PURPOSE/OBJECTIVE:Psychosocial wellness (PSW), a construct incorporating emotional/psychological well-being and social/collective well-being, is not well defined in people with multiple sclerosis (MS). We conducted a qualitative study of definitions and experiences of PSW, facilitators and barriers, and associations with distress and resilience to inform an empirically grounded person-centered conceptual model of PSW in MS. RESEARCH METHOD/DESIGN:Five focus groups (∼90 min) were conducted via videoconference with 40 adults with MS from the United States between March and April 2024. Focus groups were facilitated by a clinical psychologist using a semistructured guide and were audio-recorded, transcribed, deidentified, and analyzed using thematic analysis within a constructivist framework to generate a PSW conceptual model. RESULTS:We identified 11 minor themes (italicized in parentheses) organized under nine major themes: Definitions of PSW, temporal characteristics (daily variability, change over time, hope follows grief), psychological contributors to PSW (silver linings and flexibility and acceptance), behavioral contributors to PSW (creative outlets/hobbies, symptom management), social contributors to PSW (supporters and partners, contribution/responsibility, finding community, setting boundaries), spirituality, environmental barriers, social/cultural barriers, and health and function barriers. Themes informed a conceptual model of PSW as a dynamic, individualized equilibrium between distress and satisfaction shaped by shifting facilitators and barriers; resilience buffers the effects of barriers to PSW. CONCLUSION/IMPLICATIONS:Qualitative themes informed an empirically grounded, person-centered model of PSW in MS. Participants' descriptions highlight concrete, teachable strategies-such as psychological flexibility, value-based role redefinition, boundary setting, activity adaptations, and savoring-that could be leveraged to support living well with MS. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE:Despite increased recognition of the necessity of inclusive research and writing to encompass the diversity of human experience, discrepancies regarding how we conceptualize and describe disability persist. Differences in language signify differences in thinking, yet there also exist opportunities for reconciliation that center disability justice as a core tenet of rehabilitation research and practice. The purpose of this article is not merely to encourage academics to use the "right" language, but to question how we think about disability in our work and world. RESEARCH DESIGN:Bringing together literature from rehabilitation and critical and feminist disability studies, we propose a crip reimagining of rehabilitation research and practice. Rooted in feminist and queer theory, "to crip" means to apply a disability justice lens and unsettle ableist assumptions. RESULTS:Incorporating approaches from disabled scholars and activists encourages the adoption of a disability justice framework that centers the desires and needs of disabled people. In yet another political moment when disabled people face existential threats to their lives and well-being, it is essential that rehabilitation psychologists and other professionals follow the lead of disabled people to advance efforts for disability justice. IMPLICATIONS:Disability justice demands not the eradication of disability, but the creation of a world in which disability is recognized as part of human variation, an effort that starts without our own discipline. We must find ways to continue recognizing and promoting possibilities for treatment and support, while also understanding that many disabled people live meaningful, fulfilling lives with or without our assistance. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Publishing in peer-reviewed journals is an important part of professional life in rehabilitation psychology, yet early-career scholars and trainees often receive limited direct instruction in how to transform research ideas into publishable manuscripts. This article offers a practical, field-specific guide to support authors in developing, writing, and submitting their work. RESEARCH METHOD/DESIGN:Drawing on the author's experience as a researcher, mentor, and journal editor, the article integrates best practices from multiple sources including reporting standards and open science principles while tailoring advice to the unique values of rehabilitation psychology. RESULTS:The article provides step-by-step guidance on structuring each section of a scientific article, from the introduction through the discussion, and includes metaorganizational tools. It also addresses important preparatory steps such as clarifying authorship, engaging mentors and collaborators, and adopting effective writing strategies. Practical recommendations are provided for selecting an appropriate journal; tailoring a manuscript to word and style requirements; and navigating peer review, revision, and rejection. Special attention is devoted to issues central to rehabilitation psychology, such as using respectful and inclusive language, precisely reporting demographic characteristics, describing stakeholder engagement, and considering positionality. CONCLUSIONS/IMPLICATIONS:Together, these strategies provide a roadmap for trainees and early-career professionals, helping them publish work that is not only scientifically rigorous but also aligned with rehabilitation psychology's mission of advancing equity, inclusion, and meaningful clinical impact. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:People with disabilities (PWD) are nearly five times more likely to experience mental distress than people without disabilities. Despite this elevated risk, many mental health professionals report feeling unprepared to work with PWD, possibly due to limited disability-focused training. The objective of the current study was to assess disability-focused content in graduate and postgraduate training programs for psychologists, psychiatrists, social workers, and counselors. RESEARCH METHOD/DESIGN:An online survey was distributed (September 2024 through October 2025) to directors and faculty of graduate and postgraduate psychology, counseling, social work, and psychiatry programs in the United States. Director and faculty participants (N = 191) reported on the presence and amount of coursework/training to diagnose, assess, and treat psychiatric disorders among PWD. RESULTS:Approximately 45% of participants reported little to no instruction on diagnosing psychiatric disorders in PWD, and 42% reported little to no training in conducting mental health assessments with PWD. Half of the participants indicated minimal or no training in psychotherapeutic interventions for PWD or communicating about mental health with PWD. Only 11% rated their program as excellent in preparing future clinicians to work with PWD. Regression analyses showed that both the presence (p < .001) and amount (p < .001) of disability-focused content significantly predicted perceived student preparedness to work with PWD. A sensitivity analysis excluding potentially duplicate responses confirmed the robustness of these findings. CONCLUSION/IMPLICATION:Findings highlight substantial gaps in disability-focused training within mental health programs and suggest that increasing disability-focused content may enhance faculty-perceived clinician preparedness to work with PWD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Primary objectives of the study were: (a) to identify the most frequently used categories of cognitive-behavioral intervention (CBI) strategies used by distressed African American caregivers (CG) of persons living with dementia to address self-reported problems and; (b) to conduct an initial evaluation of the psychometric properties of the African American Dementia Caregiver Strategies Inventory (DCSI-A) in categorizing CBI strategies. RESEARCH METHOD/DESIGN:Development of the DCSI-A was divided into four steps: (a) generating a large item pool of CG intervention strategies from two parent CBI randomized controlled trials; (b) creating a preliminary version of the DCSI-A; (c) generating subsequent versions with larger number of strategy categories based on consensus agreement; and (d) finalizing the 23-item DCSI-A with coding rules, definitions, and examples. Two analytic approaches were used: (a) descriptive statistics to examine the frequency and percentage of strategy category endorsements; and (b) reliability analyses (percent agreement and kappa) to assess overall coder agreement and coder drift. RESULTS:The most frequently used CG strategy categories were as follows: (a) health-related intervention strategies; (b) strategies to facilitate socialization and community activities; (c) assertiveness techniques; (d) relaxation strategies; and (e) effective thinking strategies. Average coder agreement was high (93.31%, κ = .92). Considerable stability across coders was shown across assessment intervals: 94.56% average agreement (κ = .94) for the first interval and 92.07% agreement (κ = .91) for the second interval. CONCLUSIONS/IMPLICATIONS:Findings of this investigation showed strong initial support for the reliability of the DCSI-A and its capacity to capture diverse components of CBI for African American CGs of persons living with dementia. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Women with Chiari malformation (CM), a congenital physical disability associated with significant chronic pain, frequently experience functional difficulties and depression. This study examined whether chronic pain acceptance, defined as the ability to acknowledge unpleasant sensations without attempting to alter or avoid them, mediates the association between functional difficulties and depression symptoms. RESEARCH METHOD/DESIGN:This study included a baseline and 1-month follow-up assessment of 100 women with CM. At baseline, participants completed the interference subscale of the Brief Pain Inventory, the Instrumental Activities of Daily Living scale, and the Chronic Pain Acceptance Questionnaire; at 1-month follow-up, participants completed the depression subscale of the 21-item version of the Depression, Anxiety, and Stress Scale. Mediation analyses were conducted using maximum likelihood estimation with missing values. RESULTS:Chronic pain acceptance fully mediated the relationship between Instrumental Activities of Daily Living scores and depression symptoms, accounting for 76% of the total effect (b = 0.87, SE = 0.28, p = .002). Chronic pain acceptance partially mediated the relationship between pain interference and depression symptoms, accounting for 29% of the total effect (b = 0.71, SE = 0.30, p = .02). CONCLUSION/IMPLICATIONS:Chronic pain acceptance may be one possible modifiable mechanism linking functional difficulties and pain interference to depression symptoms among women with CM, suggesting that interventions targeting chronic pain acceptance may reduce depression risk in this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Data on commonly reported unmet needs poststroke are crucial to inform interventions and ongoing care of survivors. We aimed to synthesize contemporary data on the prevalence of unmet needs among survivors in the community, and associated factors. RESEARCH METHOD/DESIGN:We searched MEDLINE, Embase, and CINAHL for articles with prevalence estimates on unmet needs poststroke. Only articles comprising data collected from 2013 to June 2025 from survivors living in the community or their proxies were included. A random-effects model was used to meta-analyze prevalence, whereas associated factors were summarized. RESULTS:Of 1,233 articles screened, 19 were eligible for inclusion (n = 8,138 participants), including 13/19 with data on associated factors, and one from a low-to-middle-income country. Overall, 68 unique unmet needs were identified across six domains: body function (n = 13), cognition/mental health (n = 10), social/community integration (n = 7), activity/participation (n = 14), service/information (n = 11), and recovery (n = 13). The pooled prevalence of reporting ≥1 unmet need was 65%. Unmet needs with the greatest pooled prevalence estimates were those related to education/information on stroke (60%), fatigue (49%), concentration (46%), headache (37%), anxiety/depression (36%), and diet (36%). Factors that were commonly associated with reported unmet needs include those related to social determinants of health (most commonly age and sex), stroke type/severity, poststroke care (most commonly length of hospital stay and poststroke services), multimorbidity, and health and well-being. CONCLUSION/IMPLICATIONS:We provide contemporary data on unmet needs among stroke survivors in the community, and associated factors. Our findings could inform more tailored support, particularly psychological support, for survivors in the community. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Brain injuries often have lifelong consequences that include long-term impairments and disability. Policy-, community-, and society-level interventions are a critical path to survivor impact. A recent qualitative study highlighted the potential of a new tool, Brain Injury Identification Cards, for enhancing survivor safety, self-advocacy, and well-being. The primary purpose of our study was to conduct a quantitative assessment of perceived benefits and self-reported credibility, expectancy, and acceptability to inform future trials. RESEARCH METHOD/DESIGN:In this cross-sectional study, we assessed the impressions of current owners (N = 99) of Brain Injury Identification Cards. We administered online self-report questionnaires and characterized perceived experiences, acceptability, and utility using descriptive statistics. RESULTS:Most (>67%) had favorable impressions about their own use of the Brain Injury Identification Cards, although approximately 19% perceived the cards as stigmatizing or embarrassing, and 22% said the cards were not helpful for their stress and anxiety surrounding traumatic brain injury symptoms. Overall, participants rated treatment credibility and expectancy as high, and all respondents who completed survey items (n = 96) indicated that they would recommend cards to others with traumatic brain injury and other medical conditions. CONCLUSIONS/IMPLICATIONS:Our findings highlight the perceived benefits of using a Brain Injury Identification Card among established Card owners. Future studies in representative samples of survivors assessing user experiences before and after the receipt of Brain Injury Identification Cards are needed to assess potential intervention effects. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
OBJECTIVE:Stroke recovery and its associated outcomes have an impact on both persons with stroke and their care partners. The current study examined differences between younger and older couples coping with stroke, as well as focusing on how depression and satisfaction outcomes for one member of the dyad impacted the other. DESIGN:This cross-sectional secondary analysis examines baseline data from a pilot study involving 34 couples coping with stroke, originally part of an 8-week positive psychology intervention designed to foster resilient romantic relationships. Participants completed self-reported ratings of depressive symptoms (Patient Health Questionnaire) and satisfaction with social roles (Patient-Reported Outcomes Measurement Information System Satisfaction with Social Roles-Short-Form 7a v1). RESULTS:Younger persons with stroke were more likely to be unemployed, have children under 18, and report lower education levels, whereas older participants were more often male and had longer relationships. Significant inverse correlations were found between depressive symptoms (Patient Health Questionnaire-9) and satisfaction with social roles (Patient-Reported Outcomes Measurement Information System Satisfaction with Social Roles), particularly among younger dyads. Actor-partner interdependence models revealed that younger stroke survivors' social role satisfaction was inversely related to both their own and their care partners' depressive symptoms, whereas in older dyads, only care partners' outcomes showed significant negative associations. CONCLUSIONS:This study highlights differences between younger and older couples coping with stroke, revealing that younger dyads exhibit more influence among one another as well as worse recovery outcomes. These findings underscore factors that can impact long-term recovery and life participation for both persons with stroke and their care partners. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Traumatic brain injury (TBI) is a major health concern for military personnel, and recovery and rehabilitation have historically focused on pathology and deficits. Recent efforts have shifted toward strength-based approaches, with a focus on positive psychology factors in TBI recovery. This study conducted a scoping review of the current research on positive psychology constructs (PPCs) among military personnel with TBI. RESEARCH METHOD/DESIGN:Using Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we identified English peer-reviewed studies published from 2000 to 2024 across four databases (MEDLINE, Embase, APA PsycInfo, and Web of Science) using search terms representing PPCs investigated among adults with military background and TBI. After abstract and full-text screening of 942 studies, data were extracted from 55 studies that met the inclusion criteria for this scoping review. RESULTS:The majority of studies represent veterans (n = 42) who sustained a mild TBI more than 12 months before the study. Social support (n = 18), resilience (n = 14), and quality of life (n = 14) emerged as the most studied PPCs. Studies were primarily based in the United States (n = 49) with positive constructs examined through quantitative, cross-sectional methods (n = 32) using diverse self-report measures. Positive psychology intervention studies among military personnel are sparse (n = 3). CONCLUSIONS/IMPLICATIONS:An ecological framework situates PPCs across individual, social, and environmental domains, contextualizing multiple spheres of influence on recovery from TBI. Future rehabilitation research would benefit from intentional study design planning with coherent theoretical frameworks that clarify the relationships between PPCs, outcomes, and contextual factors. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
People with disabilities experience increased amounts of ableism, and people of color (POC) experience increased amounts of racism. However, little research has observed the intersection of racism and ableism for POC with disabilities. PURPOSE/OBJECTIVE:The purpose of this study was to determine differences in perceived discrimination, discrimination attributions, and discrimination coping between those with varying levels of disability observability who are and are not POC. RESEARCH METHOD/DESIGN:One-hundred and three adults with disabilities completed a cross-sectional online questionnaire measuring their discrimination frequency, attributions, and coping. Multiple regressions were used to analyze differences between POC and non-POC and whether disability observability was a moderator. RESULTS:Experiences of discrimination due to disability were reported by 62% of participants. Those with multiple disabilities were more likely to perceive discrimination to occur and to attribute experiences of discrimination to ableism. Regarding coping with racial discrimination, being a person of color predicted lower feelings of worth as a member of their racial group, perceived negative judgements from others of their racial group, and higher importance of their racial group membership to their self-concept. As observability of a disability increased, feelings of worth regarding their racial group increased for non-POC but decreased for POC. CONCLUSION/IMPLICATIONS:Results show differences in coping with discrimination for those with disabilities who are and are not POC. Discrimination perceptions and coping seem to vary based on how closely disabled peoples' identities fit with prototypical constructions of disability. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Perceived injustice, the appraisal of injury-related losses as severe, permanent, and unfairly caused by others, is a significant predictor of poor outcomes in musculoskeletal and pain conditions. This scoping review investigates the landscape of perceived injustice research in mixed traumatic injury and spinal cord injury/disorder populations. RESEARCH METHOD/DESIGN:This scoping review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) reporting guidelines. We reviewed 41 studies published between 2009 and 2024, including quantitative, qualitative, and mixed-methods research. RESULTS:The majority of studies were cross-sectional (n = 27) and conducted in North America (n = 30). Across the reviewed studies, higher perceived injustice, as measured by the Injustice Experience Questionnaire, was consistently reported to be associated with adverse psychosocial and functional outcomes. Specifically, multiple studies reported perceived injustice was a strong predictor of depression, posttraumatic stress disorder, anxiety, and anger, even after controlling for pain and demographic variables. Findings also frequently linked it to greater functional impairment, poorer treatment response, and significant barriers to return to work. Anger and stigma were identified as key mediators in the relationship between perceived injustice and adverse outcomes. CONCLUSIONS/IMPLICATIONS:Despite robust evidence that perceived injustice could be an intervention target, a critical gap exists in the literature: No studies were found that evaluated interventions designed to target and reduce perceived injustice in these populations. This review underscores the urgent need for the development and testing of targeted interventions to address perceived injustice and improve recovery trajectories for individuals with spinal cord injury and mixed traumatic injuries. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:This study examined how resilience, conceptualized at both the within-person (state-like) and between-person (trait-like) levels, relates to psychological and social adjustment among individuals with spinal cord injury and chronic pain. RESEARCH METHOD/DESIGN:A prospective observational study combining ecological momentary assessment and traditional survey methods was conducted over two time points (baseline and a 6-month follow-up). Participants reported on resilience, pain intensity, and psychosocial outcomes using validated scales. Linear mixed-effects models were used to examine daily (state-like) resilience in relation to end-of-day positive affect, well-being, social participation, depressive symptoms, and anxiety while controlling for daily pain intensity and between-person resilience. Multiple regression models tested whether baseline (trait-like) resilience predicted psychosocial outcomes 6 months later, adjusting for baseline levels of each outcome, pain intensity, and relevant covariates. RESULTS:Higher levels of both daily state-like and trait-like resilience were significantly associated with better same-day psychological and social outcomes. These associations remained significant after controlling for pain intensity and demographic/injury-related covariates. In contrast, trait-like resilience at baseline only predicted social participation at 6 months and was not a significant predictor of long-term emotional well-being, anxiety, or depression. CONCLUSION/IMPLICATIONS:Our findings support the conceptualization of resilience as both an adaptable, immediate resource and a stable trait. Daily resilience may represent an important intervention target to improve real-time management, whereas trait resilience may have a greater impact on long-term social functioning. This study highlights the potential for developing personalized interventions that promote both state-like and trait-like resilience. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Well-being is a multidimensional concept that includes physical health, mental and emotional wellness, social connection, and the ability to live a meaningful and engaged life. Promoting the well-being of people with disabilities is vital for advancing health, equity, and meaningful inclusion. The purpose of this study was to evaluate the psychometric properties of the Positive emotion, Engagement, Relationships, Meaning, and Accomplishment (PERMA) Profiler in a sample of individuals with disabilities. RESEARCH METHOD/DESIGN:Adults with disabilities completed an online survey (N = 946). A confirmatory factor analysis was conducted to examine the factor structure of the PERMA Profiler. Reliability, convergent validity, and correlations with related constructs were examined to assess psychometric properties. RESULTS:Findings supported a five-factor structure for the PERMA Profiler with acceptable model fit (comparative fit index = .967, Tucker-Lewis index = .956, standardized root-mean-square residual = .035, root-mean-square error of approximation = .069). All factor loadings were significant and ranged from .40 to .90, supporting convergent validity. Internal consistency was acceptable across subscales (α = .68-.90; ω = .72-.91), and average variance extracted values ranged from .47 to .77. PERMA domains correlated as expected with measures of life satisfaction, perceived stress, and functional disability, supporting construct validity within the nomological network. CONCLUSION/IMPLICATIONS:Findings highlight the value of the PERMA Profiler as a multidimensional well-being measure with practical applications in research and clinical care. The tool can guide targeted interventions across PERMA domains to enhance holistic well-being. Further research should examine its use in diverse populations and its potential to predict health and functioning outcomes in rehabilitation settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:This study's aim was to describe adapted mountain biking facilitators based on the lived experiences of people with a spinal cord injury. METHOD/DESIGN:Participants in this study live with a spinal cord injury and actively participate in adapted mountain biking. Each participant was interviewed online in a one-on-one semistructured format. Transcribed interviews were coded and analyzed using NVivo software, following descriptive phenomenology's Colaizzi method. RESULTS:Ten participants (9 male, 1 female) described their experiences with facilitators of adapted mountain biking, which were conceptualized into the following themes: motivation, human connection, personal facilitators, organizational facilitators, and accessible physical environments. CONCLUSIONS/IMPLICATIONS:Although distinct themes arose from the data, the facilitators that participants described, such as accessible trail infrastructure, access to resources, and being a part of social groups for adapted mountain biking, operate together to help make adapted mountain biking participation more accessible to people with a spinal cord injury. Despite the presence of these facilitators described by participants, there are still existing sociocultural barriers and not enough efforts to enable participation, which limits the inclusivity of the sport for current and future adapted mountain bikers. Collaboration with policymakers, park management departments, and other stakeholders is essential for implementing the recommended facilitators into practice. Furthermore, there is a need for additional research to understand how facilitators affect individuals on a broader and more in-depth scale, to help grow participation in adapted mountain biking for more people living with a spinal cord injury. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Describe and compare the perspectives of people with spinal cord injuries (SCIs), care partners, and rehabilitation clinicians regarding rehabilitation experiences, preparation for discharge, and community integration. RESEARCH METHOD/DESIGN:We recruited people with SCI, care partners, and rehabilitation clinicians through SCI Model Systems contacts and other sources. We sought variations in injury, demographic characteristics, and rehabilitation settings. Separate focus groups for each stakeholder group lasted 90 min, guided by a semi-structured questionnaire. Transcript coding involved deductive and inductive analyses. RESULTS:Nine people with SCI, 11 care partners, and eight rehabilitation clinicians participated. Themes discussed by people with SCI related to inpatient rehabilitation experiences, home and community reintegration, balancing loss and acceptance, accessibility barriers, strength of relationships, and transitions to community living. Topics unique to care partners were the nature of their involvement during inpatient rehabilitation, services that they found helpful or not, and the extent to which they felt prepared for discharge. Clinicians discussed planning inpatient rehabilitation, managing inpatient length of stay (LOS), and preparing patients for discharge. CONCLUSION/IMPLICATIONS:Most people with SCI and care partners thought LOS were too short, leaving them insufficiently prepared for community living, and emphasized the need for additional training and resources to prepare for community transition. Clinicians highlighted the importance of determining LOS based on patients' needs and insurance requirements. Regardless of how prepared participants felt at discharge, they all encountered challenges that they did not anticipate. Findings provide insights into the organization of rehabilitation services and highlight opportunities to enhance rehabilitation services and policy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:The Multidimensional Health Perceptions Questionnaire (MHPQ) is a comprehensive self-reported multidimensional measure of health perceptions that was previously validated in a sample of individuals with no specific health conditions. It has 8 subscales: Anticipated Discrimination and Judgment, Communication With Healthcare Providers, Spiritual Health Beliefs, Health Self-Efficacy, Trust in Social Health Advice, Trust in Medicine, How Health Affects My Life, and How Others Affect My Health. The study objective was to determine MHPQ structural validity among English-speaking adults with ≥ 1 year history of traumatic brain injury (TBI) who required inpatient rehabilitation. RESEARCH METHOD/DESIGN:The MHPQ was administered via electronic survey (REDCap) or telephone interview to 250 participants enrolled in the TBI Model Systems National Database study. We conducted Rasch analysis per MHPQ subscale to confirm the structural validity of the MHPQ. The sample was 30.8% cisgender-female (68.4% cisgender-male, 0.8% Other gender), 18-90 years old (M = 45.8, SD = 16.2), 16.0% Hispanic/Latino, and White (68.0%), Black (18%), and all other races (2.0-5.2%). RESULTS:Internal consistency reliabilities ranged from acceptable to excellent across subscales (Cronbach's alpha = .64-.91). Rasch analysis confirmed unidimensionality in all subscales, with 2 items removed to improve unidimensionality and fit indices (final 51 items). The MHPQ displayed excellent reliability via item (.77-.99) and person (.74-.87) separation indices per subscale. CONCLUSIONS/IMPLICATIONS:This study established psychometric evidence for the MHPQ as a measure to comprehensively characterize health perceptions among adults with chronic TBI, which could support more culturally responsive and person-centered care. Future work will validate the Spanish-language version of the MHPQ and evaluate subscale test-retest reliability. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Changes in perceived cognitive function after spinal cord injury (SCI) may have important implications for psychosocial well-being. Our purpose was to examine the association between 5-year changes in perceived cognitive function and subjective well-being, satisfaction with participation, depressive symptoms, and anxiety in adults with SCI. RESEARCH METHOD/DESIGN:Data were collected from 385 individuals with traumatic SCI in 2018 and 2023, the two most recent time points in the 50-year SCI Longitudinal Aging Study. Perceived cognitive function was assessed at both times using the Patient-Reported Outcomes Measurement Information System-Cognitive Function scale. RESULTS:Participants whose perceived cognitive function scores were below normal limits on both occasions reported significantly lower satisfaction with participation (B = -3.25, p < .01) and subjective well-being (B = -6.08, p < .05), greater depressive symptoms (B = 3.83, p < .01), and higher anxiety (B = 2.99, p < .01) compared with those who remained within normal limits. Participants whose scores declined below normal limits also reported significantly lower satisfaction with participation (B = -4.73, p < .01) and greater depressive symptoms (B = 2.64, p < .01) and anxiety (B = 2.48, p < .01). CONCLUSIONS/IMPLICATIONS:Perceived cognitive function may be particularly important to maintaining psychological and social well-being after SCI. Routinely assessing perceived cognitive function may guide interventions to support well-being after SCI. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Caregiving for individuals with traumatic brain injury (TBI) is often highly stressful, and traditional in-person interventions can be inaccessible given the demands of their caregiver role. Mobile health (mHealth) interventions offer a low-burden, scalable alternative by delivering personalized, real-time support. However, how effective these interventions depends on whether people perceive them as useful and engage with them. The role of perceived usability in mHealth efficacy remains underexplored in the TBI caregiver population. This study primarily evaluates the relationship between self-reported app usability and the efficacy of a fully automated mHealth intervention, delivered via personalized mobile-app messages, in reducing caregiver strain, anxiety, and depression in a TBI caregiver population. The secondary aim is to identify variables that moderate the intervention efficacy among caregivers reporting high app usability. RESEARCH METHOD/DESIGN:We analyzed data from 122 TBI caregivers assigned to receive self-monitoring plus push notifications for self-care as part of a larger randomized controlled trial. Perceived app usability was assessed via caregiver responses to a questionnaire item. We applied multivariate linear models with a weighted and centered least squares estimator to assess the moderating effects of perceived app usability and other variables on message efficacy. RESULTS:Messages were more effective in reducing depression among TBI caregivers who reported high app usability. Moreover, shorter caregiving duration, higher Fitbit step count, and lower prior-week anxiety were significantly associated with improved message efficacy among this high usability group. CONCLUSION/IMPLICATIONS:Perceived app usability plays a critical role in the mHealth message efficacy among TBI caregivers. Tailoring interventions based on perceived app usability and identified moderators may optimize health outcomes and support more personalized care for this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
PURPOSE/OBJECTIVE:Although research suggests that adults with chronic illnesses experience disability in ways that are not fully captured by objective indicators of illness, little is known about subjective aspects of disability among pediatric populations and their parents/caregivers. This qualitative study explored the substance and context of disability appraisals held by youth with chronic spinal cord injury (SCI) and their parents/caregivers. RESEARCH METHOD/DESIGN:This study was part of a larger study to develop a patient-reported outcome measure capturing appraisals of disability in youth with chronic SCI and their caregivers. Data were gathered through 60- to 90-min semistructured cognitive pretest interviews with 14 youth-caregiver dyads and one caregiver. Interviews were conducted between April 2022 and June 2024. Youth-caregiver dyads were recruited from an active patient list at a specialty hospital. Data were analyzed using a thematic analysis coding reliability approach, grounded in a critical realism philosophy of science. RESULTS:Thematic analysis generated six themes of disability appraisals: (a) disability is one part of a person, (b) centering disability to identity, (c) process of adaptation and acceptance, (d) the costs of living with SCI, (e) the collaborative aspect of managing SCI, and (f) accessibility based on the environment, adaptive equipment, and physical body. CONCLUSIONS/IMPLICATIONS:Disability appraisals are dynamic and vary. Most themes indicated positive adjustment among youth living with chronic SCI and their caregivers. The diversity of appraisals, however, underscores the need for ongoing assessment as families reappraise the significance of SCI to their lives. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
