Indiana University-Purdue University Indianapolis (IUPUI) / Many advanced cancer patients struggle with distress including depressive symptoms, anxiety, anger about cancer, and anger toward God. Cancer patients may perceive their illness as an injustice (i.e., appraise their illness as unfair, severe, and irreparable or blame others for their illness), and this may be a risk factor for distress. To date, illness-related perceptions of injustice have not been examined in cancer patients. Based on prior research and theory (i.e., Just World Theory, Park’s Meaning Making Model, and Loneliness Theory), there are multiple ways to conceptualize the relationship between perceived injustice related to the cancer experience and distress. The purpose of this project was to compare two theory-based conceptualizations of the relationships between perceived injustice and distress symptoms in advanced lung and prostate cancer patients. Aims were to (1) examine the direct effects of perceived injustice on distress symptoms; (2) examine the indirect effects of perceived injustice on distress symptoms through meaning making and acceptance of cancer (my conceptual model), examine the indirect effects of perceived injustice on psychological outcomes (i.e., distress symptoms and acceptance of cancer) through meaning making (Park’s Meaning Making Model), and compare the two models; (3) examine loneliness as a potential moderator of the mediations based on my conceptual model; and (4) explore whether the associations based on my conceptual model differed between advanced lung and prostate cancer patients. Cross-sectional data from advanced lung (n = 102) and prostate (n = 99) cancer patients were examined. Seven models were tested using path analyses. Results partially supported my conceptual model; perceived injustice was directly and indirectly associated with distress symptoms through acceptance of cancer but not through meaning making. Findings did not support Park’s Meaning Making Model, as meaning making did not help account for the associations between perceived injustice and psychological outcomes. Path analyses also indicated that loneliness was not a significant moderator of the mediations based on my conceptual model. Furthermore, associations based on my conceptual model did not differ between advanced lung and prostate cancer patients. Given mixed support for my conceptual model, supplemental path analyses were conducted that included loneliness as an exploratory mediator of associations between perceived injustice and distress symptoms. Findings suggested that perceived injustice was indirectly associated with distress symptoms through loneliness and acceptance of cancer. Findings support testing acceptance-based interventions to address distress related to perceived injustice in advanced cancer patients.

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Research has begun to explore the presence and role of health-related injustice perceptions in samples of individuals who experience chronic pain associated with traumatic injury. Existing studies indicate that higher level of injustice perception is associated with poorer physical and psychosocial outcomes. However, to date, few clinical populations have been addressed. The aim of the current study was to explore injustice perceptions in a sample of individuals who have sustained a spinal cord injury (SCI), as research suggests that such individuals are likely to experience cognitive elements characteristic of injustice perception (e.g., perceptions of irreparable loss, blame, and unfairness). The study explored the relationship between participants’ level of perceived injustice and several variables associated with outcomes following SCI (depression, pain, and disability) at initial admission to a rehabilitation unit and at three months following discharge. The Injustice Experience Questionnaire was used to measure injustice perceptions. IEQ was found to significantly contribute to depression and anger at baseline. IEQ significantly contributed to depression, present pain intensity, and anger at follow-up. The implication of these preliminary findings may be beneficial for development of future interventions, as many individuals in the United States experience the lifelong physical and psychological consequences of SCI at a high personal and public cost.

Esta tesis se inscribe en una trayectoria de pensamiento libre de la diferencia sexual para nombrar en femenino la injusticia. Estudia específicamente lo negativo que encierra la creación y la gestión de la casa, el trabajo, el matrimonio y la maternidad. Teniendo en cuenta la teoría psicosocial sobre la percepción de injusticia y siguiendo la necesidad de ampliar el conocimiento de la justicia, la investigación profundiza en la representación de la injusticia en lengua materna. Participan 95 mujeres de la Región de Murcia narrando el trabajo y los cuidados en el ámbito doméstico y familiar. Se han utilizado varias metodologías y teorías de investigación: teoría feminista, teoría basada en los datos y psicología discursiva. La hipótesis de trabajo principal es que las palabras de las mujeres trascienden el sentido corriente de la injusticia de un modo inaudito. Los resultados re-significan los denominados paradigmas populares de la justicia. / The present study focuses on the meaning of injustice for women from the thinking of sexual difference. The negative about household labor is studied. In response to psychosocial theory on the perception of injustice and to continue with justice knowledge, this research explores the representation of injustice for 95 women from Region of Murcia. These female participants were invited to narrate work and care in their families. It have been used several research methodologies and theories: feminist theory, Grounded theory and discursive psychology. The strongest support is for the hypothesis that suggests that women's words transcend the ordinary sense of injustice in a way unheard of. Findings give a new meaning of justice for social sciences.

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