The Relationship Between Perceived Injustice and Chronic Pain

When an individual experiences long-term pain following an injury, some people may believe they have been the victim of unfair treatment; this may be particularly relevant if another person is to blame for what has happened to them. The question of whether an individual’s belief is objectively true is less relevant here, what we feel is most important is what a person truly believes about their situation.

To date, research has demonstrated that perceptions of injustice, following an injury or accident, is linked to more severe and long-standing experiences of pain, in addition to greater pain related disability. Moreover, there is often increased resistance to specialist pain management treatments and interventions designed to target chronic pain. Because of this, those who have co-occurring chronic pain and perceptions of injustice represent a particularly vulnerable group within the pain population that warrant further consideration in the field of pain management research.

The research will assess if sleep disturbance mediates the relationship between perceived injustice and chronic pain. This is the technical language used in the world of academia, however, what we simply mean here is: does perceived injustice influence a persons' sleep; then following this, does a persons' sleep influence their experience of pain. If sleep disturbance is identified as playing a major role, this may help guide future studies to further validate the findings. Ultimately, this may help to further support the idea that addressing poor sleep should represent an important factor for clinicians to consider when offering pain management interventions.

Why might sleep play a role here?

Sleep is one of the most vital components of human functioning; it helps to reset our mood and restore our performance capabilities; additionally, sleep regenerates our immune, endocrine, and nervous system all at the same time. Ultimately, we need sleep to survive, and it may play a crucial role in helping us to heal more effectively following an injury. Using experimental evidence, sleep problems and chronic pain have been shown to possess a bi-directional relationship. In other words, they both affect each other. However, in a systematic review (essentially a study of other studies), it was concluded that sleep disturbance was a stronger and more reliable predictor of pain (see Finan et al., 2013 if you are interested in this).

Sleep disruption can be caused by a variety of reasons; however, one common reason for why we have poorer sleep is often when we experience a significant adverse event (for example, an injury that is perceived as unfair). Following this, an individuals' selective attention is directed towards this stressful event which can cause a state of psychological and physiological hyperarousal. Ultimately, this state of hyperarousal may prevent our ability to initiate sleep and feel fully rested.

What can I expect if I wish to take part in the research?

If you decide to participate, the survey will require approximately 15 minutes of your time and you will be asked questions on the following:

• Information about your injury (for example, type of injury and when it happened).
• Information about your pain and the impact it has had on your life
• Whether you feel your injury is unfair.
• Information about your sleep.
• Questions designed to assess i) anger ii) depression and iii) anxiety.
• Demographic information (for example, your age, gender, and occupation).

Who is conducting the study?

The research is being conducted by Craig Govan, a Trainee Clinical Psychologist completing their Professional Doctorate in Clinical Psychology at Teesside University.

Am I eligible to take part?

The eligibility criteria for the study are as follows:

• Aged 16 or over.
• Able to understand English using written material.
• Experienced an injury or accident which you feel has contributed to your pain (for example, whiplash, broken bone, burn).
• Have experienced pain following the above injury for 3 months or longer.
• Currently do not have a diagnosed sleep condition, other than insomnia (for example, restless leg syndrome, parasomnia, or sleep apnoea).
• Do not have an acquired brain injury.

Interested?

If you are eligible and would like to take part, you can access the study by clicking (or copying and pasting) the link below. This will take you directly to the study. Please note, you do not have to feel like your injury is unfair to take part, as long as you meet the above criteria you can participate.

Take part: teesside.onlinesurveys.ac.uk/painproject