not only with physical recovery after injury, but perceptions of injustice also impact negatively on recovery of the mental health problems that might arise subsequent to traumatic injury. Although research has yet to address the process by which perceptions of injustice impact on pain-related outcomes systematically; possible mechanisms include attentional disengagement difficulties, emotional distress, maladaptive coping, heightened displays of pain behavior, anger, and revenge motives.
Perceived injustice appears to be associated with problematic health and mental health recovery trajectories after the onset of a pain condition. Future directions for research and treatment are addressed.
新兴研究表明，肌肉骨骼损伤后对不公正的感知会对许多与疼痛相关的结果产生重大影响。
本文旨在综述将不公正感与不良疼痛结果联系起来的证据。就本文而言，不公正感被定义为一种包含伤害后损失严重程度（“大多数人都不了解我的病情有多严重”）、责任（“我遭受痛苦是因为别人的疏忽”）、不公平感（“这一切似乎都如此不公平”）和损失无法挽回（“我的生活再也不会一样了”）等元素的评价认知。
横断面研究表明，不公正感得分高与疼痛灾难化、运动恐惧和抑郁有关。前瞻性研究表明，不公正感得分高是康复结局不良和工作残疾延长的预后指标。研究表明，不公正感不仅会干扰受伤后的身体恢复，还会对随后发生的创伤性伤害所导致的心理健康问题的恢复产生负面影响。尽管研究尚未系统地研究不公正感对疼痛相关结果的影响过程；但可能的机制包括注意力脱离困难、情绪困扰、适应不良的应对方式、疼痛行为表现加剧、愤怒和报复动机。
不公正感似乎与疼痛状况发作后出现的健康和心理健康恢复轨迹问题有关。探讨了未来的研究和治疗方向。
