title: Perceived injustice after traumatic injury: Associations with pain, psychological distress, and quality of life outcomes 12 months after injury.
abstract: OBJECTIVE
  There is growing recognition that individuals who experience traumatic injuries perceive themselves as victims of injustice and that elevated levels of perceived injustice are associated with problematic physical and psychological outcomes. To date, research regarding injustice perception and injury outcomes has been restricted to a small number of musculoskeletal pain conditions. No research to date has examined the potential impact of perceived injustice among individuals admitted for trauma care.
  
  
  METHODS
  As part of this cross-sectional study, individuals (n = 155) admitted to a Level-1 trauma center completed measures of perceived injustice, pain, depression, posttraumatic stress, and health related (physical and mental/emotional) quality of life (HRQoL) outcomes 12 months after trauma admission.
  
  
  RESULTS
  Bivariate analyses revealed significant associations between perceived injustice and demographic variables (education, income, race, and age) as well as injury-related variables (type of injury and length of hospital stay). Perceived injustice was correlated with greater pain intensity, depression, and PTSD symptoms, as well as poorer physical and mental HRQoL. Controlling for relevant demographic and injury-related variables, perceived injustice accounted for unique variance in pain intensity, depression severity, the presence and intensity of PTSD symptoms, mental HRQoL, and was marginally significant for physical HRQoL.
  
  
  CONCLUSIONS
  This is the first study to examine perceived injustice in a trauma sample. Results support the presence of injustice perception in this group and its associations with pain and quality of life outcomes. Additional research is suggested to explore the impact of perceived injustice on recovery outcomes among individuals who have sustained traumatic injury.
authors.affiliation: Department of Psychology, University of North Texas.
authors.forename: Zina
authors.initials: Z
authors.lastname: Trost
authors.affiliation: Experimental Psychology Program, University of North Texas.
authors.forename: Stephanie
authors.identifier: 0000-0002-1188-0897
authors.initials: S
authors.lastname: Agtarap
authors.affiliation: Department of Psychology, Institute of Psychiatry, King's College London.
authors.forename: Whitney
authors.initials: W
authors.lastname: Scott
authors.affiliation: Baylor Institute for Rehabilitation.
authors.forename: Simon
authors.initials: S
authors.lastname: Driver
authors.affiliation: Clinical Health Program, University of North Texas.
authors.forename: Adam
authors.initials: A
authors.lastname: Guck
authors.affiliation: Division of Trauma, Baylor University Medical Center.
authors.forename: Kenleigh
authors.identifier: 0000-0002-4623-8634
authors.initials: K
authors.lastname: Roden-Foreman
authors.affiliation: Division of Trauma, Baylor University Medical Center.
authors.forename: Megan
authors.initials: M
authors.lastname: Reynolds
authors.affiliation: Division of Trauma, Baylor University Medical Center.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Foreman
authors.affiliation: Division of Trauma, Baylor University Medical Center.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Warren
mesh_terms: D003430:Cross-Sectional Studies; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000523:psychology*; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors; D015206:Southwestern United States; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D014947:Wounds and Injuries / Q000150:complications / Q000523:psychology*