The Impact of Injustice Appraisals on Pyschosocial Outcomes Following Spinal Cord Injury: A Longitudinal Study
Abstract
Objectives & Rationale: Individuals with spinal cord injury (SCI) face a set of unique challenges, including poor psychosocial adaptation to disability, changes in social roles and relationships, decreased independence, and physical pain and discomfort. Injustice appraisals are a potentially modifiable risk factor for poor psychosocial adjustment to various chronic health conditions, including SCI. Injustice appraisal is defined as the severity of injury or disability-related loss and perceived unfairness. Appraisals of injustice are relevant when individuals feel a sense of undeserved suffering and loss or are struggling to understand why they were injured (i.e., Why me?), as may be the case after SCI. Appraisals are associated with psychological distress and coping following SCI and may be more amenable to change than coping strategies. Appraisals have a strong relationship with adjustment, accounting for 12% of the variance in anxiety and 34% of the variance in depression, highlighting the importance of appraisals in the process of psychosocial adjustment to SCI. At present, there are no interventions that specifically target appraisals of injustice, and there is limited research upon which to recommend clinical interventions to alleviate the impact of injustice appraisals on rehabilitation outcomes. Treatment techniques currently being used within multidisciplinary rehabilitation programs do not yield clinically meaningful reductions in perceptions of injustice. The objectives of this study are to (1) determine the course and impact of SCI-related injustice appraisals among civilians and Veterans who have recently acquired an SCI, and (2) use qualitative research to gain a rich, in-depth understanding of appraisals as individuals adjust to a newly acquired SCI. Applicability and Impact: To date, no study has examined injustice appraisals over time, particularly as individuals adapt to SCI. This study will fill a gap in the current literature by allowing us to understand how injustice appraisals change over time. Because all of the current studies on injustice appraisals are cross-sectional, we have a good understanding of the psychological factors that are related to injustice appraisals. Unfortunately, we have limited understanding of the impact of injustice appraisals on psychosocial outcomes throughout the process of adaptation to SCI. The proposed study is the first to take a longitudinal approach to the study of injustice appraisals and will allow us to understand how injustice appraisals impact psychosocial outcomes during the acute, sub-acute, and chronic phases of SCI. We will also use qualitative methodology to help us understand appraisals of injustice, as understood by individuals with SCI. Research increasingly highlights the harmful impact of injustice appraisals on psychological, functional, and rehabilitation outcomes in the context of neurological injury. The proposed study addresses the Fiscal Year 2020 Spinal Cord Injury Research Program Investigator-Initiated Research Award Focus Area of psychosocial issues relevant to people with SCI. This research will make a significant contribution to our current understanding of psychological processes that impact psychosocial outcomes following SCI. Our goal is to use the information from this study to develop an intervention targeting injustice appraisals to improve long-term psychosocial outcomes (i.e., depression, post-traumatic stress disorder, pain, quality of life) following SCI within the next 5 years.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110589
Entities
People
- Kimberley Monden
Organizations
- United States Army
- University of Minnesota