Rehabilitation Psychology最新文献

Purpose: Peer support has been identified as an important aspect of rehabilitation for visually impaired adults. However, there is a limited exploration in rehabilitation studies literature of the identity-related impact of these interventions, both at an individual and collective level. Through attending to the discourses on blindness, well-being, and social inclusion that circulate in organization cultures, this article considers the role that peer support plays in forming "blind communities" with particular characteristics, and what these communities might model about life with blindness, both to newly blind persons and to society.

Research method: Foucauldian discourse analysis was conducted on semi-structured interviews with 18 visual impairment rehabilitation service users and eight rehabilitation practitioners at four organizations providing services in the Western Cape, South Africa.

Results: Formal peer support is lacking in the sampled organizations, suggesting that relational aspects are not a priority in rehabilitation practice. The formal and informal peer support that does exist in these services is shadowed by largely negative sociocultural beliefs about blindness. Participants described a culture of comparison, othering, and surveillance within which, the article suggests, they are unable to explore and embrace authentic and positive blind identities. This has implications for both individual and collective empowerment.

Conclusions: Greater attention must be paid to both rehabilitation practitioner training and the design and implementation of rehabilitation services to the identity-level impact of rehabilitation. This is essential to develop services that promote individual and collective empowerment and that respond to the multilayered practical, social, and psychoemotional needs of blind adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Positionality statements accompanying peer-reviewed publications are increasingly being implemented in academic journals across many disciplines, including psychology. These statements serve as transparent, public acknowledgments of the authors' identities, which can offer valuable insight into the authors' work in the context of their lived experiences and potential biases. However, journal editors and associated staff risk harm by uniformly adopting a policy on positionality statements without consideration of the unintended consequences of implementing such practices.

Objective/purpose: The purpose of the current article is to discuss the benefits and challenges of incorporating positionality statements, with a focus on the specific context and principles of rehabilitation psychology.

Method: We reviewed the literature on positionality statements and disclosure and incorporated our own experiences as researchers and authors from marginalized and/or minoritized groups.

Results: Editorial and research teams in rehabilitation psychology are encouraged to reflect on both the potential benefits of positionality statements (e.g., greater recognition of "insider perspectives," recognition of potential biases) as well as the potential negative consequences (e.g., forced disclosure of characteristics and identities in published work, minimization of the impact of intersectional identities, dissolution of dynamic identities and stages of identity development).

Conclusions/implications: Positionality statements present complex challenges for rehabilitation psychology researchers from diverse backgrounds and their colleagues; thus, authors should be given the freedom to choose if and how to include a positionality statement in their work. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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: Chronic pain is common among people with spinal cord injury (PwSCI) and impacts mental health (MH). Mindfulness may buffer the association of pain with MH, but few studies have examined this among PwSCI. This study examines the extent to which mindfulness moderates the association of pain intensity with MH among PwSCI.

Method: PwSCI (N = 64) and chronic pain provided demographic and disability information, ratings of pain intensity (0-10 Numeric Rating Scale), pain interference, depression (eight-item Patient Health Questionnaire [PHQ-8]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), positive affect/wellbeing (SCI-QOL Positive Affect and Well-Being Short Form [PAWB-SF]), stress (Perceived Stress Scale-4 [PSS-4]), and mindfulness (15-item Five Facet Mindfulness Questionnaire [FFMQ-15]) at the time of their enrollment in a randomized controlled trial of a mindfulness intervention. The present, cross-sectional study used baseline data. Pain intensity, pain interference, mindfulness (FFMQ-15), the Pain Intensity × FFMQ-15 interaction, and relevant covariates were regressed on the four outcome measures (PHQ-8, GAD-7, PAWB-SF, and PSS-4).

Results: There was a significant Pain Intensity × FFMQ-15 interaction effect on PHQ-8 (p = .008) and GAD-7 (p = .021), such that mindfulness buffered the positive relation of pain intensity with depression and anxiety. Additionally, there was a significant Pain Intensity × FFMQ-15 interaction effect on PAWB-SF (p = .032), but contrary to the hypothesis, mindfulness intensified a positive relation between pain intensity and positive affect/well-being.

Conclusion: Dispositional mindfulness may buffer the association of pain intensity with depression and anxiety. Examining interventions to enhance mindfulness among PwSCI is warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Purpose/objective: To propose a predictive model for caregivers' psychological distress (including anxiety, depression, and cognitive overload) based on different data gathered from amyotrophic lateral sclerosis (ALS) patients (cognitive level, psychological distress, type of ALS, and sex).

Research method/design: A cross-sectional study with a sample of 51 ALS patients and their respective main carers. Various instruments were used such as the Beck Anxiety Inventory, ALS Depression Inventory-12, and the Edinburgh Cognitive and Behavioral ALS Screen, Zarit Burden Interview, Self-Rating Depression Scale, and Self-Rating Anxiety Scale for caregivers.

Results: ALS type, sex, and cognition were predictive variables for caregiver distress, with the main explanatory variable being the distress of the patients themselves. Spinal ALS led to higher psychological distress in caregivers (β = .38), as did male patients with ALS and preserved cognition.

Conclusions/implications: The proposed confirmatory model demonstrates that patients' psychological distress is the best predictor of psychological distress in their caregivers. (PsycInfo Database Record (c) 2024 APA, all rights reserved).