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Further Validation of a Measure of Injury-Related Injustice Perceptions to Identify Risk for Occupational Disability: A Prospective Study of Individuals with Whiplash Injury

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Abstract

Purpose Emerging evidence suggests that perceptions of injustice negatively impact return to work following whiplash injury. The Injustice Experiences Questionnaire (IEQ) is a recently developed measurement tool that may be used to assess injury-related perceptions of injustice following injury. To date, although research has supported the predictive validity of the IEQ, a clinical cut off for interpreting this measure has not been established. Increased support for the validity and clinical interpretation of the IEQ represents a first step towards identifying patients that might benefit from targeted intervention to mitigate the impact of perceived injustice. Methods The IEQ was completed by 103 whiplash-injured patients upon commencement and completion of a standardized multidisciplinary rehabilitation program. One year later, individuals reported on their employment activity, pain severity, and use of narcotics. A receiver operating characteristic (ROC) curve analysis was conducted to identify the post-treatment IEQ score that was optimally associated with unemployment status at the follow-up. Secondary ROC curve analyses examined IEQ scores best associated with high pain severity and narcotic use 1 year following treatment. Results Results indicated that IEQ scores significantly discriminated individuals who returned and did not return to work at the follow-up. An IEQ score of 19 optimally identified participants in terms of follow-up employment status. IEQ scores at the end of treatment also discriminated individuals with high and low pain severity ratings and narcotic use status at the follow-up. Post-treatment IEQ scores of 18 and 20 optimally identified participants who had high pain severity ratings and who were using narcotics at the follow-up, respectively. Conclusions These results further support the validity of the IEQ and provide a guideline for its clinical interpretation in patients with persistent pain and disability following musculoskeletal injury. IEQ scores above the identified cut off may represent a barrier to work return and may warrant targeted intervention.

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Acknowledgments

This research was supported by funds from the Canadian Institutes for Health Research and the Fonds de la Recherche en Santé du Québec.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, McGill University, 1205 Doctor Penfield Avenue, Montreal, QC, H3A1B1, Canada

    Whitney Scott & Michael J. L. Sullivan

  2. Department of Psychology, University of Northern Texas, Denton, Texas, USA

    Zina Trost

  3. Centre d’évaluation et de readaptation de l’est, Montreal, QC, Canada

    Maria Milioto

Authors
  1. Whitney Scott
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  2. Zina Trost
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  3. Maria Milioto
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  4. Michael J. L. Sullivan
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Correspondence to Michael J. L. Sullivan.

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Scott, W., Trost, Z., Milioto, M. et al. Further Validation of a Measure of Injury-Related Injustice Perceptions to Identify Risk for Occupational Disability: A Prospective Study of Individuals with Whiplash Injury. J Occup Rehabil 23, 557–565 (2013). https://doi.org/10.1007/s10926-013-9417-1

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  • DOI: https://doi.org/10.1007/s10926-013-9417-1

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