gms | German Medical Science

15th Congress of the European Forum for Research in Rehabilitation (EFRR)

15.04. - 17.04.2019, Berlin

Differential effects of humiliation and injustice in patients in psychosomatic rehabilitation

Meeting Abstract

15th Congress of the European Forum for Research in Rehabilitation (EFRR). Berlin, 15.-17.04.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. Doc013

doi: 10.3205/19efrr013, urn:nbn:de:0183-19efrr0138

Veröffentlicht: 16. April 2019

© 2019 Linden et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Background: It has been shown that injustice and humiliation are the most frequent and burdensome negative life events, as reported by patients in psychosomatic rehabilitation [1]. They both can result in embitterment reactions and can lead to strong negative emotions, including shame, feelings of inferiority, and helplessness, anger, vindictive feelings, and even aggressive rumination and acting out. This can severely impair the affected person, but also her or his environment.

Aim: The research question is whether there are differences between injustice and humiliation in regard to the type and severity of consequences.

Method: In an ICF-oriented semi-structured interview, 102 inpatients from a department of behavioural medicine were asked about burdens in life. Additionally, patients filled in the “ICD-10 Symptom Rating”, the “ICF AT 50-Psych”, the “Beck Depression Inventory” and the “HEALTH-49”.

Results/findings: The experience of humiliation was rated as strong or very strong by 70.6% of the patients, which is the most frequent burden. It is followed by persistent stress (59.9%), and the experience of injustice in 56.8% of patients. Comparisons between patients who complained about injustice alone, humiliation alone, injustice and humiliation combined, and neither injustice or humiliation show that humiliation and injustice similarly and significantly impair psychological well-being. If both are combined negative reactions are augmented.

Discussion and conclusions: Humiliation and injustice are the most frequent and important negative life events in psychosomatic patients. They need proper recognition and treatment in psychosomatic rehabilitation care.


Bülau NI, Kessemeier F, Petermann F, Bassler M, Kobelt A. Evaluation von Kontextfaktoren in der psychosomatischen Rehabilitation. Rehabilitation. 2016;55:381-7.