PsyResearch
ψ   Psychology Research on the Web   



Couples needed for online psychology research


Help us grow:




Rehabilitation Psychology - Vol 59, Iss 3

Random Abstract
Quick Journal Finder:
Rehabilitation Psychology Rehabilitation Psychology is a quarterly peer-reviewed journal that publishes articles in furtherance of the mission of Division 22 (Rehabilitation Psychology) of the American Psychological Association and to advance the science and practice of rehabilitation psychology.
Copyright 2014 American Psychological Association
  • Attributions of responsibility and recovery within a no-fault insurance compensation system.
    Objective: Although a great deal of literature supports the negative relationship between postinjury health outcomes and compensation, it has not fully examined the relative influence of the diverse factors that underlie compensable status. In particular, this study sought to understand the relative influence that attributions of responsibility for accidents have on mental and physical health outcomes. Method: Using a structural equation modeling approach, we assessed the strength of relationships between demographic and accident circumstance variables, and postinjury mental and physical health for 934 road-trauma survivors compensated under a single no-fault insurance system. Results: Analysis of direct and indirect effects demonstrated that although a range of standard demographic and accident circumstance variables influenced health outcomes, by far the greatest effect was generated from perceptions of responsibility for the accident. People who reported lower levels of responsibility for their accident showed significantly poorer mental and physical health outcomes. Conclusions: Perceptions of responsibility for accidents are strongly associated with postaccident mental and physical health outcomes within compensable road trauma populations. Future studies should control for attributions of responsibility when assessing the effect of compensation, or any other variable, on health outcomes among injured populations. Mechanisms underlying the effect of attributions of responsibility on outcomes, particularly in relation to its association with self-blame, warrant further exploration. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Reinjury anxiety, coping, and return-to-sport outcomes: A multiple mediation analysis.
    Purpose/Objective: This study aimed to examine whether the dimensions of reinjury anxiety (i.e., intensity, frequency, and direction) predicted perceived return-to-sport outcomes and whether coping mediated this relationship. Research Method/Design: Using a cross-sectional research design, 335 participants (M age = 23.5; SD = 6.6) who had sustained a sports-related injury preventing participation in training and competition for a minimum of 4 weeks (M time loss = 98 days; SD = 96.8) completed measures of reinjury anxiety (RIA-RE subscale of the Reinjury Anxiety Inventory (RIAI); Walker, Thatcher, & Lavallee, 2010), coping (MCOPE; Crocker & Graham, 1995), and perceived return-to-sport outcomes (RSSIQ; Podlog & Eklund, 2005). Pearson product–moment correlation and Preacher and Hayes’s (2008) bootstrapping procedure were used to analyze the data. Results: Consistent with our hypotheses, results indicated a positive relationship between reinjury anxiety (intensity and frequency) and heightened return concerns, whereas reinjury anxiety interpreted as facilitative toward postinjury performance was associated with a positive renewed perspective on sport participation. Significant indirect effects for coping were found for wishful thinking, venting of emotions, denial, and behavioral disengagement. Conclusions/Implications: Future avenues of research that aim to provide a greater knowledge and understanding of the relationship between reinjury anxiety and return-to-sport outcomes are discussed, including the need for alternative theoretical perspectives and diverse methodologies. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • The assessment of patients’ quality of experience: Autonomy level and perceived challenges.
    Purpose/Objective: Motor rehabilitation programs in hospital aim at promoting patients’ highest attainable recovery of body functions and capabilities. Well-being is predominantly identified with physical autonomy, yet the psychological dimensions of rehabilitation are often overlooked. Research Method/Design: To partially fill this gap, the quality of daily experience reported by 50 adult participants hospitalized in an Italian rehabilitation unit was investigated. Data were gathered through Experience Sampling Method, (ESM), providing repeated real-time assessments of the experience associated with daily activities. Before analysis, participants were divided into 3 groups, according to their low, moderate, or high levels of autonomy assessed through Barthel Index. Results: Participants predominantly associated rehabilitation activities with optimal experience, characterized by high concentration, engagement, control of the situation, and by the perception of high challenges matched with adequate personal skills. During personal care and leisure—the most frequent daily activities—participants reported instead low challenging experiences of apathy and boredom. During social interactions perceived high challenges prevailed. Multilevel analysis showed that the type of activity performed was a significant predictor of participants’ quality of experience, and the level of autonomy had a modest impact on it. Conclusions/Implications: Results highlighted the potential added value of rehabilitation tasks as opportunities to promote patients’ well-being. The predominantly negative experiences associated with the other daily activities point instead to the need for changes in hospital organization in order to more effectively promote patients’ autonomy and resource mobilization. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Using the social cognitive theory to understand physical activity among dialysis patients.
    Purpose/Objective: The purpose of this study was to use the social cognitive theory (SCT) constructs self-efficacy, outcome expectations, and self-regulation to better understand associations of physical activity (PA) behaviors among dialysis patients after controlling for demographic and health-related factors. Research Method/Design: This study was cross-sectional in design. Participants (N = 115; mean age = 61.51 years, SD = 14.01) completed self-report questionnaires during a regularly scheduled dialysis treatment session. Bivariate and hierarchical linear regression analyses were conducted to examine relationships among SCT constructs and PA. Results: Significant relationships between PA and self-efficacy (r = .336), self-regulation (r = .280), and outcome expectations (r = .265) were detected among people on dialysis in bivariate analyses. Hierarchical linear regression revealed significant increases in variance explained for the addition of self-efficacy, self-regulation, and covariates (p p R² = .272). Conclusion/Implication: This research supports the use of SCT in understanding PA among people undergoing dialysis treatment. The findings of this study can help health educators and health care practitioners better understand PA and how to promote it among this population. Future research should further investigate which activities dialysis patients participate in across the life span of their disease. Future PA programs should focus on increasing a patient’s self-efficacy and self-regulation. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Listeners’ preference for computer-synthesized speech over natural speech of people with disabilities.
    Purpose/Objective: There are few controlled experimental studies that examine reactions to people with speech disabilities. We conducted 2 studies designed to examine participants’ reactions to persuasive appeals delivered by people with physical disabilities and mild to moderate dysarthria. Research Method/Design: Research participants watched video clips delivered by actors with bona fide disabilities and subsequently rated the argument, message, and the speaker. The first study (n = 165) employed a between-groups design that examined reactions to natural dysarthric speech, synthetic speech as entered into a keyboard by hand, and synthetic speech as entered into a keyboard with a headwand. The second study (n = 27) employed a within-groups design that examined how participants reacted to natural dysarthric speech versus synthetic speech as entered into a keyboard by hand. Results: Both of these studies provide evidence that people rated the argument, message, and speaker more favorably when people with disabilities used synthetic speech than when they spoke in their natural voice. Conclusions/Implications: The implications are that although people react negatively to computer-synthesized speech, they prefer it to and find it more persuasive than the speech of people with disabilities. This appears to be the case even if the speech is only moderately impaired and is as intelligible as the synthetic speech. Hence, the decision to use synthetic speech versus natural speech can be further complicated by an understanding that even the intelligible speech of people with disabilities leads to more negative reactions than synthetic speech. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Psychosocial outcomes after traumatic brain injury: Life satisfaction, community integration, and distress.
    Objective: To examine the relationship between life satisfaction, community integration, and emotional distress in adults with traumatic brain injury (TBI). Method: This was an archival study of a longitudinal data set on the outcome and recovery process of persons with TBI. Participants were 253 consecutive adults with mild complicated, moderate, and severe TBI who were enrolled in a large, longitudinal study of persons with TBI. Main measures included the Satisfaction with Life Scale, the Positive Affective and Negative Affective Schedule, the Craig Hospital Assessment and Reporting Technique Short-Form, the Community Integration Measure, and the Brief Symptom Inventory-18. Results: The three-factor model adequately fit the data, and a higher-order model did not necessarily improve model fit but revealed significant relationships with first-order constructs and one second-order construct. Conclusions: Life satisfaction, community integration, and emotional distress were found to be related yet unique concepts in persons with TBI. Life satisfaction was positively related to community involvement and inversely related to emotional distress. Community integration was inversely related to emotional distress. In addition, these concepts are related to a higher-order concept of psychosocial status, a global representation of subjective and objective functioning. These findings demonstrate the interrelated and dynamic nature of psychosocial well-being after brain injury and highlight the need for integrative and holistic treatment plans. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Effort in acute traumatic brain injury: Considering more than pass/fail.
    Purpose/Objective: Performance validity is often conceptualized as a dichotomous process. Effort likely lies on a continuum, however, and psychologists’ tendency to rely on pass/fail descriptors of one’s effort may not be the only approach. The current study aims to show that when performance validity is considered on a continuum, it may provide clinical information related to cognitive functioning. Research Method/Design: Forty-four patients with moderate or severe traumatic brain injury were evaluated with the Repeatable Battery for the Assessment of Neuropsychological Status upon their emergence from posttraumatic amnesia. From this data, previously developed effort index scores and “other cognitive functions” index scores were calculated. Results: Performance on the effort index significantly accounted for the patients’ performance on a cognitive composite score after considering education and severity of injury. Conclusions/Implications: Findings suggest that more in-depth analysis of validity test performance is beneficial to gauge a patient’s level of effort and is important to consider when interpreting results and in treatment planning. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Unmet expectations of adjustment and depressive symptoms among people with chronic traumatic spinal cord injury.
    Objective: We attempted to gain a better understanding of overall adjustment among people with chronic traumatic spinal cord injury (TSCI) by identifying participants who experienced unmet expectations of adjustment to TSCI. We also examined the relationship between unmet expectations and depressive symptoms. Method: This was a prospective cohort study. Participants who survived at least 1 year postinjury (N = 863) were assessed at 2 time points separated by 10 years. Using a 10-point ladder (1 = worst and 10 = best adjustment), self-predicted future adjustment was measured at Time 1. At Time 2, current adjustment was reassessed using the same scale to evaluate differences between predicted and actual adjustment. Adjustment expectations were considered unmet when actual adjustment ratings at Time 2 were lower than predicted adjustment at Time 1. We measured depressive symptoms by using the Older Adult Health and Mood Questionnaire at both time points. Results: More than half of our participants experienced unmet expectations of adjustment over a 10-year period, and having unmet expectations was positively associated with depressive symptoms. Conclusion: Unmet expectations of adjustment after TSCI are common among those injured, and they are important predictors of depressive symptoms. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Stability of vocational interests after recent spinal cord injury.
    Objective: We sought to identify the stability of vocational interests among persons with spinal cord injury (SCI) first assessed during inpatient rehabilitation. Design: Initial assessments were completed during inpatient rehabilitation an average of 50 days after SCI onset (n = 521). Follow-up measures, collected by mail, were obtained an average of 16.6 months postinjury (n = 190) and 29.1 months postinjury (n = 296). Participants (n = 135) completed all 3 assessments. Participants completed the 1994 Strong Interest Inventory (Campbell, 1971; Harmon, Hansen, Borgen, & Hammer, 1994), Form T317, a 317-item measure of vocational interests. Results: Comparison of scale means across 3 times of measurement indicated significant changes in 2 of 6 general occupational themes (GOT), 8 basic interest scales (BIS), and 2 special scales (leadership style, risk taking/adventure). With 1 exception, a linear trend indicating an increase in reported interests accounted for observed relationships. An age by time interaction occurred with 1 GOT and 3 BIS. The average stability coefficient was 0.61 for the GOT, 0.59 for the BIS, and 0.70 for the special scales. The average coefficients were somewhat lower for the oldest participants. Conclusion: Interests do not appear to be static when first measured during inpatient rehabilitation after SCI. Rather, they evolve with average increases on select themes more compatible with the limitations of SCI. Stability coefficients suggest that interests are likely to change more than indicated in earlier studies. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Coping strategies and resources as predictors of psychosocial adaptation among people with spinal cord injury.
    Purpose: The onset of a spinal cord injury (SCI) is accompanied by a massive amount of stress, on which professionals in the medical field focus attention and care. The subsequent cascade of psychological stressors related to SCI often receives lesser attention. When individuals experience new forms of stress, they typically respond with attempts to cope, which may or may not be adaptive in reducing their stress levels. The twofold purpose of this study was to investigate whether SCI survivors’ use of coping resources (i.e., hope, sense of coherence) and coping strategies (e.g., engagement coping, seeking social support) influences their psychosocial adaptation, and whether their use of coping strategies moderates the effect of coping resources, after controlling for the influence of depression and anxiety, on psychosocial adaptation. Design: This cross-sectional study involved a self-report survey of survivors of SCI. Inclusion criteria included: (a) being 18 years of age or older, (b) having received inpatient rehabilitation services following the SCI, and (c) not having traumatic head injury at the time of the SCI onset. Participants: The sample consisted of 95 individuals with SCI who received outpatient rehabilitation services at a center in the midsouthern United States. Results: Results indicated that coping resources and coping strategies were significantly associated with psychosocial adaptation. Furthermore, engagement coping explained a significant portion of the variance in psychosocial adaptation both individually and as an interactive variable with the 2 coping resources of sense of coherence and hope. Conclusions: Findings indicate that both coping resources and strategies (especially engagement coping) are reliably linked to adaptation to SCI. The findings further suggest that engagement coping positively influences psychosocial adaptation even when coping resources are mostly absent. Other implications for the field of rehabilitation are briefly outlined. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Health care transition services for youth with autism spectrum disorders.
    Objective: Little is known about accessibility to health care transition (HCT) services (HCT) for youth with autism spectrum disorders (ASD). This study examined how often youth with ASD receive HCT services and how access varied by individual, family, and health system characteristics. Method: Questionnaires were completed by 101 parents of youth with ASD (ages 12–17 years) enrolled in a national online autism registry. Descriptive statistics and bivariate analysis were used to examine a composite HCT variable and its components. Results: Fewer than 15% of youth received HCT services. Although 41% received at least 1 HCT discussion, only 3% received all 3. One-quarter had a discussion with their health care provider about transitioning to an adult provider, adult health care needs, or insurance retention, and 31% of providers encouraged youth to take on more responsibilities. Most caregivers reported not needing 1 or more of the discussions. Results varied significantly when the sample was divided by age, with older youth more likely to have received transition services than younger adolescents. Conclusions: These findings indicate a significant disparity in access to HCT services for youth with ASD. Further research is needed to understand this disparity and develop interventions to improve HCT both for youth with ASD and those with other disabling health conditions. Additionally, many caregivers do not recognize the importance of HCT services. Education and training for caregivers, youth, and providers is essential to ensure all parties are working together to address transition issues early and often. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Does seeking safety reduce PTSD symptoms in women receiving physical disability compensation?
    Objective: This secondary analysis investigated the impact of 12 sessions of Seeking Safety (SS) on reducing posttraumatic stress disorder (PTSD) symptoms in a sample of dually diagnosed women with physical disabilities versus nondisabled (ND) women. SS is an evidence-based and widely implemented manualized therapy for PTSD and/or substance use disorder. It is a present-focused model that promotes coping skills and psychoeducation. Design: As part of the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN), 353 participants with current PTSD and substance use disorder (SUD) were randomly assigned to partial-dose SS or Women’s Health Education (WHE) group therapy conducted in community-based substance abuse treatment programs. The women were categorized as participants with disabilities (PWD; n = 20) or ND (n = 333) based on the question, “Do you receive a pension for a physical disability?” PTSD was assessed on the Clinician-Administered PTSD Scale (CAPS) at baseline and follow-ups after treatment (1 week, 3 months, 6 months, and 12 months). Results: PWD experienced sustained reductions in PTSD symptoms when treated with SS but not WHE. Indeed, PTSD symptoms of PWD in WHE returned to baseline levels of severity by 12-month follow-up. This pattern of results was not observed among ND women, who sustained improvements on PTSD in both treatment conditions. Implications: These results suggest strong potential for using SS to treat PTSD among women with physical disabilities, and speak to the genuine need to address trauma and PTSD more directly with PWD. Our results are also consistent with other findings from the NIDA CTN trial, in which virtually all significant results evidenced SS outperforming WHE. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • Health care worry is associated with worse outcomes in multiple sclerosis.
    Purpose/Objective: People with multiple sclerosis (MS) experience higher levels of depression and anxiety than the general population. This is the first study to examine the relationship of worry about affording health care and symptoms in MS. Research Method/Design: People with MS (n = 405) were recruited for a needs assessment study. Participants completed a structured telephone interview measuring depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning, and rated their worry about the following: premiums increasing, income decreasing, affording health care services, insurance dropping coverage, and affording prescriptions. Multiple regression analyses controlled for age, gender, disability status, education, income, and health insurance coverage. Results: The highest rated worry was inability to afford health care services. Higher health care worry was reported by women, younger participants, participants with lower incomes, and those with only private (vs. public) insurance. Total level of health care worry was significantly related to depression, anxiety, fatigue, sleep disturbance, pain interference, social function, and perceived cognitive functioning. Conclusions/Implications: Health care worry was significantly related to psychological, physical, and cognitive symptoms. Future research should compare health care worry in MS with other populations (i.e., healthy adults) and should examine changes in health care worry over time. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source

  • The role of resilience in adjustment and coping with chronic pain.
    Purpose: In clinical practice, it is often noted that some individuals struggle with chronic pain, while others find effective means to cope. The purpose of this study was to better understand how resilience fits into coping with persistent pain problems. Of interest was whether measures of resilience add to the prediction of adjustment to chronic pain over and above measures of pain coping as typically used with this patient group. Method: Individuals (N = 101) with chronic pain who attended an initial assessment at a pain clinic completed self-report measures of resilience and coping. Pain related outcome data were also collected. Results: Bivariate correlations indicated that higher resilience was associated with significantly less fear avoidance, less pain-related disability, and lower reported pain intensity. Consistent with theoretical propositions, bivariate analyses also indicated that more resilient individuals with chronic pain reported better social support, and were more likely to be working. Higher resilience was also positively correlated with greater pain self-efficacy. However, when hierarchical regression analyses were performed, resilience did not add significantly to the prediction of depression scores and disability scores, over and above the contribution made by existing measures of pain coping. Conclusion: These findings suggest that, although the construct of resilience appears to have important relationships with various dimensions of chronic pain, as currently operationalized, it does not add significantly to the understanding of chronic-pain adjustment. Rather than abandoning the resilience construct, our findings suggest that resilience as applied to the problem of chronic pain may require a refinement in measurement with this population. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
    Citation link to source



Back to top


Back to top