Daenen Frederick, McParland Joanna, Baert Fleur, Miller Megan Marie, Hirsh Adam Todd, Vervoort Tine
Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
Department of Psychology, Glasgow Caledonian University, Glasgow, UK.
Eur J Pain. 2021 Apr;25(4):757-773. doi: 10.1002/ejp.1707. Epub 2020 Dec 11.
Research among adult and paediatric samples suggests that pain-related injustice appraisals contribute to adverse pain-related functioning. However, a singular focus on pain-related injustice appraisals carries the risk of underestimating the role of broader concepts of justice. This study examined the unique roles of child pain-related injustice appraisals and just-world beliefs in understanding disability and physical, emotional, social and academic functioning, as well as the mediating role of injustice appraisals in the relationship between just-world beliefs and functioning.
Participants comprised a school sample of 2,174 children (Study 1) and a clinical sample of 146 paediatric chronic pain patients (Study 2) who completed the Injustice Experience Questionnaire (IEQ), Personal and General Belief in a Just World scales (JWB-P/G), Functional Disability Inventory (FDI), Pain Catastrophizing Scale for Children (PCS-C) and Pediatric Quality of Life Inventory (PEDSQL).
For both samples, child pain-related injustice appraisals were associated with poorer functioning, after controlling for just-world beliefs, catastrophizing, pain intensity, age and sex. In the school sample, injustice appraisals mediated the associations of both personal and general just-world beliefs with functioning. In the clinical sample, injustice appraisals mediated the association of personal, but not general, just-world beliefs with all functioning scales.
The current findings attest to the unique role of pain-related injustice appraisals in understanding child pain-related functioning and their explanatory value in understanding the relationship between fundamental just-world beliefs and child pain-related functioning.
The present study adds to emerging literature on the adverse effects of child pain-related injustice appraisals in the context of pain, through showing that pain-related injustice appraisals are uniquely associated with pain-related functioning and mediate the relationship between just-world beliefs and pain-related functioning. These findings suggest that interventions may target pain-related injustice appraisals as a mechanism for change in children.
针对成人和儿童样本的研究表明，与疼痛相关的不公正评价会导致不良的疼痛相关功能。然而，仅关注与疼痛相关的不公正评价存在低估更广泛正义概念作用的风险。本研究考察了儿童与疼痛相关的不公正评价和公正世界信念在理解残疾以及身体、情感、社会和学业功能方面的独特作用，以及不公正评价在公正世界信念与功能之间关系中的中介作用。
参与者包括一个由2174名儿童组成的学校样本（研究1）和一个由146名儿科慢性疼痛患者组成的临床样本（研究2），他们完成了不公正经历问卷（IEQ）、个人和一般公正世界信念量表（JWB - P/G）、功能残疾量表（FDI）、儿童疼痛灾难化量表（PCS - C）和儿童生活质量量表（PEDSQL）。
对于两个样本，在控制了公正世界信念、灾难化、疼痛强度、年龄和性别后，儿童与疼痛相关的不公正评价都与较差的功能相关。在学校样本中，不公正评价介导了个人和一般公正世界信念与功能之间的关联。在临床样本中，不公正评价介导了个人公正世界信念（而非一般公正世界信念）与所有功能量表之间的关联。
当前研究结果证明了与疼痛相关的不公正评价在理解儿童疼痛相关功能方面的独特作用，以及它们在理解基本公正世界信念与儿童疼痛相关功能之间关系方面的解释价值。
本研究通过表明与疼痛相关的不公正评价与疼痛相关功能存在独特关联，并介导了公正世界信念与疼痛相关功能之间的关系，为有关儿童与疼痛相关的不公正评价在疼痛背景下的不良影响的新兴文献增添了内容。这些发现表明，干预措施可能以与疼痛相关的不公正评价为目标，作为改变儿童状况的一种机制。
