Mental Health and Spinal Cord Injury: Clinical Considerations for Rehabilitation Providers.

Purpose of Review: Assessing and addressing the mental and behavioral health concerns of individuals with SCI during rehabilitation is crucial, as untreated mental health distress can lead to reduced gains in rehabilitation and poor overall health. This review provides an overview of the latest research on prevalence rates of common mental and behavioral health concerns in the SCI population, highlighting disability-specific factors that may impact traditional assessment and treatment of mental health concerns. Recent Findings: While those with SCI are at a heightened risk for experiencing mental health distress, overall, the majority of those with SCI adapt well, and live a full and meaningful life. Summary: Rehabilitation psychologists are a vital aspect of rehabilitation teams, as they can address behavioral health and mental health concerns that may impede patients achieving their rehabilitation goals.

Health care providers' perspectives on resilience and positive adjustment within the spinal cord injury population.

PURPOSE/OBJECTIVE: Spinal cord injury (SCI) often represents a significant life change, yet most individuals with SCI show resilience and positive adjustment after injury. Social support, including support from health care providers, has been associated with increased resilience among the SCI population. This study aimed to further understand health care providers' perceptions of resilience in their SCI patients, as patient-provider relationships can impact health care outcomes and overall health and well-being. RESEARCH METHOD/DESIGN: Eighty-four health care providers from a Veterans Health Administration SCI service in California participated in this study. Using a cross-sectional survey design, a 22-item questionnaire was created to explore health care providers' perceptions of resilience and positive adjustment among the SCI population. RESULTS: Overall, 44% of participants accurately stated that 60% of the SCI population shows resilience. However, 62%-67% reported significant levels of mental health symptoms and 48% indicated poor adjustment following SCI. Eighty percent believed that quality of life is dependent on level of injury. CONCLUSIONS/IMPLICATIONS: Results highlighted discrepancies between providers' perceptions and the current literature on resilience and SCI. Specifically, while many acknowledge resilience within this population, many providers indicated significant levels of mental health concerns and poor adjustment following an SCI. Due to the impact health care providers have on patient care, and research linking positive support from health care providers to resilience in SCI, further understanding of these misperceptions and biases is critical. Suggestions for providers to address potential biases and misperceptions, and ultimately strengthen the provider-patient relationship, are provided. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Associations Between Autonomic and Orthostatic Self-report and Physician Ratings of Orthostatic Intolerance in Youth.

PURPOSE: There is no known biological marker or physical assessment to diagnose chronic fatigue syndrome (CFS), leaving physicians to heavily rely on self-report measures regarding the symptoms associated with CFS. Common symptoms of CFS include difficulty sleeping, joint pain, headaches, sore throat, cognitive dysfunction, physical exhaustion, dizziness, and nausea. Because of the overlap among CFS symptoms and autonomic functioning, we examined the association between 2 self-report measures of orthostatic and autonomic symptoms and a physician's report of autonomic functioning (measures of changes in blood pressure and pulse) to further understand the association among autonomic functioning within individuals with symptoms of CFS. METHODS: With data from an ongoing study, we used independent t tests and Pearson correlation tests to assess the association among the orthostatic domain from the DePaul Symptom Questionnaire, Autonomic Symptom Checklist composite scores, and the physician's assessment of orthostatic intolerance obtained from a sample of 191 participants, 42 who were healthy controls. FINDINGS: No significant demographic differences were found between the CFS-like group and the healthy controls. Results indicate a significant correlation between orthostatic and autonomic functioning (r = 0.58) and a correlation with a low effect size among autonomic functioning and physician measures of orthostatic functioning (r = -0.01 to 0.29). However, fewer correlations were found between self-reported symptoms of orthostatic functioning and the physician's measures of orthostatic functioning. IMPLICATIONS: These results suggest that although orthostatic dysfunction is reported in children and adolescents with CFS-like symptoms, the physical measures of autonomic functioning in this study were unable to detect these symptoms.