Comparisons Between Illness and Injury Outcomes: Potential Suppression Effects by Emotional Representations.

BACKGROUND: Based on recent findings that people perceive illness and injury as separate categories, we compared ill and injured participants with similar health conditions on illness perceptions and reported outcomes, e.g., functioning, distress, well-being. METHOD: A cross-sectional study with 182 ill and 160 injured participants affected by ankle, knee, or neck conditions compared them on standard measures of illness perception and other reported outcomes (self-assessed health; physical, emotional, and social functioning; depression, anxiety, and somatization; satisfaction with life, self-esteem, and acceptance of disability). RESULTS: The groups did not differ on the measured outcomes, but injury elicited stronger emotional representations, and illness was perceived as more chronic. After controlling for the effects of emotional representations, the injured group presented better outcomes on all outcome measures, including self-assessed health, physical functioning, emotional functioning, social functioning, vitality, health beliefs, depression, somatization, total distress, and acceptance of disability. CONCLUSION: Emotional representations may suppress the potential superior outcomes of injury compared with illness. The theoretical implications of these results for self-regulation theories are discussed, as well as clinical implications.

The role of centrality to self-concept in moderating the associations between injury perceptions and outcomes.

OBJECTIVES: To test the centrality of injury to self-concept as a moderator of the associations between injury perceptions and outcomes. METHODS: Two concurrent studies on samples of injured individuals. MEASURES: The centrality of injury to one's self concept was measured by the degree of self-injury separation (PRISM); injury perceptions were measured by the injury perception questionnaire; and outcomes by standard scales of self-assessed health, physical, emotional and social functioning, vitality, depression, anxiety and somatisation. Regression analyses examined the significance of adding the interactions between injury centrality and injury perceptions to explained outcome variance, beyond their separate contributions. RESULTS: Both injury centrality and injury perceptions significantly explained variance in patients' functioning and well-being. Injury centrality moderated the associations between various injury perceptions and outcomes, especially pronounced for emotional representations of the injury. As hypothesised, the effects of injury perceptions on outcomes were stronger among patients for whom the injury was central to their self-concept compared to patients who perceived the injury as peripheral to their self-concept. CONCLUSIONS: 'Centrality to the self' is a moderator of the impact of perceptions on outcomes of injuries. The findings suggest ways to tailor interventions to sub-groups of injured patients based on injury centrality to their self-concept.

Development of the Injury Perceptions Questionnaire (InjPQ).

OBJECTIVES: Injuries are major causes of morbidity and mortality in the population. Given the central role of perceptions in self-regulation of health conditions, it is important to investigate how they are perceived. This article describes the development of the Injury Perceptions Questionnaire (InjPQ). METHODS: A concurrent study in a diverse sample of injured individuals (n = 333). The internal structure and the reliability (Cronbach's α) of InjPQ sub-scales were explored by factor analyses. Relationships between injury perception dimensions and equivalent illness perception scales and outcome measures (self-assessed health; physical, emotional and social functioning; depression, anxiety and somatisation; satisfaction with life) were investigated. RESULTS: The InjPQ was found to represent the following perception scales: injury identity composed of social and body part components, PTSD symptoms, Injury event, Injury specific emotions, Injured self-image, Positive consequences, Responsibility/guilt, Coping, Time distance, Dependency, Healthy self, External attributions and Injury risk factors. The reliability and construct validity of the scales were found adequate. CONCLUSIONS: Injury perceptions can be reliably measured. While partly overlapping with equivalent illness perception scales, the InjPQ depicts cognitive dimensions unique to injury that add significantly to explaining variance in outcomes. The InjPQ is recommended for research and clinical use as a measure of injury perceptions.

Attitudes toward people with disabilities caused by illness or injury: beyond physical impairment.

This study examined differences in attitudes toward and reactions to individuals with comparable disabilities caused by injury or illness. Participants were students and healthcare professionals randomly assigned to read one of eight vignettes constructed in a between-subjects, full-factorial design: 2 (illness/injury)× 2 (male/female)× 2 (visible/not visible). Participants completed questionnaires measuring reactions to the target person and attitudes toward people with disabilities. We found that both students and healthcare professionals expressed more positive attitudes toward persons with injury-related compared with illness-related disabilities, but that these differences were typically not expressed in reported social encounters with individual disabled persons. The effects of the illness-injury distinction were moderated by sex only among students, with the highest distancing reported from a female with an illness-related disability. Visibility of the disability triggered more social distancing among students, regardless of the injury-illness distinction. We concluded that the illness-injury distinction is a socially and psychologically significant factor.