[Validation of the German-language version of the Injustice Experience Questionnaire (IEQ) in five outpatient clinics]. / Validierung der deutschen Übersetzung des Injustice Experience Questionnaire (IEQ) in 5 ambulanten Schmerzbehandlungseinrichtungen.

INTRODUCTION: Occupational and social rehabilitation can be influenced by perceived injustice that results from pain. Currently, the Injustice Experience Questionnaire (IEQ), the tool most commonly used to assess perceived injustice, is not available in German. The aim of this study was the validation of the German-language version of the IEQ. MATERIALS AND METHODS: The validation of the IEQ was carried out via a web-based survey. For this purpose, participants completed the IEQ and construct-related scales analogous to the original study Tampa Scale of Kinesiophobia (TSK), Depression scale of the Depression Anxiety and Stress Scales (D-DASS), Pain Disability Index (PDI), and McGill Pain Questionnaire (MPQ). In addition, the participants completed questions on their socioeconomic status and on the cause of their pain, taken from the German Pain Questionnaire. RESULTS: Of 223 respondents, 134 (60.1%) returned a completed questionnaire and were included in the study. In all, 26.1% of participants reported suffering from pain resulting from accidents. None of the reviewed one- to three-factor solutions for the IEQ's structure achieved a good model fit. The best results were found for a two-factor solution, whereby the exploratory factor analysis revealed almost all items loaded highly on both factors and the confirmatory factor analysis showed high correlations between the factors. These findings are consistent with previous studies. The IEQ correlated highly and significantly with the other psychological instruments. There were no floor or ceiling effects. Cronbach's α for the German IEQ version was 0.93 and thus attests a high level of internal consistency. CONCLUSION: The analyses attest the excellent psychometric properties of the German translation of the IEQ and so the German-language version of the IEQ can be used as a validated questionnaire to screen for perceived injustice.

[German transcultural translation of the Injustice Experience Questionnaire]. / Deutsche transkulturelle Übersetzung des Injustice Experience Questionnaire.

BACKGROUND: Occupational and social rehabilitation is influenced by perceived injustice as a result of injury. To assess perceived injustice, the Injustice Experience Questionnaire (IEQ) has been developed and is available in English. The aim of this study was to translate and culturally adapt the English version of the IEQ into German. MATERIALS AND METHODS: The IEQ was translated into German according to the criteria for the transcultural adaptation of self-assessment tools. The translation was examined in a sample of 19 pain patients as to whether the translated items were comprehensible, unacceptable or offensive, and what their meaning and the reason for the chosen response were. Data were assessed using nonparametric statistical methods. RESULTS: The German translation of the IEQ showed a high degree of comprehensibility. The items' meanings and participants' selected answer options were rated as highly plausible by two raters and the wording of the items was assessed as being neither unacceptable nor offensive by participants. Because of the slightly increased values with regard to Item 3, whose meaning was unrecognized by the raters, the term "Unachtsamkeit" was replaced by "Unaufmerksamkeit." CONCLUSION: The study attests to the cultural and linguistic intelligibility and precision of the German translation of the IEQ. In a follow-up study, the translation should be validated in a larger sample of pain patients.

Executive functions deficits impair extinction of generalization of fear of movement-related pain.

BACKGROUND: Generalization of fear of movement-related pain across novel but similar movements can lead to fear responses to movements that are actually not associated with pain. The peak-shift effect describes a phenomenon whereby particular novel movements elicit even greater fear responses than the original pain-provoking movement (CS+), because they represent a more extreme version of the CS+. There is great variance in the propensity to generalize as well as the speed of extinction learning when these novel movements are not followed by pain. It can be argued that this variance may be associated with executive function capacity, as individuals may be unable to intentionally inhibit fear responses. This study examined whether executive function capacity contributes to generalization and extinction of generalization as well as peak-shift of conditioned fear of movement-related pain and expectancy. METHODS: Healthy participants performed a proprioceptive fear conditioning task. Executive function tests assessing updating, switching, and inhibition were used to predict changes in (extinction of) fear of movement-related pain and pain expectancy generalization. RESULTS: Low inhibitory capacity was associated with slower extinction of generalized fear of movement-related pain and pain expectancy. Evidence was found in favor of an area-shift, rather than a peak-shift effect, which implies that the peak conditioned fear response extended to, but did not shift to a novel stimulus. CONCLUSIONS: Participants with low inhibitory capacity may have difficulties withholding fear responses, leading to a slower decrease of generalized fear over time. The findings may be relevant to inform treatments. SIGNIFICANCE: Low inhibitory capacity is not associated with slower generalization, but extinction of fear generalization. Fear elicited by a novel safe movement, situated outside the CS+/- continuum on the CS+ side, can be as strong as to the original stimulus predicting the pain-onset.