Rehabilitation Psychology最新文献

Purpose/objective: The aim of this article is to evaluate the measurement invariance (MI) of the Patient Health Questionnaire-9 (PHQ-9) in a sample of individuals during the first 2 years after traumatic brain injury (TBI). MI was examined among racial/ethnic groups and over time to determine the utility of the PHQ-9 across these dimensions.

Research method/design: In total, N = 3,227 (20% of the total sample) at 1 year and N = 3,153 (19% of the total sample) at 2 years were included for cross-sectional analyses. For the longitudinal analyses, participants with the PHQ-9 at both time points (N = 2,234; 14% of the total study sample) were included.

Results: Results were that the PHQ-9 is fully invariant and maintains its unidimensional factorial structure across racial/ethnic groups during the first 2 years after TBI, suggesting the scale measures the same construct equally well for participants from each group.

Conclusion/implications: Based on these results, clinicians should feel confident using the PHQ-9 with diverse TBI patient populations, and researchers can reliably and validly employ it in TBI studies across racial/ethnic groups in the United States. Given the high rates of depression among individuals after TBI and its negative impact on their lives, this instrument will continue to be a key tool to measure the prognosis and success of rehabilitation programs. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Clinical trials often focus on symptom reduction as a primary outcome, overlooking positive psychology factors of potential importance although many individuals can and do live well with pain. The Patient-Reported Outcomes Measurement Information System (PROMIS) Psychosocial Illness Impact-Positive (PIIP) scale assesses perceptions of adaptive psychosocial functioning (e.g., coping and meaning-making) after illness onset. This study evaluated the effects of hypnosis (HYP), mindfulness meditation (MM), and pain psychoeducation (ED) on PIIP scores, using data from a completed randomized clinical trial (RCT) of complementary and integrative chronic pain interventions. We hypothesized that treatment effects on PIIP would mirror the RCT's primary pain intensity outcome, such that HYP and MM, relative to ED, would lead to greater improvements in PIIP during trial follow-up.

Method: Our sample included 262 Veterans who completed the PROMIS PIIP Short-Form 8a at pre- and posttreatment and at 3- and 6-month follow-up. Linear regression was used to test between-group differences in PIIP at each time point, controlling for baseline PIIP, average pain intensity, and baseline perceptions of prepain psychosocial functioning.

Results: There were no significant between-group differences in PIIP at posttreatment or 3-month follow-up. However, group differences emerged at 6-month follow-up: individuals randomized to MM and HYP showed improved PIIP relative to those randomized to ED.

Conclusions: Positive psychosocial outcomes are a mostly untapped territory in clinical trials of pain interventions. The present work highlights the potential benefits of including positive psychology concepts in both research and clinical contexts, emphasizing the importance of understanding human flourishing in the presence of illness and disability. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Nutrition knowledge, beliefs, and behaviors have important implications for managing and preventing chronic and injury-related secondary conditions in persons with spinal cord injuries and disorders (SCI/D). Yet, the unique dietary and nutritional needs and recommendations specific to individuals with SCI/D and their eating beliefs and behaviors have been understudied. Aim is to describe nutrition and eating beliefs and behaviors from the perspectives of individuals with SCI/D.

Research method/design: Descriptive qualitative design using in-depth semistructured interviews with a national sample of veterans with SCI/D (n = 33). Audio-recorded and transcribed verbatim transcripts were coded and analyzed using thematic analysis.

Results: Participants were male (61%), aged 29-84 years, and 55% had tetraplegia. Five key themes were identified: extreme fasting/caloric restriction, perceived healthy eating behaviors, perceived unhealthy eating behaviors, modified eating behaviors due to SCI/D-related symptoms, and food/preparation choices based on abilities/independence and access.

Conclusions/implications: Nutrition among veterans with SCI/D may be impacted by many factors, such as nutrition knowledge and beliefs/behaviors about "healthy" and "unhealthy" nutrition, fasting, caloric restriction, imbalanced intake of macro- and micronutrients, overconsumption relative to energy needs, injury-related secondary complications, postinjury body composition and function changes, impairments related to satiety and hunger signals, and difficulty in obtaining and preparing food. Study findings provide many areas that would benefit from intervention. Findings can be used to inform ideal nutrition and healthy eating beliefs and behaviors which are important because nutritional inadequacies can lead to diet-related diseases, may exacerbate SCI secondary conditions, and lead to poor overall health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: To examine the association of changes in homebound status (i.e., never/rarely leaving the home) with life satisfaction in the first 10 years after traumatic brain injury (TBI).

Research method/design: We analyzed data from 2,294 individuals with moderate-to-severe TBI from the TBI Model Systems National Database using a longitudinal multilevel model with time-varying predictors to account for within-person changes over time as well as between-person differences. We measured homebound status (defined as leaving the home ≤ 2 days/week) and life satisfaction (defined as the total score on the Satisfaction With Life Scale) at 1, 2, 5, and 10 years post-TBI. We adjusted the models for demographic and injury-related covariates and used inverse probability weighting to account for selection bias.

Results: Forty-five (2%) individuals were homebound at all follow-up visits, 523 (22.8%) were homebound at least one follow-up visit, and 1,726 (75.2%) were never homebound. Individuals with TBI who were consistently homebound had > 1 SD lower life satisfaction compared to those who were never homebound, β = -8.07, 95% confidence interval (CI) = [-9.39, -6.76], p < .001. Individuals who became homebound experienced a significant, but modest, decline in life satisfaction (β = -2.13, 95% CI = [-2.66, -1.61], p < .001).

Conclusions/implications: Our results indicate that being homebound and becoming homebound are associated with decreased life satisfaction. Homeboundness is a potentially modifiable target to improve life satisfaction, and elucidation of contributing factors to homebound status will help develop interventions to ameliorate post-TBI homeboundness. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: The transition from childhood to adulthood often involves emotional challenges. These problems may be especially prominent for transition-age adults (TAA) with pediatric-onset disabilities, although there are currently few studies that speak to this. The aim of this study is to characterize depressive symptoms and the association with family functioning in a sample of TAA with pediatric-onset disabilities.

Research method/design: This sample is comprised of 55 TAA (18-28 years of age, M = 20.88, SD = 2.49) who were followed by pediatric rehabilitation medicine clinics. Participants have childhood acquired brain injury (n = 17), spina bifida (n = 10), or neuromuscular disorders (n = 28). Participants completed the Center for Epidemiological Studies-Depression scale and the Family Assessment Device Short Form.

Results: Clinically elevated depressive symptoms were endorsed by 65.4% of the sample. Forty-five percent of those with elevated depressive symptoms were not currently receiving psychotherapy services. Poorer family functioning on the Family Assessment Device Short Form and older age were independently associated with more depressive symptoms, controlling for medical condition, mobility status, and other relevant sociodemographic factors.

Conclusions/implications: Emotional problems are quite common in TAA with a history of acquired brain injury, spina bifida, and neuromuscular disorders, yet are seemingly inadequately managed. In view of the results of this study, TAA with pediatric-onset disabilities are likely to benefit from interventions that bolster emotional well-being and target risk factors related to their family system. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose: This article will review the historical underpinnings of informed consent and decisional capacity, current practices, and potential evolving future modifications or elaborations of decision-making practices in clinical settings.

Method: Ethical and legal foundations for informed consent for health care are reviewed. Contemporary issues with decision making, clinical capacity, and proxy decision making in rehabilitation psychology practice are discussed with a specific focus on health care decision making.

Conclusions: As a subspecialist in psychology, a rehabilitation psychologist necessarily seeks to incorporate a working knowledge of its historical anchors while simultaneously seeking changes sensitive to honoring and advocating for the rights of the individuals whom they serve. The contributions of the disability rights movement have been immeasurable in ensuring that those most impacted with potential challenges to their right to self-determine their choices across a wide range of psycholegal issues are safeguarded. As rehabilitation psychologists, we must remain steadfast stewards and constructive supporters of those under our care through protecting and advocating for their rights. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: This study investigated the development of posttraumatic growth (PTG) in relatively young persons with stroke. It examined the contribution of potential predictive variables and their changes over time.

Research method/design: Participants completed questionnaires at baseline (n = 78, median time since injury = 47 days) and 3 (n = 53) and 6 months (n = 47) later. Each assessment included the Posttraumatic Growth Inventory, the COPE Inventory, and the Centrality of Event Scale. Data were analyzed using a sequence of linear mixed effect models.

Results: PTG was evident at baseline, but did not significantly increase over time. Higher event centrality, approach-oriented coping, and lower coping flexibility at baseline were associated with higher PTG 6 months later. Higher coping flexibility at baseline and an increase in event centrality were associated with a more positive trend in PTG over time. The final model explained 67% of variance in PTG. Time since injury, age, gender, social support seeking, and avoidance coping did not contribute significantly.

Conclusion/implications: Individual changes in the predictors contributed to high and stable PTG. How central the stroke was perceived to one's identity was the most important predictor for the absolute level of PTG as well as its change over time. This illustrates the complex and dynamic development of PTG. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Disability stigma has been linked with adverse chronic and acute health outcomes in people with disabilities. The present study updated the widely used Attitudes Toward Disabled Persons measure (to the revised Attitudes Toward People With Disabilities [ATPD] scale) among health care professionals and validated the measure using a disability stigma framework.

Design: A survey with 272 health care professionals and students was conducted.

Results: Regression analyses revealed that men, compared to women and nonbinary people, scored higher on disability stigma. Quality of contact, but not quantity of contact nor disability status was associated with less stigmatized attitudes. Those who scored higher on agreeableness, openness, and conscientiousness also scored lower on stigmatizing attitudes about people with disabilities. Furthermore, psychological inflexibility, social dominance orientation, and authoritarianism were all positive predictors of stigmatizing attitudes about people with disabilities. Finally, we found that medical model endorsement, but not social model endorsement positively predicted stigmatizing attitudes as measured by the revised ATPD scale.

Conclusion: Our findings validate the revised ATPD scale and illuminate disability stigma as expressed by a diverse sample of health care professionals. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Self-awareness (SA) is a crucial component of the neurorehabilitation processes for persons with acquired brain injury. Specific intervention programs to improve SA have been developed and implemented with heterogeneous results. The current study was undertaken to summarize this evidence by conducting a systematic review of relevant literature and to perform a meta-analysis of the most reliable and important results.

Method: A systematic literature search made in May 2023 across three databases (Web of Science, PubMed, and PsycINFO) resulted in a final selection of 16 primary studies based on 17 different groups.

Results: In an initial meta-analysis, the effect sizes were calculated as the standardized d, that is, pre-post change scores corrected for bias. Using a random-effects model, we obtained a significant mean effect size for the interventions, k = 17, g = 0.6404 [0.411, 0.870] with significant heterogeneity among the studies, Q(16) = 43.06, p < .001, and a significant, but modest publication bias. Moderator analysis showed that the SA intervention efficacy could be improved by "metacognition" as an intervention technique. A second meta-analysis was carried out considering the seven studies with between-subjects designs, and again a significant mean effect size was obtained, k = 7, g = 0.6713 [0.403, 0.94].

Conclusion: Overall, the present study provided positive evidence to support the efficacy of specific SA interventions in adults with acquired brain injury. Further studies are warranted to explore the mechanisms by which SA interventions exert their effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: People often view individuals with disabilities as incapable of working, contributing to society, and forming relationships. Therefore, it is important to develop interventions to reduce those negative stereotypes. Increasing accurate disability representation is one way to counteract those stereotypes. The present study's aim was to examine the impact of disability representation on disability stigma.

Research method/design: Participants consisted of 246 people from the U.S. general population who were randomized into one of three vignette groups: counterstereotypical representation (read about individuals with disabilities who were thriving), stereotypical representation (read about individuals with disabilities who were struggling), and a control group (read about able-bodied individuals who were thriving). Visual analog scales assessing disability stigma were completed pre- and postexposure to the vignettes.

Results: Disability stigma significantly decreased in the counterstereotypical group, significantly increased in the stereotypical group, and did not change in the control group from pre- to postexposure. At postexposure, the counterstereotypical group had significantly lower disability stigma than the stereotypical group, and the stereotypical group had significantly higher disability stigma than the control group.

Conclusion/implications: It would be valuable for the media to increase counterstereotypical representations and decrease stereotypical representations of individuals with disabilities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).