Perceived injustice: a historical and clinical review of a useful concept for psychiatry
Open accessAbstract
Objective: Perceived injustice, a concept that arose in pain medicine, refers to an individual’s experiences and perceptions of victimisation from injuries resulting in chronic pain. Here, we have undertaken a historical and clinical review on the role of perceived injustice medicine in psychiatry and a systematic review on psychotherapeutic interventions for perceived injustice. Method: For the systematic review, two studies were identified from a search of six databases. Results: Though evidence is limited, psychotherapeutic interventions show promise in addressing perceived injustice and associated symptomatology. Conclusion: Perceived injustice is a concept which may have great potential utility to psychiatry, particularly in occupational and medicolegal areas. Interventions addressing perceived injustice may help improve clinical outcomes. © The Royal Australian and New Zealand College of Psychiatrists 2023.
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Claims the paper makes
6 of 18 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Among patients with advanced lung or prostate cancer, perceived injustice significantly influenced depression and anxiety symptoms, anger at the cancer, and anger at God.
“In patients with advanced lung and prostate cancer, perceived injustice significantly affected symptoms of depression and anxiety along with anger towards the cancer and anger towards God.11”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [11] 11. Secinti E, Wu W, Krueger EF, et al. Relations of perceived injustice to psycho-spiritual outcomes in advanced lung and prostate cancer: examining the role of acceptance and meaning making. Psycho-Oncology 2022; 31: 2177-2184. Article. DOI: 10.1002/pon.6065 source
The Results report significant relationships between perceived injustice and all four outcomes: depressive symptoms, anxiety, anger about cancer, and anger toward God. But the Methods describe a one-time survey, and the Discussion acknowledges that distress might instead contribute to perceived injustice. The claim’s word “affected” implies a causal direction the study does not establish. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Premisecitation
Among women with cervical cancer given false-negative smear results, perceived injustice significantly predicted depression and anxiety symptoms.
“in women with cervical cancer who received falsenegative smear results, perceived injustice was shown to be a significant predictor of symptoms of depression and anxiety.10”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [10] 10. Lynch J, D'Alton P and Gaynor K. Evaluating the role of perceived injustice in mental health outcomes in cervical cancer care. Support Care Cancer 2022; 30: 6215-6223. Article. DOI: 10.1007/s00520-022-07060-z source
- Premisecitation
Among patients with mild traumatic brain injury, perceived injustice correlated significantly with self-reported depressive, post-traumatic stress, pain and post-concussion symptoms.
“In patients with mild traumatic brain injury, significant correlations were reported between perceived injustice and selfreported depressive, post-traumatic stress, pain and post-concussion symptoms.12”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [12] 12. Mäki K, Nybo T, Hietanen M, et al. Perceived injustice after mild traumatic brain injury. J Head Trauma Rehabil 2022; 37: E157-E164. Article. DOI: 10.1097/HTR. 0000000000000698 source
- Findingcitation
In seven women with vulvodynia, a 6- to 7-week therapist-assisted online acceptance and commitment therapy programme led to improvement on perceived injustice measures in three of the seven.
“Chisari and colleagues, 18 in a cohort of seven women with vulvodynia, assessed a 6-to 7-week program of therapistassisted online acceptance and commitment therapy in seven women with vulvodynia.Three of the seven women had an improvement on measures of perceived injustice.”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [18] 18. Chisari C, McCracken LM, Cruciani F, et al. Acceptance and commitment therapy for women living with Vulvodynia: a single-case experimental design study of a treatment delivered online. J Context Behav Sci 2022; 23: 15-30. Article. DOI: 10.1016/j.jcbs.2021. 11.003 source
- Premisecitation
Consulting a lawyer was associated with perceived injustice.
“One study showed that lawyer consultation was associated with perceived injustice.14”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites [14] 14. Ioannou LJ, Cameron PA, Gibson SJ, et al. Traumatic injury and perceived injustice: fault attributions matter in a "no-fault" compensation state. PLoS One 2017; 12: e0178894. Article. DOI: 10.1371/journal.pone.0178894 source
- Findingown data
The search found only two studies of psychotherapeutic interventions for perceived injustice.
“and identified only two such studies.”
- Also stated in: § Systematic review of literature · plain
“there have been very few studies that have investigated the effect of psychotherapeutic interventions on perceived injustice.”
Quote in the paperSubstantial claim - Also stated in: § Systematic review of literature · plain
- Premisecitation
In a Victorian study, perceived injustice mediated the association between compensation eligibility and return to work.
“In a Victorian study, perceived injustice was found to mediate the relationship between eligibility for compensation and return to work.17”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [17] 17. Giummarra MJ, Cameron PA, Ponsford J, et al. Return to work after traumatic injury: increased work-related disability in injured persons receiving financial compensation is mediated by perceived injustice. J Occup Rehabil 2017; 27: 173-185. Article. DOI: 10. 1007/s10926-016-9642-5 source
- Interpretationcitation
Perceived injustice plays a significant role in the medicolegal domain.
“Perceived injustice also plays an important role in the medicolegal sphere.”
Quote in the paperSubstantial claim- Rests on an assumption: Involvement of lawyers and litigation after injury is linked to worse psychological, functional and pain outcomes.
- Interpretationcitation
Perceived injustice has been shown to be a useful construct outside pain medicine.
“Perceived injustice has also been shown to be a useful construct beyond the field of pain medicine.”
Quote in the paperSubstantial claim - Interpretationcitation
Perceived injustice can affect functioning.
“Unsurprisingly, perceived injustice can also impact functioning.”
Quote in the paperSubstantial claim - Premisecitation
In a sample of 253 people attending an occupational rehabilitation service, perceived injustice was a significant determinant of symptom outcomes in major depressive disorder.
“in a cohort of 253 individuals in an occupational rehabilitation service, showed that perceived injustice was a significant determinant of symptom outcomes in major depressive disorder.13”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] 13. Sullivan MJL, Adams H, Yamada K, et al. The relation between perceived injustice and symptom severity in individuals with major depression: a cross-lagged panel study. J Affect Disord 2020; 274: 289-297. Article. DOI: 10.1016/j.jad.2020.05.129 source
- Premisecitation
The link between legal involvement or litigation and perceived injustice may run in both directions.
“The relationship between litigation and legal involvement and perceived injustice may be bidirectional.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] 16. Sullivan MJL, Scott W and Trost Z. Perceived injustice: a risk factor for problematic pain outcomes. Clin J Pain 2012; 28: 484-488. Article. DOI: 10.1097/AJP.0b013e3182527d13 source
- Premisecitation
Merskey reported that 30 of 76 patients with persistent pain, versus 5 of 37 patients without pain, showed 'resentment'.
“In the 1960s, Merskey 6 noted that 30 out of 76 patients with persistent pain (compared with 5 out of 37 patients without pain) had 'resentment'”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [6] 6. Merskey H. Psychiatric patients with persistent pain. J Psychosom Res 1965; 9: 299-309. Article. DOI: 10.1016/0022-3999(65)90055-3 source
- Premisecitation
Perceived injustice has been linked to an intention to litigate.
“perceived injustice has also been associated with intent to litigate.15”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [15] 15. Trost Z, Monden KR, Buelow M, et al. Perceived injustice predicts intention to litigate: findings from a spinal cord injury sample. Psychol Inj Law 2016; 9: 31-40. Article. DOI: 10. 1007/s12207-015-9245-z source
- Interpretationcitation
Perceptions of injustice may contribute to psychiatric conditions.
“As Freud 5 noted, perceptions of injustice may play a role in psychiatric conditions.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [5] 5. Freud S. Mourning and melancholia. In: A Strachey (ed) The standard edition of the complete psychological works of Sigmund Freud. London, UK: Hogarth Press, 1917, pp. 237-258.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Rests on an assumption: Much psychiatric morbidity results directly from physical or emotional injury.
- Premisecitation
Perceived injustice shares ideas with post-traumatic embitterment disorder.
“The idea of perceived injustice overlaps with the ideas behind another concept, post-traumatic embitterment disorder”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] 7. Linden M. Posttraumatic embitterment disorder. Psychother Psychosom 2003; 72: 195-202. Review. DOI: 10.1159/000070783 source
- Interpretationown data
Although the evidence is limited, psychotherapeutic interventions appear promising for perceived injustice and its associated symptoms.
“Though evidence is limited, psychotherapeutic interventions show promise in addressing perceived injustice and associated symptomatology.”
Quote in the paperSubstantial claim - Interpretationreasoning
Treatments that target perceived injustice may improve clinical outcomes.
“Interventions addressing perceived injustice may help improve clinical outcomes.”
Quote in the paperSubstantial claim
- May combine two claims. 6
- Classified as probably not a substantial claim. 6
May combine two claims.
FindingcitationIn a cohort with musculoskeletal back or neck injury and current work absence (initial pre-dropout n = 66), a 10-week risk-targeted behavioural activation programme with added techniques for perceived injustice and catastrophising produced a large fall in IEQ scores (25%, Cohen's d = 1.0), and change in IEQ correlated positively with change in pain severity, pain catastrophising and depression.
“In a cohort of individuals with musculoskeletal back or neck injury associated with a current work absence (initial predropout size of 66), Sullivan and colleagues 19 assessed a 10week program of risk-targeted behavioural activation, supplemented by specific techniques to address perceived injustice and catastrophising.”
- Also stated in: § Systematic review of literature · plain
“A large reduction in IEQ scores was noted (25%, Cohen's d = 1.0), with change in IEQ being positively correlated with changes in symptom severity for pain, pain catastrophising and depression.”
Quote in the paperSubstantial claim1 of 1 sources checked- cites [19] 19. Sullivan MJL, Wideman TH, Gauthier N, et al. Risk-targeted behavioral activation for the management of work disability associated with comorbid pain and depression: a feasibility study. Pilot Feasibility Stud 2022; 8: 90. Article. DOI: 10.1186/s40814-022-01040-0 source
- Also stated in: § Systematic review of literature · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationThe Injustice Experience Questionnaire is a 12-item instrument created to measure perceived injustice.
“The Injustice Experience Questionnaire (IEQ), a 12-item scale, has been developed to assess perceived injustice.1”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [1] 1. Sullivan MJL, Adams H, Horan S, et al. The role of perceived injustice in the experience of chronic pain and disability: scale development and validation. J Occup Rehabil 2008; 18: 249-261. Article. DOI: 10.1007/s10926-008-9140-5 source
May combine two claims.
PremisecitationIn people with musculoskeletal pain, perceived injustice is generally linked to greater pain intensity, greater disability, worse functional outcomes such as a lower chance of returning to work, and more depressive, post-traumatic stress and anxiety symptoms.
“perceived injustice has generally been associated with higher pain intensity, higher disability, poorer functional outcomes (such as decreased likelihood of an individual returning to work) and higher levels of psychological symptoms including depressive, post-traumatic stress and anxiety symptoms.9”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [9] 9. Carriere JS, Pimentel SD, Yakobov E, et al. A systematic review of the association between perceived injustice and pain-related outcomes in individuals with musculo- skeletal pain. Pain Med 2020; 21: 1449-1463. Review. DOI: 10.1093/PM/PNAA088 source
May combine two claims.
InterpretationreasoningPerceived injustice may have considerable potential value for psychiatry, especially in occupational and medicolegal settings, and for medicine more broadly beyond pain medicine.
“Perceived injustice is a concept which may have great potential utility to psychiatry, particularly in occupational and medicolegal areas.”
- Also stated in: § Summary · hedged
“Perceived injustice may be a useful concept with applications beyond the field of pain medicine whence it originated and may have great potential utility to psychiatry as well as medicine more broadly and particularly in the occupational and medicolegal fields.”
Quote in the paperNot a substantial claim- Also stated in: § Summary · hedged
Classified as probably not a substantial claim.
PremisecitationPerceptions of injustice can arise when an injury results from the faults or omissions of others and the person then suffers loss or deprivation.
“Perceptions of injustice may arise when an injury has occurred due to the faults or omissions of others, and when an individual subsequently experiences loss or deprivation.1”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [1] 1. Sullivan MJL, Adams H, Horan S, et al. The role of perceived injustice in the experience of chronic pain and disability: scale development and validation. J Occup Rehabil 2008; 18: 249-261. Article. DOI: 10.1007/s10926-008-9140-5 source
May combine two claims.
Study design and conductown dataBoth reviewed studies had methodological weaknesses: neither had a control group, neither used perceived injustice alone as the primary outcome, and both had only short follow-up of perceived injustice measures.
“neither utilised a control group, neither focused on perceived injustice alone as a primary outcome and both had only limited follow-up for measures of perceived injustice.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataThe systematic review was registered with PROSPERO (CRD42023386915) and searched Medline, Embase, Cochrane Library, PsycINFO, Epistemonikos, CINAHL and Mednar.
“We conducted a systematic review (registered through PROSPERO, registration number: CRD42023386915) of Medline, Embase, Cochrane Library, PsycINFO, Epistemonikos, CINAHL and Mednar databases”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationFreud observed that people with melancholia seem to feel slighted and treated with great injustice.
“Freud 5 noted that individuals with melancholia 'always seem as though they felt slighted and had been treated with great injustice'.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [5] 5. Freud S. Mourning and melancholia. In: A Strachey (ed) The standard edition of the complete psychological works of Sigmund Freud. London, UK: Hogarth Press, 1917, pp. 237-258.
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim. May combine two claims.
InterpretationreasoningIEQ items about blame and unfairness parallel many traumatic disorders, and IEQ items about severity and irreparability parallel almost any psychiatric condition.
“It is not difficult to draw parallels between items in the IEQ relating to blame and unfairness (e.g.'Nothing will ever make up for what I have gone through' or 'I can't believe this has happened to me') and any number of traumatic disorders, or between those IEQ items relating to severity and irreparability (e.g.'I just want my life back' or 'I worry that my condition is not being taken seriously”
Quote in the paperSubstantial claim- Rests on an assumption: Much psychiatric morbidity results directly from physical or emotional injury.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationLegal representatives have an interest in keeping their clients' perceptions of injustice high.
“'Legal representatives have a vested interest in ensuring that their clients' perceptions of injustice remain high', as Sullivan and colleagues note.16”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [16] 16. Sullivan MJL, Scott W and Trost Z. Perceived injustice: a risk factor for problematic pain outcomes. Clin J Pain 2012; 28: 484-488. Article. DOI: 10.1097/AJP.0b013e3182527d13 source
The paper relies on this without support.
Involvement of lawyers and litigation after injury is linked to worse psychological, functional and pain outcomes.
“The involvement of lawyers and litigation following injury has been associated with poorer psychological, functional and pain outcomes.”
The paper relies on this without support.
Much psychiatric morbidity results directly from physical or emotional injury.
“Like chronic pain, much psychiatric morbidity is a direct consequence of injury, either physical or emotional.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Database count differs between abstract and methods
MinorThe abstract says the review searched six databases, but the methods list seven.
“For the systematic review, two studies were identified from a search of six databases.”
“We conducted a systematic review (registered through PROSPERO, registration number: CRD42023386915) of Medline, Embase, Cochrane Library, PsycINFO, Epistemonikos, CINAHL and Mednar databases and identified only two such studies.”
Cites
The Standard Edition of the Complete Psychological Works of Sigmund Freud
Freud, S. (1953) · Cited by 17,730 · see citing works
Sullivan, M. J. L., Adams, H., Horan, S., Maher, D., Boland, D., & Gross, R. (2008) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-008-9140-5 · Cited by 389 · see citing works
Posttraumatic Embitterment Disorder
Linden, M. (2003) · Psychotherapy and Psychosomatics · doi:10.1159/000070783 · Cited by 251 · see citing works
Perceived Injustice: A Risk Factor for Problematic Pain Outcomes
Sullivan, M. J. L., Scott, W., & Trost, Z. (2012) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182527d13 · Cited by 187 · see citing works
Pain and Suffering as Viewed by the Hindu Religion
Whitman, S. M. (2007) · Journal of Pain · doi:10.1016/j.jpain.2007.02.430 · Cited by 91 · see citing works
Psychiatric patients with persistent pain
Merskey, H. (1965) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(65)90055-3 · Cited by 90 · see citing works
Carriere, J. S., Donayre Pimentel, S., Yakobov, E., & Edwards, R. R. (2020) · Pain Medicine · doi:10.1093/pm/pnaa088 · Cited by 88 · see citing works
Giummarra, M. J., Cameron, P. A., Ponsford, J., Ioannou, L., Gibson, S. J., Jennings, P. A., & Georgiou-Karistianis, N. (2017) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-016-9642-5 · Cited by 68 · see citing works
Ioannou, L. J., Cameron, P. A., Gibson, S. J., Gabbe, B. J., Ponsford, J., Jennings, P. A., Arnold, C. A., Gwini, S. M., Georgiou-Karistianis, N., & Giummarra, M. J. (2017) · PLOS ONE · doi:10.1371/journal.pone.0178894 · Cited by 42 · cited 1× · see citing works
“14 Furthermore, perceived injustice has also been associated with intent to litigate.”
BackgroundChisari, C., McCracken, L. M., Cruciani, F., Moss-Morris, R., & Scott, W. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.11.003 · Cited by 30 · cited 1× · see citing works
“Chisari and colleagues, 18 in a cohort of seven women with vulvodynia, assessed a 6-to 7-week program of therapist-assisted online acceptance and commitment therapy in seven women with vulvodynia.”
BackgroundPerceived Injustice Predicts Intention to Litigate: Findings from a Spinal Cord Injury Sample
Trost, Z., Monden, K. R., Buelow, M., Boals, A., & Scott, W. (2016) · Psychological Injury and Law · doi:10.1007/s12207-015-9245-z · Cited by 20 · see citing works
Sullivan, M. J. L., Adams, H., Yamada, K., Kubota, Y., Ellis, T., & Thibault, P. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.129 · Cited by 18 · see citing works
Evaluating the role of perceived injustice in mental health outcomes in cervical cancer care
Lynch, J., D’Alton, P., & Gaynor, K. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07060-z · Cited by 11 · see citing works
Secinti, E., Wu, W., Krueger, E. F., Hirsh, A. T., Torke, A. M., Hanna, N. H., Adra, N., Durm, G. A., Einhorn, L., Pili, R., et al. (2022) · Psycho-Oncology · doi:10.1002/pon.6065 · Cited by 11 · see citing works
Chronic pain conceptualization and religious interpretation
Conwill, W. L. (1986) · Journal of Religion and Health · doi:10.1007/bf01533052 · Cited by 9 · see citing works
Anderson, C. S. (2016) · Oxford Research Encyclopedia of Religion · doi:10.1093/acrefore/9780199340378.013.180 · Cited by 7 · see citing works
Perceived Injustice After Mild Traumatic Brain Injury
Mäki, K., Nybo, T., Hietanen, M., Huovinen, A., Marinkovic, I., Isokuortti, H., & Melkas, S. (2022) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000000698 · Cited by 7 · see citing works
Sullivan, M. J. L., Wideman, T. H., Gauthier, N., Thibault, P., Ellis, T., & Adams, H. (2022) · Pilot and Feasibility Studies · doi:10.1186/s40814-022-01040-0 · Cited by 5 · see citing works
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Flagged first, then by citations
Cited by
Sorted by citations
Development of a new perceived injustice scale for Bangla speaking population
Mourin, C., & Mozumder, M. K. (2024) · PLoS ONE · doi:10.1371/journal.pone.0311272
“However, in recent time it is being discussed and studied as a novel and useful concept in medicine and psychiatry [7].”
- Authors
- Plevin, D., & Herriot, P.
- Affiliations
- The University of Adelaide (AU)
- Flinders Medical Centre (AU)
- Corresponding author
- Plevin, David
- ORCID
- Plevin, David
- Venue
- Australasian Psychiatry
- Publisher
- SAGE Publications
- Published
- 2023-10-30
- Volume
- 32
- Issue
- 1
- Pages
- 41-43
- ISSN
- 1039-8562 (ISSN-L)
- 1440-1665
- OpenAlex
- W4388033739
- Cited by
- 1
- References
- 19
- Citations by year
- 2024: 1
- FWCI
- 0.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Australasian Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Social Psychology › Death Anxiety and Social Exclusion
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- perceived injustice, victimization, chronic pain, psychotherapeutic interventions, occupational psychiatry, conceptual history, psychological symptomatology
- MeSH terms
- Humans, Pain Measurement, Psychiatry, Chronic Pain
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