Scoping review of perceived injustice in mixed trauma and spinal cord injury/disorder samples

Perceived injustice, the appraisal of injury-related losses as severe, permanent, and unfairly caused by others, is a significant predictor of poor outcomes in musculoskeletal and pain conditions. This scoping review investigates the landscape of perceived injustice research in mixed traumatic injury and spinal cord injury/disorder populations.

This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) reporting guidelines. We reviewed 41 studies published between 2009 and 2024, including quantitative, qualitative, and mixed-methods research.

The majority of studies were cross-sectional (n = 27) and conducted in North America (n = 30). Across the reviewed studies, higher perceived injustice, as measured by the Injustice Experience Questionnaire, was consistently reported to be associated with adverse psychosocial and functional outcomes. Specifically, multiple studies reported perceived injustice was a strong predictor of depression, posttraumatic stress disorder, anxiety, and anger, even after controlling for pain and demographic variables. Findings also frequently linked it to greater functional impairment, poorer treatment response, and significant barriers to return to work. Anger and stigma were identified as key mediators in the relationship between perceived injustice and adverse outcomes.

Despite robust evidence that perceived injustice could be an intervention target, a critical gap exists in the literature: No studies were found that evaluated interventions designed to target and reduce perceived injustice in these populations. This review underscores the urgent need for the development and testing of targeted interventions to address perceived injustice and improve recovery trajectories for individuals with spinal cord injury and mixed traumatic injuries. (PsycInfo Database Record (c) 2026 APA, all rights reserved).