Perceived Injustice is Associated with Heightened Pain Behavior and Disability in Individuals with Whiplash Injuries

The present study examined the relationship between perceived injustice associated with whiplash injury and displays of pain behavior. Individuals (N=85) with whiplash injuries were filmed while performing a simulated occupational lifting task. They were also asked to complete measures of pain, perceived injustice, catastrophic thinking, depression, and functional disability. Consistent with previous research, high levels of perceived injustice were associated with more intense pain, higher levels of catastrophic thinking, depression, and disability. Analyses revealed that individuals with high levels of perceived injustice displayed more protective pain behaviors than individuals with low levels of perceived injustice, regardless of the level of physical demand of the task. The relation between perceived injustice and protective pain behavior remained significant even when controlling for pain severity, catastrophic thinking, and depression. There was no significant association between perceived injustice and displays of communicative pain behavior. The results of this study suggest that the relation between perceived injustice and pain behavior might underlie the high prevalence of occupational disability in individuals who have sustained whiplash injuries. Implications for intervention are addressed.