Rehabilitation Psychology最新文献

Purpose/objective: Text-to-image (TTI) systems are artificial intelligence (AI) models that incorporate large amounts of data to produce high-resolution images. Although research has documented racial/ethnic and gender bias in TTI, little has examined disability bias. This study compared generated images of disabled people with no prompted setting to images of disabled individuals in health care settings.

Research method/design: OpenAI's DALL-E-3 TTI generated 50 images for each of the following prompts: (a) "person with a disability," (b) "patient with a disability," (c) "doctor with a disability," and (d) "doctor with a disability and a patient without a disability." We calculated DALL-E's success in generating prompted images and coded disability type and demographics.

Results: When prompted to create a "person with a disability," DALL-E-3 was 100% successful, with a wide diversity of disabilities. When prompted to create a "patient with a disability," DALL-E-3 was similarly 100% successful, although 70% of images portrayed an individual with a stereotypical physical disability. When prompted to create a "doctor with a disability," DALL-E-3 did with 92% accuracy: 94% had a physical disability and 6% a sensory disability; no other disability types were portrayed. When prompted to create a "doctor with a disability and a patient without a disability," in 64% of cases, DALL-E-3 generated images of doctors without disabilities, and 70% portrayed a disabled patient instead.

Conclusions/implications: Disability diversity decreases dramatically when AI-generated images place disabled people in a medical environment. As TTI generation grows more ubiquitous, further work by model developers to mitigate representational harms is vital. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: To evaluate the Caring Connections intervention compared to an attention control condition on loneliness, perceived burdensomeness (PB), and thwarted belongingness (TB).

Research method/design: In a two-arm parallel randomized controlled trial (RCT), 58 individuals with spinal cord injuries and disorders were randomized 1:1 to the intervention or the attention control condition. Block randomization with random block sizes of 2, 4, or 6 and allocation concealment were used to assign individuals to arms.

Results: Both groups showed within-group improvements in loneliness from baseline to post-RCT, but no statistically significant differences in change scores between the conditions over time. The treatment group showed within-group improvement in PB from baseline to post (p = .0008), but not in TB. The control group showed within-group improvement in TB from baseline to post (p = .04), but not in PB. No significant differences over time were found for either PB or TB between conditions. A greater proportion of the treatment versus control group found the program to be beneficial (76% vs. 45%, p = .02) and satisfactory (79% vs. 52%, p = .03).

Conclusions/implications: We did not demonstrate that the Caring Connections intervention reduced feelings of loneliness compared to the control condition. We found significant within-group improvements in loneliness from baseline to post-RCT for both groups. Within-group improvements in PB were seen in the treatment group and TB in the control group, but no significant differences in change scores over time between conditions. Communication over a 6-month period (from personalized peer letters or informational material on quality of life) had some impact on loneliness, PB, and TB. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: This study (a) used OpenAI's GPT-4 large language model to generate an initial item pool for a potential scale measuring internalized ableism, (b) involved disabled community stakeholders in refining the items and prompting additional artificial intelligence-generated items, and (c) psychometrically validated the scale in a large sample of disabled individuals.

Method: Following a series of GPT-4 prompts and iterative community-based participatory research feedback, a tentative item pool of 90 statements was developed. A sample of 409 adults with diverse disabilities completed a survey containing the initial item pool, potentially related scales, and demographic questions.

Results: An exploratory factor analysis helped identify the final 51 items and subscale structure, and a confirmatory factor analysis then provided evidence of excellent factor structure fit. The scale contained eight subscales with Cronbach's αs that ranged from .85 to .97, with an overall total score α of .98. The total score and subscales showed consistent convergent validity with other measures of internalized stigma for chronic illness and anger and frustration with disability.

Conclusion: This study generated for the first time in the known research literature a nuanced, comprehensive, and psychometrically sound scale based on the integration of both artificial intelligence and community-based participatory research methodology: the Internalized Ableism Inventory. The demonstrated methodology generating it has the potential to modernize psychological scale development approaches. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: Despite daily challenges, persons with spinal cord injury (PwSCI) successfully mobilize individual and relational resources and attain good mental health. Psychosocial resources were investigated as components of resilience, defined as satisfactory adaptation to adversity. While the association between resilience and positive mental health, conceptualized as psychological, emotional, and social well-being, was widely observed in individuals, it remains unexplored within dyads. This study was thus aimed to investigate this association at both individual and relational levels among PwSCI and their informal caregivers, defined as family members providing regular and unpaid assistance.

Method: Through a cross-sectional dyadic design, 162 PwSCI and their 162 caregivers completed the Resilience Scale for Adults and the Mental Health Continuum-Short Form. Actor and partner effects were analyzed using the actor-partner interdependence model.

Results: Significant actor effects emerged for self-perception (b = .60, p < .001), planned future (b = .62, p < .001), social competence (b = .26, p < .01), and social resources (b = .28, p < .01), resilience components positively associated with individuals' own positive mental health. A significant partner effect emerged for self-perception (b = .33, p < .05), suggesting interpersonal influence within the dyad. Caregivers reported higher positive mental health than PwSCI, but no role-based interactions emerged.

Conclusions: Resilience, particularly through self-perception, supports both personal and relational well-being, suggesting the potential usefulness of dyadic-focused interventions in chronic disease. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Purpose/objective: Caregivers of children with physical disabilities face unique stressors and experience high levels of anxiety, depression, and burnout. In general, self-compassion-based skills are associated with decreased psychological distress and increased well-being. However, the nuances of why or how self-compassion may promote the psychological well-being in caregivers of children with physical disabilities are unknown. Using qualitative data, this study explores the relevance of self-compassion in supporting caregivers' psychological well-being from multiple perspectives.

Method: We conducted 13 semistructured interviews with community service providers, a group feedback session with seven caregiver advisors, and a feedback session with eight caregivers who had recently completed a self-compassion-based resilience course. Transcripts were analyzed by two coders using reflexive thematic analysis.

Results: We developed three themes regarding how self-compassion skills may promote caregivers' psychological well-being within the context of caregiving: (a) balancing "gritting through" with increased awareness and expression of emotions and needs, (b) balancing isolation with increased connection, and (c) balancing self-judgment with increased grace and self-advocacy.

Conclusion: Self-compassion skills may benefit caregivers in specific ways in the context of caring for a child with a physical disability. Self-compassion-based interventions that target and measure these unique factors are promising for alleviating psychological distress for this community. (PsycInfo Database Record (c) 2026 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).

Objective: Pain is prevalent among women living with HIV (WLWH); however, research on pain experience among WLWH in the United States is limited. This study used a network analysis to simultaneously examine the relationships between pain experience and psychosocial functioning among WLWH and human immunodeficiency virus (HIV)-negative women.

Method: A secondary analysis of public data from the Women's Interagency HIV Study, a U.S. longitudinal cohort study of the experiences of WLWH and women at increased risk for HIV (HIV negative), was completed. Data were from Visit 42 in 2015 and included 451 WLWH and 194 HIV-negative women who endorsed experiencing pain in the week prior to the interview. Similar to the sociodemographic characteristics of WLWH in the United States, the majority of women in the sample were racially and/or ethnically minoritized and of low socioeconomic position. Networks were modeled using measures of pain intensity, pain interference, depression symptoms, anxiety/worry symptoms, meaning in life, and emotional support.

Results: Network models for WLWH and HIV-negative women were comparable (ps > .05). Depression symptoms were a central construct (strength = 1.82 and 1.77, respectively) within the networks, and pain interference was associated with psychosocial constructs (ps < .05), while pain intensity was not (ps > .05). Meaning in life and emotional support were not directly associated with pain (ps > .05).

Conclusions: Network findings suggest that reducing depression symptoms may result in improved pain experience and broader positive impact for WLWH and for women at increased risk of HIV. This finding is consistent with research with other pain-focused populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Experiences of disability-based discrimination among adults with disabilities (AWD) span individual, interpersonal, and structural domains that are implicated in mental health disparities. Ableist microaggressions, a subtle and contemporary form of disability-based discrimination, are positively associated with psychological distress. Additionally, disability characteristics may impact mental health outcomes differently. This study investigated (a) the association between lifetime experiences of ableist microaggressions and psychological distress and (b) the moderating effect of disability visibility.

Research method/design: A cross-sectional survey-based online study through Amazon's Mechanical Turk was conducted among 995 AWD whose ages ranged from 18 to 70 (M = 34.73, SD = 9.45).

Results: After adjusting for confounds linear regression analyses revealed a significant, positive relationship between ableist microaggressions and depressive, anxiety, and stress symptoms. Models explained approximately 18%-23% of the variance in psychological distress. Moderation analyses indicated that associations were stronger among participants with less visible disabilities.

Conclusions/implications: Findings underscore disability visibility as an important correlate in AWD mental health disparities. Results should be interpreted within the scope of the sampling procedures and sample demographics. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: People with disabilities often achieve lower educational attainments and face worse employment outcomes compared to the general population, a disparity partially due to the insufficient development of self-advocacy skills in academic and professional environments where targeted interventions are limited. This study designed and evaluated a 6-week self-advocacy program (SAP) enhanced with solution-focused brief therapy techniques for college students with disabilities (SWDs).

Research method/design: A program evaluation on process and outcomes was conducted using a pilot randomized controlled trial with college SWD (n = 28). Process evaluations included feasibility, fidelity, and acceptability, whereas the preliminary impact was determined by comparing the outcome assessments of SAP and the control groups.

Results: Process findings indicated that the SAP was conducted as planned, with facilitators effectively employing solution-focused techniques. The program gained traction among SWD and proved feasible for implementation in college settings. SWD reported satisfaction with their participation and shared SAP's strengths as well as areas for improvement. Results indicated that SAP significantly increased SWDs' confidence in disclosing their disabilities and requesting accommodations in the workplace compared to their peers in the waitlist control group. However, no group differences were observed in self-advocacy and self-determination.

Conclusions/implications: The findings suggest that SAP offers benefits in various aspects of self-advocacy for college SWD, informing future implementations of SAP or similar initiatives targeting this group. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Inflicted traumatic brain injury (iTBI), or abusive head injury, is a common cause of mortality and disability among infants and toddlers. Social determinants of health (SDoH) have a critical and multifaceted impact on iTBI, influencing both prevalence and outcomes. The area deprivation index (ADI) is a comprehensive metric of SDoH developed to assist in understanding how community-level socioeconomic factors influence patient outcomes. The current study sought to describe the sociodemographic characteristics, including ADI, of a cohort of 373 infants and young children who sustained an iTBI.

Research method/design: This study was a retrospective analysis utilizing a cohort of pediatric patients treated for iTBI at a large, tertiary care children's hospital serving seven states in the Rocky Mountain region.

Results: Mortality prevalence was higher among older children, and older children were more likely to have a longer stay in the pediatric intensive care unit. Children who were identified as Hispanic/Latino lived in areas with greater socioeconomic disadvantage than children identified as non-Hispanic/Latino. Specifically, participants who were identified as White Hispanic/Latino lived in areas with greater disadvantage than children who were identified as White non-Hispanic/Latino. There were no other significant differences by race. Contrary to hypotheses, ADI was not significantly related to mortality, injury severity, or follow-up visits.

Conclusions/implications: While SDoH are known to influence outcomes in iTBI, it may be necessary to incorporate individual or family-level SDoH variables within this clinical sample and examine the interaction between individual and community-level factors. (PsycInfo Database Record (c) 2025 APA, all rights reserved).