Highlights
- •Meta-analysis finds moderate to strong association between injustice and depression.
- •Injustice has predictive utility for depression in acute and chronic pain samples.
- •Injustice-depression relationship does not vary across acute and chronic pain.
Abstract
Perceived injustice is increasingly recognized as a risk factor for problematic recovery,
with a growing body of evidence documenting its association with heightened pain,
disability, medication use, anger and post-traumatic stress. The aim of this paper
was to systematically review and critically appraise the association between perceived
injustice and depressive symptomatology across a wide range of medical and mental
health populations, including acute and chronic pain samples. A search of published,
English language studies in the PubMed, EMBASE, CINAHL, and PsycINFO databases from
1990 to June 2020 was performed. Thirty-three studies met inclusion criteria with
a total sample of 5,425 individuals (61% female), primarily with acute injury or chronic
pain. Results indicated a moderate to strong positive association between perceived
injustice and depressive symptomatology (meta-analysis pooled effect of r = .57, 95%
confidence interval [.55, .58], P< .001). A narrative synthesis of regression models indicated standardized beta coefficients
between .19 and .66, with perceived injustice consistently contributing significant
unique variance to the prediction of depression in final regression equations. Selection
bias and response bias were common limitations in the studies. The clinical implications
of an association between injustice and depression in acute and chronic pain are discussed.
PROSPERO
CRD42019143465.
Perspective
This review demonstrates that in acute injury and chronic pain samples, perceived
injustice is associated with depression. These findings could help clinicians in the
field of pain and rehabilitation identify who may be at greater risk for a problematic
recovery trajectory.
Keywords
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Article info
Publication history
Published online: January 16, 2021
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
The authors report no conflicts of interest.
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Copyright
© 2021 by United States Association for the Study of Pain, Inc.
