Rehabilitation Psychology最新文献

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).

Objectives: This study aimed to identify important mental health topics for people with spinal cord injuries (PwSCI) and garner insights from health care clinicians working with this population. In doing so, we identified psychosocial adaptations in the context of sexuality, intimacy, and reproductive health.

Method: A qualitative, phenomenological approach was used, with 60-90-min virtual focus groups involving PwSCI, rehabilitation clinicians, and psychologists. Themes were identified through deductive and inductive transcript analysis. Eligibility for PwSCI included: (a) SCI for ≥ 1 year, (b) 18+ years, (c) U.S. residency, (d) conversational English skills, and (e) cognitive capacity to provide informed consent. Clinicians required ≥ 5 years of rehabilitation experience.

Results: Sixteen PwSCI, eight rehabilitation clinicians, and four psychologists participated. Three major themes emerged: (1) The effects of SCI on relationships with noninjured significant others with subthemes of (a) internalized and partnered ableism in intimate relationships and (b) navigating care partner dynamics and resource gaps; (2) sexual self-esteem with subthemes of (a) gender role adaptation and (b) body image concerns; and (3) challenges in sexual and reproductive health with subthemes of (a) family planning and self-advocacy in health care settings, (b) access to specialized care, and (c) health care provider competence.

Conclusions: This report illuminates the complex effects of SCI on their relationships with noninjured partners, revealing how internalized and partnered ableism can heighten feelings of inadequacy and alter relationship dynamics. These findings underscore the need for more research, support, and services in sexual and reproductive health for all PwSCI. (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).

Objective: To evaluate an online intervention to support family members of individuals who sustained a traumatic brain injury (TBI).

Research design: Randomized control trial. Parallel assignment to TBI Family Support (TBIFS) intervention or enhanced usual care control (TAU). Three testing timepoints: pretest baseline (T1), posttest within 2 weeks of assignment (T2), and follow-up 1 month after posttest (T3).

Setting: Online.

Participants: Sixty-eight caregivers recruited nationally: 18 years of age or older, English speaking, providing primary caregiving to an adult family member with TBI and mild to moderate disability.

Intervention: Eight interactive modules providing information about cognitive, behavioral, and social consequences of TBI, training in problem-solving framework, and application exercises (N = 35). TAU was an informational website (N = 33).

Measures: Proximal outcomes-program use, usability, and user satisfaction for TBIFS participants. Primary outcomes-TBI content knowledge, strategy application objective response and open-ended response, and strategy-application confidence. Secondary outcomes-appraisals of burden, satisfaction, uncertainty in mastery, guilt, and negative environment.

Results: Proximal outcomes-about 80% of TBIFS participants completed the posttest assessment, and 91% reported moderate to high usability and user satisfaction. Primary outcomes-greater posttest gains in TBI content knowledge for TBIFS than TAU (t = 3.53, p = .0005, adjusted p = .0090, d = 0.91). Gains maintained through follow-up (t = 2.89, p = .0038, adjusted p = .0342, d = 0.90). No other effects for the primary or secondary outcomes.

Conclusion: TBIFS improved TBI content knowledge relative to TAU. Modifications might be needed to improve application and distal outcomes for caregivers. (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).

One common gait issue associated with advanced Parkinson's disease (PD) is freezing of gait (FoG). FoG impacts approximately half of people with PD and negatively impacts quality of life. Studies have suggested that anxiety may contribute to FoG. Individuals with FoG exhibit higher rates of anxiety, but it is unclear if anxiety contributes to FoG development. No known studies have assessed the impact of treating anxiety to improve FoG symptoms.

Objective: This pilot study evaluated the efficacy of cognitive behavioral therapy (CBT) training in reducing anxiety and improving gait in persons with PD following standard physical therapy (PT) treatment.

Method: Ten participants who had completed PT treatment for FoG were evaluated for psychological distress and gait parameters at baseline. They were then seen for four weekly virtual individual CBT sessions. Outcome measures were subsequently obtained 1 week after the CBT intervention and 5 weeks after the CBT intervention.

Results: Comparisons of baseline and postintervention Depression Anxiety Stress Scale-21 scores 1 week after the intervention were not statistically significant; however, improvements were both statistically and clinically significant a few weeks after the intervention, likely reflecting ongoing positive impact of CBT treatment. Gait parameters were noted to be clinically but not statistically significant after CBT treatment.

Conclusion: This study suggests that a brief course of CBT may help to reduce emotional distress and to improve aspects of gait in a cohort of PD patients with FoG. Future research using a larger cohort and providing concurrent CBT/PT interventions is needed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Lower mental health was observed in individuals with lower socioeconomic position (SES) in the general population. Similarly, social inequalities in mental health have also been observed in individuals with spinal cord injury (SCI), however, there is limited knowledge of the nonbiological mechanisms contributing to this uneven distribution. Previous research has demonstrated that psychosocial resources are linked to improved mental health. The aims of the present study were (a) to investigate the direct effects between SES and mental health load and (b) the mediating role of psychosocial resources in the SES mental health load associations in individuals living with SCI.

Research method: Cross-sectional self-report data from N = 1,294 persons living with SCI from the Swiss Spinal Cord Injury Cohort study were analyzed using structural equation modeling. SES was operationalized by education, household income, perceived financial hardship, and subjective social status. Psychosocial resources were operationalized by self-esteem, self-efficacy, hope, optimism and energy, feeling of belonging, purpose in life, social support, and relationship satisfaction. Mental health load was operationalized by emotional state, depressive symptoms, psychological distress, and affective components of well-being.

Results: Higher SES was significantly associated with lower mental health load. Self-esteem, self-efficacy, optimism and energy, feeling of belonging, purpose in life, and relationship satisfaction were found to mediate the association between SES and mental health load.

Conclusion: The study underscores potential interventions to address socioeconomic inequalities in mental health load among individuals living with SCI. Strengthening psychosocial resources could offer promising interventions, particularly for those from low SES backgrounds facing mental health challenges. (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: Prior research highlights the complex interplay among disability, education, employment, and poverty, underscoring the importance of investigating how positive academic experiences among disabled individuals may predict employment status and poverty levels, potentially many years later. To address this gap, this study examined how educational factors including academic satisfaction, college degree attainment, and unmet academic accommodation needs predict employment and poverty among adults with disabilities or chronic health conditions.

Research method/design: A sample of 409 adults with disabilities or chronic health conditions while they had attended school in the United States completed an online survey of these constructs. Random forest models and their built-in measures of feature (or predictor) importance were used to predict the binary outcomes of employment status and poverty status using academic satisfaction, college degree attainment, and unmet academic accommodation needs as well as several common sociodemographic characteristics, including age, disability level, gender, rurality, and minority racial/ethnic identity. Across measures of feature importance, the academic factors showed comparable or greater predictive importance than all other sociodemographic predictors, and correlational analyses revealed that these academic factors were associated with higher levels of employment and lower levels of poverty.

Conclusion/implication: These findings suggest that positive educational experiences and accommodations are important predictors of both employment and poverty outcomes for individuals with disabilities. Future research should further explore how specific educational experiences impact employment outcomes for individuals with disabilities and examine supports and interventions that can create positive academic experiences. (PsycInfo Database Record (c) 2026 APA, all rights reserved).