Rehabilitation Psychology最新文献

Purpose/objective: There is a significant gap in the literature with regards to the synthesis of qualitative research that explores the parenting experiences of parents with physical disabilities. This systematic review aims to synthesize the evidence regarding the experiences of parents with acquired and congenital physical disabilities.

Research method/design: This article presents a thematic synthesis of qualitative research carried out in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified through searches of Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PubMed, Scopus, and Web of Science databases and backward snowballing. The Critical Appraisal Skills Programme qualitative checklist was used as a quality assessment tool.

Results: Eleven articles were included in this review, and all were deemed to be high quality. Seven themes were identified: stigmatization and the need to prove competence as a parent; feeling underrepresented as a parent with a physical disability; environmental limitations; experiences of accessing support; using skills and strategies to fulfill parenting role; children's roles and reactions, and changes as they grow; and safety, wellness, and health when parenting with a physical disability.

Conclusions/implications: The findings emphasize the adaptability and resourcefulness of parents with physical disabilities in navigating environments that can be unsupportive, while continuing to prioritize their children's safety and well-being. The need for community peer-support groups and health care professionals who can provide emotional support, further public education with regards to the capabilities of parents with physical disabilities, prioritization of accessibility in public and private spaces, and the development of adapted childcare equipment, were all highlighted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Brain injuries are often "invisible" injuries that can have lifelong consequences including changes in identity, functional independence, relationships, and reduced participation in daily activities. Survivors of brain injury experience stigma and challenges related to the misattribution of symptoms to other causes that are significant barriers to recovery and adjustment. Changes in policy and other large-scale interventions are cited as an underexplored, yet critical path to reducing the impact of brain injury. The present study sought to comprehensively characterize the impact of one such initiative-Brain Injury Identification Cards-among survivors to further refine the resource.

Research method/design: In this cross-sectional qualitative focus group study, we recruited 16 individuals with a history of brain injury via email listservs of individuals who registered for a Brain Injury Identification Card. We used rapid data analysis with a hybrid of deductive and inductive analytic strategies to identify themes within a priori domains.

Results: We extracted themes within four domains: (a) process and reasons for obtaining cards; (b) overall impressions of the cards; (c) uses of the cards; and (d) feedback and proposed changes. Participants described the process of obtaining cards as straightforward and shared wide-ranging benefits across domains, including improving survivors' sense of safety, self-advocacy, and ability to participate in daily activities.

Conclusions/implications: Findings highlight the utility of Brain Injury Identification Cards for improving community understanding of brain injury symptoms and how injury-related challenges may manifest in daily life. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Individuals with a spinal cord injury (SCI) may experience posttraumatic stress disorder (PTSD) at a higher rate, which is associated with worse psychiatric comorbidity, decreased quality of life, and greater disability. Yet, effective PTSD interventions remain understudied for individuals with SCI. We conducted the first randomized controlled trial (RCT) of an evidence-based psychotherapy (prolonged exposure [PE]) with survivors of SCI during acute rehabilitation. We examined the efficacy, feasibility, and secondary outcomes.

Research method/design: Participants (n = 29) were adults recruited from 2018 to 2021 1-month postinjury with PTSD randomized into either PE therapy or treatment as usual. The primary outcome was PTSD assessed at baseline, 6, 10, and 32 weeks postenrollment.

Results: An overall group-by-time interaction was not statistically significant (p = .102), but effect sizes demonstrated moderate and large improvements in PTSD for the PE group at 6 (-19.4 vs. -9.7) and 10 (-25.8 vs. -5.7), respectively. Similarly, moderate to large effect sizes were observed for depression, maladaptive posttraumatic cognitions, disruptive nocturnal behaviors, SCI-related quality of life, and risky alcohol consumption. Low rates of enrollment (50%) and treatment completion (25%) suggest feasibility challenges; however, treatment completers did report high satisfaction (100%).

Conclusions/implications: Results suggest that individuals who received PE had a quicker and clinically meaningful reduction in PTSD symptoms, but delivery during acute rehabilitation is not feasible for many individuals. Future research should examine abbreviated versions of PE for PTSD to enhance the feasibility of treatment in this setting. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Caregivers of veterans with comorbid traumatic brain injury (TBI) and dementia face many challenges managing their loved ones' neurobehavioral functioning and, importantly, their own well-being. This study developed and tested Resources for Enhancing All Caregivers' Health (REACH) Hope, which provides caregivers with one-on-one telehealth education, support, skills building, and personalized digital information.

Method: Caregivers (N = 110) of veterans with both TBI and dementia were randomly assigned to either REACH Hope (n = 56) or a waitlist-control group (n = 54) for 3 months; waitlist participants then received REACH Hope. Data collection occurred by telephone at baseline, 3 months (postintervention/waitlist switch), 6 months, and 9 months (for waitlist-control only). The 12-item short-form Zarit Burden Interview (ZBI-12) at 3 months (posttreatment) was the primary outcome. Secondary outcomes included caregiver depression, anxiety, self-efficacy, and number of veteran safety risks.

Results: REACH Hope reduced burden and anxiety for caregivers with moderate to high levels of burden and anxiety compared to the waitlist group. Caregivers with ZBI-12 scores ≥ 21 had increasing treatment benefits with higher burden. Caregivers with Generalized Anxiety Disorder-7 scores ≥ 13 showed the same pattern for higher anxiety levels. There were no significant treatment group effects for depression, self-efficacy, or veteran safety.

Conclusion: This is the first clinical trial to evaluate the efficacy of a telehealth intervention for caregivers of veterans with both TBI and dementia. REACH Hope represents the first evidence-based intervention of its kind and one that warrants further study and implementation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: People with disabilities (PWDs) are at elevated risk for depression compared to their nondisabled peers (Okoro et al., 2021). Experiences of ableism and emotion dysregulation are identified risk factors for depression among disabled adults (Almeida et al., 2017; Wang et al., 2022). This study applies a minority stress lens, originally developed among sexual minorities, to a sample of PWDs, specifically, by examining distal (i.e., interpersonal and structural ableism) and proximal (i.e., internalized ableism and disability concealment) minority stressors as predictors of emotion dysregulation and depressive symptoms in a cross-disability sample.

Research method/design: U.S. adults (N = 162) with a range of disabilities completed an online survey in Fall 2022 assessing all model variables. A cross-sectional mediation analysis examined emotion dysregulation as a mechanism linking distal and proximal minority stressors to depressive symptoms. The model controlled for comorbid disability status to account for differences in depression among participants with multiple disabilities.

Results: As hypothesized, emotion dysregulation mediated the relationships between proximal minority stressors, internalized ableism, B = 0.12, 95% confidence interval (CI) [0.02, 0.23], and disability concealment (B = 0.13, 95% CI [0.03, 0.23]) and depressive symptoms. Ableist discrimination had a significant direct effect on depressive symptoms (B = 0.08, p = .008) but not a significant indirect effect through emotion dysregulation.

Conclusion/implications: Findings highlight emotion dysregulation as a mechanism through which proximal minority stressors are associated with depressive symptoms among PWDs, underscoring the need to target minority stressors in mental health interventions for disabled adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Fear avoidance behavior is associated with more severe postconcussion symptoms after mild traumatic brain injury (mTBI). However, it remains unclear when after injury fear avoidance behavior becomes a barrier to recovery. This study investigated changes in early fear avoidance behavior after mTBI and its associations with postconcussion symptoms.

Method: Adults with concussion (N = 308) were prospectively recruited from an outpatient concussion clinic in Ontario, Canada. They completed measures assessing fear avoidance behavior (Fear Avoidance Behavior after Traumatic Brain Injury Questionnaire) and postconcussion symptoms (Sport Concussion Assessment Tool-5) at Weeks 2 and 8 postinjury (N = 216).

Results: Based on normative reference values, the two most common postconcussion trajectories of fear avoidance behavior were those with persistently low and those with initially elevated but decreasing fear avoidance behavior. Using linear regression, we found an interaction effect between fear avoidance behavior at Weeks 2 and 8, indicating that participants with persistently elevated fear avoidance behavior (at Weeks 2 and 8) had more severe postconcussion symptoms at Week 8, whereas participants with initially elevated but decreasing fear avoidance behavior tended to recover well.

Conclusion: Early fear avoidance behavior often decreases, but when it does not, it is associated with worse recovery from mTBI. These findings may inform the timing and design of interventions targeting fear avoidance behavior in patients with mTBI. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: This study aimed to determine the relationship of participation dimensions with satisfaction with social roles and activities after traumatic brain injury (TBI).

Research method/design: Secondary analysis of baseline data from 127 participants enrolled in the MoodTracker intervention trial (https://ClinicalTrials.gov Identifier NCT04410770). Participants (M_age = 35.24) were predominately male (64.6%) and non-Hispanic White (70.1%). Primary measures were the TBI Quality of Life scales for Satisfaction With Ability to Participate in Social Roles and Activities, Ability to Participate in Social Roles and Activities, Independence, Stigma, and Self-Esteem and the Participation Assessment With Recombined Tools-Objective Out and About, Social Relations, and Productivity subscales.

Results: We performed a hierarchical regression to determine the unique association of different participation dimensions to Satisfaction with Social Roles and Activities. The Participation Assessment With Recombined Tools-Objective scores, representing the frequency of participation in activities, explained 18% of the variance (R² change = .177, p < .001) in Satisfaction with Social Roles and Activities. Ability to Participate in Social Roles and Activities and Independence, representing a person's perceived participation ability, explained 40% of the variance (R² change = .397, p < .001) when added to the model. Stigma and Self-Esteem uniquely explained 8% of the variance (R² change = .079, p < .001) when added to the model.

Conclusion/implications: A person's self-perceived ability to participate and be independent makes a greater contribution to satisfaction with social participation than the frequency of participation. Enhanced understanding of the interplay of subjective and objective factors in influencing participation satisfaction after TBI may result in more effective interventions to support meaningful participation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Spinal cord injury presents major long-term challenges, including the need to manage chronic pain and avoid overuse or misuse of prescription medication. Our purpose was to identify the extent to which resilience, bouncing back quickly from major challenges, is associated with prescription opioid use and misuse, controlling for depression.

Research method/design: Follow-up data were collected from 918 individuals with spinal cord injury. Resilience was assessed using the Brief Resilience Scale, and depression was measured with the Patient Health Questionnaire.

Results: In total, 13.6% of participants reported low resilience (n = 123), 66.1% reported moderate (n = 598), and 20.3% reported high resilience (n = 184). Resilience was protective of monthly/occasional use and misuse of opioids but not overall opioid use or regular weekly/daily use. Pain intensity was most highly associated with weekly/daily use, yet minimally related to occasional/monthly use. Depression was associated with misuse, overall opioid use, and regular use.

Conclusions/implications: Resilience was related to a lower likelihood of use of prescription opioid medications in situations where pain intensity was strongly associated with usage (i.e., intermittent use and using opioids other than prescribed). Resilience is strongly associated with a diminished likelihood of opioid misuse. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Debate continues over disability language preferences, with some individuals favoring person-first language and others preferring identity-first language. Not all people with disabilities identify as such, and language use may be influenced by an individual's disability identity. This study examined the relationship between disability identity and language use for self-identification, referring to others, and perceived appropriateness across different contexts.

Research method/design: In 2021, 776 participants (M = 39.9 years; 72.8% female, 17.5% nonbinary; 87.2% from Australia, 6.1% from the United States, 3.6% from the United Kingdom) completed a survey on demographic and health-related factors, disability identity, disability language use, and perceived appropriateness of disability language use across different contexts. Multiple linear and multinomial logistic regression models explored relationships among these variables.

Results: Participants with a stronger disability identity were more likely to use identity-first language and perceived it as more appropriate across contexts, while those with a lower disability identity preferred person-first language. Several demographic and health-related factors significantly predicted stronger disability identity, including younger age, nonbinary gender, residence in "other" countries (e.g., New Zealand, Canada, and European countries excluding the United Kingdom), neurodevelopmental, hearing, digestive, or pain conditions, congenital conditions, and having visible or both visible and invisible disabilities.

Conclusions/implications: These findings contribute to a deeper understanding of disability identity and language preferences. Future research should explore how personal and environmental contexts influence language use among people with disabilities, as addressing individuals with dignity and respect is essential in advancing toward a more inclusive society. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: Self-stigma can negatively affect transition-age individuals with disabilities, resulting in low self-worth, decreased psychosocial functioning, and reduced interest in career achievement. This study aimed to identify self-stigma profiles among transition-age individuals with disabilities, describe these profile patterns, and examine differences in basic psychological need satisfaction and career achievability across subgroups defined by these profiles.

Research method/design: We conducted a cross-sectional study using an online survey. A total of 199 transition-age individuals with disabilities were included in the data analysis. Latent profile analysis, Fisher's exact test, and one-way analysis of variance were used.

Results: The analysis identified a four-profile solution characterized by high, mid-high, mid-low, and low levels of self-stigma in cognition, affect, and behavior. Individuals in the high (n = 17) or mid-high self-stigma groups (n = 104) reported lower satisfaction in autonomy, competence, and relatedness compared to those in the low (n = 19) or mid-low (n = 59) self-stigma groups. These subgroups differed significantly in career achievability, such that individuals in the low or mid-low self-stigma groups reported higher career achievability than those in the high or mid-high self-stigma groups.

Conclusions/implications: Transition-age individuals with disabilities require support to reduce self-stigma that is associated with the satisfaction of basic psychological needs and career achievability. This can be achieved by addressing stigmatizing beliefs and fostering empowerment. Replication with a larger, more diverse sample is necessary to validate these findings and develop effective interventions to counter self-stigma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).