The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients
Sheer Raev,1 Valerie Aloush,2,3 Gadi Gilam,4 Odelia Elkana1 1Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel; 2Institute of Rheumatology and Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv-Yaffo, Israel; 3A Gray School of Medicine, Tel Aviv University, Tel Avi...
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Dove Medical Press
2025-06-01
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| Series: | Journal of Pain Research |
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| author | Raev S Aloush V Gilam G Elkana O |
| author_facet | Raev S Aloush V Gilam G Elkana O |
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| description | Sheer Raev,1 Valerie Aloush,2,3 Gadi Gilam,4 Odelia Elkana1 1Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel; 2Institute of Rheumatology and Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv-Yaffo, Israel; 3A Gray School of Medicine, Tel Aviv University, Tel Aviv, Israel; 4The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelCorrespondence: Odelia Elkana, The Academic College of Tel Aviv-Yafo (MTA), P.O.B 8401, Tel-Aviv-Jaffa, 61083, Israel, Tel +972-3 6802525, Fax +97236802526, Email odelia.elkana@gmail.com, elkana@mta.ac.il Gadi Gilam, Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel, Tel +972-54 5335986, Fax +97226757078, Email gadi.gilam@mail.huji.ac.ilBackground: Fibromyalgia (FM) patients often perceive heightened levels of injustice, which can be associated with depressive symptoms. Despite this connection, the mediating role of depression between perceived injustice and pain intensity in FM patients remains unexplored.Aim: This study explored whether depression mediates the relationship between perceived injustice and pain intensity in FM.Methods: Data were collected through an online survey distributed to FM patients at the Tel Aviv Sourasky Medical Center, Israel. A total of 161 FM patients completed the survey, with perceived injustice assessed using the Injustice Experience Questionnaire, depression evaluated using the Patient Health Questionnaire, and pain intensity measured with the numerical Pain Intensity Rating Scale. Statistical analyses included analysis of variance and bootstrap-based mediation models.Results: FM patients reported elevated levels of pain, perceived injustice, and depression. The study found that depression significantly mediated the association between perceived injustice and pain intensity in FM patients (P < 0.001, CI = 0.024, 0.312).Conclusion: The link between perceived injustice and pain intensity in FM is partially explained by the level of depression. Individuals with higher perceived injustice scores are more susceptible to depression, subsequently experiencing increased pain. These findings suggest that intervention programs targeting depression may mitigate the impact of perceived injustice on pain intensity in FM, potentially enhancing health-related quality of life.Plain Language Summary: This study explores the connection between feelings of unfairness, depression, and pain levels in people with fibromyalgia, a chronic condition that causes widespread pain and emotional distress. Fibromyalgia patients often report experiencing a sense of injustice, such as feeling misunderstood or treated unfairly, which can worsen their mental and physical health.We aimed to investigate whether depression plays a role in linking perceived injustice to the intensity of pain experienced by these patients. To do this, we surveyed 161 individuals with fibromyalgia using online questionnaires. Participants rated their feelings of injustice, symptoms of depression, and pain intensity. Statistical methods were used to analyze how these factors interact.Our findings showed that people who felt a higher sense of injustice were more likely to experience symptoms of depression. This depression, in turn, contributed to higher levels of pain. In other words, depression served as a bridge connecting feelings of injustice to increased pain intensity.These results highlight the importance of addressing depression in fibromyalgia treatment. By helping patients manage depressive symptoms, healthcare providers may reduce the impact of perceived injustice on pain, potentially improving patients’ quality of life. This study emphasizes the need for psychological interventions to complement traditional pain management strategies for fibromyalgia patients.By understanding how mental health influences physical pain, this research supports a more comprehensive approach to care for people living with fibromyalgia.Keywords: fibromyalgia, perceived injustice, depression, pain intensity, psychological distress, injustice experience questionnaire |
| format | Article |
| id | doaj-art-5751fd2d809c42f0953ff8f95db9af15 |
| institution | OA Journals |
| issn | 1178-7090 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj-art-5751fd2d809c42f0953ff8f95db9af152025-08-20T02:24:08ZengDove Medical PressJournal of Pain Research1178-70902025-06-01Volume 18Issue 130773085104041The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia PatientsRaev S0Aloush V1Gilam G2Elkana O3Behavioral SciencesRheumatologyInstitute of Biomedical and Oral ResearchBehavioral SciencesSheer Raev,1 Valerie Aloush,2,3 Gadi Gilam,4 Odelia Elkana1 1Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel; 2Institute of Rheumatology and Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv-Yaffo, Israel; 3A Gray School of Medicine, Tel Aviv University, Tel Aviv, Israel; 4The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, IsraelCorrespondence: Odelia Elkana, The Academic College of Tel Aviv-Yafo (MTA), P.O.B 8401, Tel-Aviv-Jaffa, 61083, Israel, Tel +972-3 6802525, Fax +97236802526, Email odelia.elkana@gmail.com, elkana@mta.ac.il Gadi Gilam, Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, 91120, Israel, Tel +972-54 5335986, Fax +97226757078, Email gadi.gilam@mail.huji.ac.ilBackground: Fibromyalgia (FM) patients often perceive heightened levels of injustice, which can be associated with depressive symptoms. Despite this connection, the mediating role of depression between perceived injustice and pain intensity in FM patients remains unexplored.Aim: This study explored whether depression mediates the relationship between perceived injustice and pain intensity in FM.Methods: Data were collected through an online survey distributed to FM patients at the Tel Aviv Sourasky Medical Center, Israel. A total of 161 FM patients completed the survey, with perceived injustice assessed using the Injustice Experience Questionnaire, depression evaluated using the Patient Health Questionnaire, and pain intensity measured with the numerical Pain Intensity Rating Scale. Statistical analyses included analysis of variance and bootstrap-based mediation models.Results: FM patients reported elevated levels of pain, perceived injustice, and depression. The study found that depression significantly mediated the association between perceived injustice and pain intensity in FM patients (P < 0.001, CI = 0.024, 0.312).Conclusion: The link between perceived injustice and pain intensity in FM is partially explained by the level of depression. Individuals with higher perceived injustice scores are more susceptible to depression, subsequently experiencing increased pain. These findings suggest that intervention programs targeting depression may mitigate the impact of perceived injustice on pain intensity in FM, potentially enhancing health-related quality of life.Plain Language Summary: This study explores the connection between feelings of unfairness, depression, and pain levels in people with fibromyalgia, a chronic condition that causes widespread pain and emotional distress. Fibromyalgia patients often report experiencing a sense of injustice, such as feeling misunderstood or treated unfairly, which can worsen their mental and physical health.We aimed to investigate whether depression plays a role in linking perceived injustice to the intensity of pain experienced by these patients. To do this, we surveyed 161 individuals with fibromyalgia using online questionnaires. Participants rated their feelings of injustice, symptoms of depression, and pain intensity. Statistical methods were used to analyze how these factors interact.Our findings showed that people who felt a higher sense of injustice were more likely to experience symptoms of depression. This depression, in turn, contributed to higher levels of pain. In other words, depression served as a bridge connecting feelings of injustice to increased pain intensity.These results highlight the importance of addressing depression in fibromyalgia treatment. By helping patients manage depressive symptoms, healthcare providers may reduce the impact of perceived injustice on pain, potentially improving patients’ quality of life. This study emphasizes the need for psychological interventions to complement traditional pain management strategies for fibromyalgia patients.By understanding how mental health influences physical pain, this research supports a more comprehensive approach to care for people living with fibromyalgia.Keywords: fibromyalgia, perceived injustice, depression, pain intensity, psychological distress, injustice experience questionnairehttps://www.dovepress.com/the-mediating-role-of-depression-in-the-relationship-between-perceived-peer-reviewed-fulltext-article-JPRFibromyalgiaPerceived InjusticeDepressionPain IntensityPsychological DistressInjustice Experience Questionnaire |
| spellingShingle | Raev S Aloush V Gilam G Elkana O The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients Journal of Pain Research Fibromyalgia Perceived Injustice Depression Pain Intensity Psychological Distress Injustice Experience Questionnaire |
| title | The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients |
| title_full | The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients |
| title_fullStr | The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients |
| title_full_unstemmed | The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients |
| title_short | The Mediating Role of Depression in the Relationship Between Perceived Injustice and Pain Intensity Among Fibromyalgia Patients |
| title_sort | mediating role of depression in the relationship between perceived injustice and pain intensity among fibromyalgia patients |
| topic | Fibromyalgia Perceived Injustice Depression Pain Intensity Psychological Distress Injustice Experience Questionnaire |
| url | https://www.dovepress.com/the-mediating-role-of-depression-in-the-relationship-between-perceived-peer-reviewed-fulltext-article-JPR |
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