Rehabilitation Psychology最新文献

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).

Objective: This scoping review aims to describe measures of patient engagement in acute inpatient rehabilitation settings, measurement approaches, and conceptualizations of patient engagement.

Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and the Joanna Briggs Scoping Review Framework, we searched seven databases-PubMed, EMBASE, Cochrane Library, CINAHL Plus, Web of Science, Scopus, and PsycInfo-from inception to May 2024. Inclusion criteria included (a) participants aged 18 or older; (b) conducted in a hospital-based acute inpatient rehabilitation program irrespective of diagnosis; (c) measured patient engagement during rehabilitation; and (d) published in English. Major search concepts included patient engagement, measures, rehabilitation, and inpatient rehabilitation settings. Two independent reviewers assessed eligibility and extracted data, resolving conflicts through consultation with a third reviewer. The initial search identified 8,320 records.

Results: Of the 384 studies that underwent full-text review, 37 met inclusion criteria and reported on 10 engagement measures. The Pittsburgh Rehabilitation Participation Scale was the most frequently used, followed by therapy dosage and the Hopkins Rehabilitation Engagement Rating Scale. Most studies used an observer-rated approach. Conceptualizations of engagement varied in depth and integration of theoretical models. Although motivation was a central theme, conceptualizations have evolved, recognizing multiple factors influencing engagement.

Conclusion: The lack of consensus on measuring and conceptualizing patient engagement limits efforts to advance research and clinical practices to improve engagement and, ultimately, outcomes in rehabilitation. Future research could explore the clinical utility of existing measures and establish patient-centered best practices for measurement. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: The Body Compassion Scale (BCS) is a novel measure assessing the extent to which an individual is able to (a) view their body as one of the many components of their personhood, (b) recognize that everyone shares the experience of living in a physical body, with its advantages and disadvantages, and (c) embrace their body's current appearance, state of health, and functioning. It has been validated in healthy undergraduate samples; yet, there exists limited work documenting the psychometric properties among individuals with chronic health conditions. We evaluated the factor structure of the BCS among a sample of individuals with multiple sclerosis (MS).

Research method/design: In total, 677 people (M_age = 52.89, SD_age = 12.83) reported on their body compassion, fatigue, pain, cognitive functioning, disability, depression, anxiety, and resilience in an online survey sent out to a regional and national MS listserv.

Results: A three-factor structure (defusion, common humanity, and acceptance) emerged as the best fit to the data. All three subscores demonstrated acceptable internal consistency and validity evidence.

Conclusions/implications: The findings extend existing work demonstrating a three-factor structure of the BCS and provide preliminary validity for the use of the BCS among people living with MS and potentially other rehabilitation populations. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: The recovery experiences of individuals with serious mental illness (SMI) involve a complex interaction between intrapersonal and interpersonal factors through which they continue to pursue life goals and enhance their psychosocial adaptation. Among these outcomes, disability acceptance is an important aspect but remains underexplored in this context. This study aimed to identify recovery patterns among individuals with SMI using a latent profile approach and explore how these patterns relate to disability acceptance.

Research method/design: We analyzed responses from participants with SMI (N = 268) and employed latent profile analysis to uncover distinct recovery profiles based on key indicators: resilience, self-efficacy, coping, social support, and perceived social stigma. Each profile was then examined in relation to levels of disability acceptance. The participant sample had a relatively higher employment rate and was more educated compared to "typical" populations with SMI.

Results: Latent profile analysis revealed three subgroups: recovery-initiating, recovery-developing, and recovery-sustained. Over half of the participants were classified in the recovery-developing group, while approximately one-third were included in the recovery-sustained group. High levels of resilience, self-efficacy, coping, and social support-along with low levels of perceived social stigma-increased the likelihood of being classified in the recovery-sustained group. This group also demonstrated the highest levels of disability acceptance.

Conclusions/implications: The identification of distinct recovery patterns suggests the importance of enhancing resilience, self-efficacy, coping strategies, and social support, as well as managing perceived social stigma when working with individuals with SMI. Considerations for tailored interventions to promote recovery and disability acceptance among individuals with SMI are discussed. (PsycInfo Database Record (c) 2025 APA, all rights reserved).