Perceived Injustice in Multiple Sclerosis: An Initial, Exploratory Study

• Published in: Rehabilitation psychology 2021-08, Vol.66 (3), p.335-343
• Main Authors: Kidwell, Ariel L., Motl, Robert W., Cederberg, Katie L., Jeng, Brenda, Sasaki, Jeffer E., Trost, Zina
• Format: Article
• Language: English
• Subjects: Anger; Fatigue; Health Related Quality of Life; Human; Multiple Sclerosis; Physical Activity; Psychometrics; Questionnaires; Test Validity
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000387

Purpose/Objective: The current study represents an initial examination of condition-related perceived injustice (PI) in multiple sclerosis (MS) by examining (a) the structural validity and reliability of the Injustice Experience Questionnaire (IEQ) scores and (b) the associations between IEQ scores and scores from measures of anger, pain, depression, anxiety, fatigue, disability, health-related quality of life (HRQOL), physical activity, and sedentary behavior. Research Method/Design: Persons with MS were recruited through the distribution of letters to a random sample of 1,000 persons from the North American Research Committee on MS registry. Participants who completed the IEQ (N = 139) were included in this analysis. Results: Our results support the structural validity of the 2-factor model of Severity/Irreparability and Blame/Unfairness subscales with a Cronbach's alpha of .917 for the overall scale, and values of .857 and .889 for the subscales, respectively. All measures were meaningfully correlated with IEQ scores. Pain (ρ = .466), fatigue (ρ = .430), disability (ρ = .416), walking impairment (ρ = .446), and physical HRQOL (ρ = .624) were strongly correlated with Severity/Irreparability. Anger; however, was strongly correlated with Blame/Unfairness (ρ = .437). Physical activity and sedentary behavior were similarly correlated with the 2 subscales; however, both moderate-to-vigorous (ρ = −.332) and light physical activity (ρ = −.275) were slightly more correlated with Severity/Irreparability. Conclusions/Implications: The IEQ is a reliable and valid measure of PI in MS. Physical manifestations of MS are primarily associated with PI, and negative associations were observed between physical activity and IEQ scores. Physical activity may increase self-efficacy and counteract cognitions of permanent disability and frustration concerning limitations that are associated with PI. Impact and ImplicationsMultiple sclerosis (MS) results in perceptions of uncertainty and stress that increase the likelihood of condition-related perceived injustice (PI), yet limited research has assessed PI in this population. The standard approach for measuring PI involves the administration of the Injustice Experience Questionnaire (IEQ). This paper provides preliminary evidence for measuring condition-related PI using the IEQ in MS. PI was associated with a variety of physical (e.g., pain, fatigue, physical health-related quality of life [HRQOL], disability, and walking impairm