Treatment-Related Reductions in Disability Are Associated with Reductions in Perceived Injustice Following Treatment of Whiplash Injury

Emerging evidence suggests that perceived injustice is a risk factor for poor recovery outcomes in individuals with whiplash injuries. The present study examined the relative contributions of treatment-related reductions in pain severity, depressive symptoms, and disability in the prediction of reductions in perceived injustice in individuals with whiplash injury. The study sample consisted of 71 individuals (43 women and 28 men) who sustained whiplash injuries in motor vehicle accidents and who were enrolled in a treatment program designed to promote functional recovery following whiplash injury. For the purposes of this study, only individuals who scored above the risk threshold on a measure of perceived injustice were included in the study sample. Participants completed measures of pain severity, disability, depressive symptomatology, and perceived injustice prior to treatment and after treatment. Change scores were computed for study variables. The results revealed that reductions in pain severity and disability were correlated with reductions in perceived injustice. Regression analyses revealed that only reductions in disability contributed significant unique variance to the prediction of reductions in perceived injustice. Clinical and theoretical implications of the present findings are discussed.     

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.     

Work Impairment and Disability in Posttraumatic Stress Disorder: A Review and Recommendations for Psychological Injury Research and Practice

Work impairment and disability are common consequences of posttraumatic stress disorder (PTSD), as reflected by significant rates of sickness absence, failure to return to work, and reduced work performance. Within the psychological injury field, the issue of work impairment and disability in PTSD often arises in workers’ compensation and disability insurance claims and in personal injury litigation. In this context, clinical and forensic practitioners are faced with challenges in rendering expert opinions on diagnosis, causality, prognosis, and recommendations for treatment and rehabilitation. To promote understanding of this important, yet understudied area, there are three aims of this paper: first, to review the current literature on work impairment and disability associated with PTSD; second, to draw on this literature to present a biopsychosocial framework of work impairment and disability in PTSD; and third, to offer suggestions for improving the assessment and management of PTSD-related work impairment and disability.     

Still Paying for the Past: Examining Gender Differences in Employment Among Individuals with a Criminal Record

Although many studies have examined employment outcomes of those with criminal convictions, no study to date has examined gender differences in employment outcomes of individuals with criminal convictions using a nationally representative sample of individuals from the United States. In this study, we use data from the 1997 National Longitudinal Survey of Youth to examine differences in employment after a criminal conviction for females and males. Results reveal that for women with a conviction, a drug offense and having dependent children limit the number of weeks of employment. For males, race, education, age at first conviction, and a subsequent conviction predict the number of weeks employed. Implications for policy and future research are discussed.