Rehabilitation Psychology最新文献

Purpose: Due to the ways disability and race overlap, intersect, and inform each other, to dismantle ableism, we must first understand how these processes operate in an intersectional manner, including when it comes to implicit bias. Yet, social psychology, and its prominent measures, including the implicit association test (IAT), have often taken a single-axis approach rather than attending to intersectionality. This study's aim was to develop and establish the intersecting disability and race attitudes implicit association test (IDRA-IAT).

Research method: We piloted the IDRA-IAT (July-October 2024) with 536 people (27.7% nondisabled White people, 32.3% disabled White people, 12.7% nondisabled people of color, and 27.3% disabled people of color). We analyzed the data using descriptive statistics, t tests, split-half reliability (internal consistency), and correlation analyses (test-retest reliability, and construct validity).

Results: People preferred nondisabled White people the most (M = 0.19), then disabled White people (M = 0.04), then nondisabled people of color (M = -0.09), and then disabled people of color (M = -0.13). However, the findings differed significantly based on the participants' identities. Our findings also indicated the IDRA-IAT has similar psychometrics to other IATs.

Conclusion: To advance disability justice, much more research about intersectionality and quantitative methodologies that promote intersectionality are necessary. We recognize that there is a lot more that comprises oppression and discrimination than attitudes alone. However, our hope is that the IDRA-IAT can be one valuable tool in the arsenal of many in the work to dismantle the oppression disabled people face. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: People with poststroke aphasia (PWA) are at increased risk for developing symptoms of depression. However, access to mental health (MH) care is often limited for this population. The goal of this study was to survey clinicians about current practices and specifically to examine (1) whether they work with PWA, (2) how often they observe symptoms of mood disorders in PWA, (3) how often these symptoms are treated, (4) who provides treatment for PWA, (5) what treatment consists of, and (6a) what training clinicians receive and (6b) provide for their trainees.

Research method/design: A 19-question multiple-choice and free-response survey was shared widely with clinicians.

Results: One hundred sixteen participants responded to at least 80% of the survey. The respondents were grouped as: MH and non-MH providers. Among MH and non-MH providers, most observed mood symptoms in PWA at least half the time, though the majority reported PWA receiving behavioral interventions for depression only sometimes/rarely. Responses regarding who provides care and what types of care are provided were mixed. Only 24% of MH and 9% of non-MH providers reported receiving specific training to address mood disorders in PWA, and more supervisors reported teaching MH trainees to work with people with language disorders than teaching non-MH providers to provide mental health care.

Conclusion/implications: The path for receiving and providing MH treatment for PWA does not appear to be standardized, which may contribute to gaps in services. Considerations for collaborative training and treatment are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: This study aimed to explore family risk factors for chronic neurobehavioral symptoms in service members and veterans (SMVs) with traumatic brain injury (TBI).

Research method/design: SMVs (n = 72) completed eight neurobehavioral outcome measures. Their family members (n = 72) completed 13 family risk factor measures assessing physical, psychological, and social health, and family functioning. The number of neurobehavioral measures that were clinically elevated (≥ 60T) were summed and used to classify SMVs into three outcome groups: (a) none/few symptoms (0-1 elevated scores), (b) several symptoms (2-3 elevated scores), and (c) many symptoms (4-8 elevated scores).

Results: SMVs in the many symptoms group had family members with significantly higher scores on nine family risk factor measures compared to family members of SMVs in the none/few symptoms group and two family risk factors compared to family members of SMVs in the several symptoms group. SMVs in the several symptoms group had family members with higher scores on three risk factor measures compared to family members of SMVs in the none/few symptoms group. Family member Anger was the most significant predictor of the total number of SMV elevated scores followed by family functioning, together accounting for 26.9% of the variance.

Conclusions/implications: An important and unique addition to the literature was the finding that a range of risk factors in the warfighter's family environment were strongly associated with clinically elevated chronic neurobehavioral symptoms following a TBI of any severity. More attention to the well-being of family members and their role in warfighter recovery and return to duty following a TBI are required. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Moderate-to-severe traumatic brain injury (TBI) often results in cognitive deficits that hinder the ability to drive an automobile, which in turn hinders independence and quality of life. Determinants affecting the relationship between impaired cognition and return to driving have been understudied. The current study examined the relationship between cognition and driving status following moderate-to-severe TBI.

Research method/design: Participants were 585 adults aged 19-96 (70% male) who sustained a moderate-to-severe TBI and were enrolled in the TBI Model System. Cross-sectional data were obtained (2018-2019) 1-30 years post injury (M = 8.2 years). Relationships were examined between driving status (active drivers vs. nondrivers), cognitive function (verbal memory, executive function), and covariates (demographics; injury factors including motor function; social factors).

Results: About 70% were driving at interview. Higher memory (OR = 1.36, p < 0.05) and executive function (OR = 1.38, p < .001) scores predicted active driving status; however, the relationships were not significant when the covariates were included. Family income, motor function, and history of seizure were related to driving status (all p < .05). Income and motor function were related to memory and executive function (all p < .001), whereas seizure history was not.

Conclusion/implications: Memory and executive function are significantly associated with driving status following TBI, but these relationships dissipate after accounting for sociodemographic/injury factors, particularly family income and motor function. Further research is needed to understand the interplay of cognition with other factors in return to driving decisions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: This study aims to investigate the parents' perspectives of the social experiences of their daughters with a physical disability during adolescence.

Research method/design: Parents of girls with a physical disability aged 7-26 were recruited through a combination of convenience, purposive, and snowball sampling. Semistructured interviews were conducted with respect to the experience of adolescence for their daughters. An interpretive phenomenological analysis was performed by three members of the research team with lived and clinical experience to identify superordinate and subordinate themes describing mother's perceptions of their daughter's social experiences during adolescence.

Results: Interviews were conducted with 21 mothers and mother-like figures of daughters (Mdn_age = 11) with spina bifida (10), cerebral palsy (nine), spinal cord injury (one), and another physical disability (one). We identified six superordinate themes, each defined by several experiences. These include amplification of differences during puberty (increasing differences and self-consciousness regarding differences), barriers to peer friendships (lack of opportunities, difficulties relating to peers with disabilities, difficulties relating to peers without disabilities, and lack of comfort with peers), facilitators of peer relationships (family support, school environment, and social skills), romantic relationship interest (perceived age-appropriate interest, perceived immature interest, and lack of interest), romantic relationship opportunities (lack of opportunities, relationship experiences, and parental support), and stability of parent-child relationships (dependence on mothers, impact of disability, and desire for independence).

Conclusions/implications: Mothers perceived their daughters with a physical disability experience increased disability awareness and variable challenges with peer relationships during adolescence. Regardless of the disability characteristics, mothers felt their daughters struggled to fully relate to peers both with and without disabilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Transgender/gender nonbinary (TGNB) and disabled individuals commonly experience microaggressions that can lead to depression, anxiety, and suicidality; yet, limited research has explored the intersections of disabled and TGNB identities. This study explored hypothesized pathways leading from microaggressions through internalized oppression and mental health to suicidal ideation in a sample of disabled TGNB individuals.

Research method/design: Disabled TGNB individuals (n = 289) completed an online survey assessing the constructs under scrutiny. The study performed multiple mediation path analyses to identify direct and indirect effects of each aspect of the hypothesized model.

Results: Fifty-seven percent of the sample had clinically significant anxiety symptoms and 71% depression symptoms; 47% experienced suicidal ideation in the past month and 93% during their lifetime. Suicide attempt rates were 3% for the past 3 months and 52% lifetime. Within the good-fitting path model, cisgenderist microaggressions had a direct effect on internalized cisgenderism. Disability microaggressions had direct effects on internalized ableism and mental health symptoms. Internalized ableism had direct effects on mental health symptoms and suicidal ideation. Internalized ableism mediated the relationship between disability microaggressions and mental health symptoms, mental health symptoms mediated the relationship between internalized ableism and suicidal ideation, and both internalized ableism and mental health symptoms mediated the relationship between disability microaggressions and suicidal ideation.

Conclusions/implications: Rehabilitation clinicians working with disabled TGNB individuals should consider the intersections of both systems of oppression (ableism and cisgenderism) and how microaggressions impact internalized oppression, mental health, and suicide. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Individuals with spinal cord injuries and disorders (SCI/D) may exhibit cues that tell a story about their loneliness. Health care providers must recognize loneliness cues in order to take action. This study identified and described loneliness cues exhibited by persons with SCI/D from health provider perspectives.

Research method/design: Descriptive qualitative design using in-depth interviews with health providers and analyzed using thematic analysis.

Results: Multidisciplinary SCI/D health providers from 10 nationwide Veterans Health Administration facilities. Ten themes described loneliness cues exhibited by persons with SCI/D: (a) direct or indirect verbal expression; (b) physical health symptoms/conditions; (c) mental health indicators; (d) withdrawal/lack of engagement; (e) "severe" voluntary seclusion, for example, not leaving house, not getting out of bed, sitting in the dark; (f) poor lifestyle behaviors, for example, substance use, poor nutrition; (g) neglecting personal self-care, for example, poor hygiene; (h) neglecting ones' internal environment, for example, dirty home, hoarding; (i) avoiding health care and health care management needs, for example, missing medical appointments, neglecting bowel care; and (j) fixating on health care to meet social health needs.

Conclusions/implications: Health care providers identified several loneliness cues commonly exhibited by individuals with SCI/D. These cues, whether verbal or nonverbal, may represent a signal that alerts the provider of a concern around loneliness. The value of such cues depends on the health provider's ability to identify them in order to decide on next steps, which may involve formal screening or validated measurement followed by collaborative patient engagement to identify potential sources contributing to loneliness and areas patients wish to address. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Disability has traditionally been viewed as a deficit in psychology research; however, accruing work suggests that viewing disability as an identity may be protective for mental health and well-being among disabled individuals. Therefore, developing disability identity measures that comprehensively capture this view of disability as an identity is an important step for promoting disabled individuals' flourishing.

Research method/design: To address this, we conducted two studies aimed at developing and validating a new scale to measure physical disability identity among adults with physical disability. In Study 1 (N = 104), we solicited feedback on our new scale from adults with physical disabilities and revised our scale to ensure that it captured their lived experiences. In Study 2 (N = 296), we tested the factor structure of the new Physical Disability Identity Scale. All data were collected in 2023.

Results: Most participants reported that our scale was easy to comprehend and comprehensively captured their lived experiences. We found evidence for a six-factor structure of the new Physical Disability Identity Scale, which assessed the following dimensions: Connection, Satisfaction, Centrality, Openness, Individual Self-Stereotyping, and Disability Lens. In addition, results suggested that Connection, Satisfaction, and Openness were adaptively related to well-being and health, whereas Centrality, Individual Self-Stereotyping, and Disability Lens were mostly adversely related to well-being and health.

Conclusion/implications: This research suggests that our Physical Disability Identity Scale is valid among adults with physical disabilities and that physical disability identity dimensions may be valuable to consider in future work on well-being and health among individuals with physical disabilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: The purpose of the present study was to identify perceived effects of spinal cord injury (SCI) on identity development and processes of reestablishing an integrated identity after SCI in a veteran sample.

Research method/design: Semistructured interviews with N = 21 veterans explored perceived effects of SCI on identity, including future orientation, meaning and purpose in life, engagement in key life roles including family, friendships, and work and engagement with other individuals with disabilities. Participants also completed survey measures of depressive symptoms and self-concept clarity. Mental health history data were extracted from electronic health records. Qualitative data were analyzed using thematic analysis.

Results: Participants frequently discussed identity-relevant changes in career roles, disrupted social roles, and changes in their sense of independence. However, most participants also emphasized aspects of their identity that remained continuous despite their injury. Among the most frequently discussed strategies for reestablishing an integrated identity after SCI were "adapting activities" and "establishing an active life," themes that highlight the relevance of identity exploration in adulthood. Military identity and culture afforded both benefits in adjusting to SCI (e.g., perseverance in recovery processes) as well as vulnerabilities (e.g., threats to self-sufficiency and physical fitness).

Conclusions/implications: The findings reinforce the importance of disability identity development as well as overall identity integration and reveal potential strategies that individuals may use to adapt their identities following SCI. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Posttraumatic growth (PTG) refers to positive changes that individuals experience in the wake of a stressful or traumatic event. Though growth and adaptation are considered ideal outcomes of rehabilitation, the extent to which PTG captures the unique experience of individuals with traumatic brain injury (TBI) has not been empirically evaluated. The purpose of the current study was to establish construct validity of PTG for individuals following moderate-severe TBI.

Research method: Forty participants who received inpatient or outpatient rehabilitation services for moderate-severe TBI and who were > 1 year postinjury completed a one-time phone interview of mental health and quality of life assessments, and answered a free-response question about significant life changes after injury. Using convergent parallel design, scores on the Posttraumatic Growth Inventory (PTGI) were compared to other assessments and themes of PTG and posttraumatic depreciation derived through thematic analysis.

Results: PTGI total scores (M = 66.60, SD = 21.79) were similar to other brain injury populations respective to time since injury (M = 11.20 years). Qualitatively derived themes of PTG aligned with domains of the PTGI, and endorsement of PTG was significantly associated with greater mental health and social support.

Discussion: This study provides evidence of the existence of PTG and posttraumatic depreciation in a sample of individuals with moderate-severe TBI, supporting its construct validity using mixed-methods data. Our findings may be helpful in identifying what significant changes may indicate significant growth and depreciation during the rehabilitation process, and be critical mechanisms for optimal psychosocial adjustment following brain injury. (PsycInfo Database Record (c) 2025 APA, all rights reserved).