Psychological distress is common after critical illness and can result in long-term psychological morbidities. Early psychological support in the intensive care unit (ICU) may mitigate these effects, yet ICU psychology services remain uncommon in Australia, and little is known about their implementation. Building on the Psychology in Intensive Care Unit Protocol (PICUP) pilot study, further refinement requires understanding the perspectives of those who experienced the service. This study qualitatively explored (i) how critical care survivors experienced early psychological screening and intervention; (ii) ICU clinicians' views on the role and value of the psychology service; and (iii) facilitators and barriers to integrating it into routine ICU practice. A qualitative descriptive design was used at a metropolitan Australian ICU where the PICUP model had been implemented. Purposive sampling identified PICUP participants who received psychological support during their admission and clinicians involved in their care. Semistructured interviews were conducted with 16 patient participants and 10 clinicians. Interviews were audio recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Patient participants described critical illness as a traumatic and multifaceted experience and viewed psychological support as meaningful when accessed, though many reported limited recall and unmet needs for continuity beyond the ICU. Tailoring support to individual readiness was seen as essential. Clinician participants considered psychology integral to holistic ICU care, with benefits for patient engagement, recovery, and management of complex presentations. They also identified value for significant others and staff. However, clinicians perceived unclear referral pathways, low service visibility, limited psychology resources, and the inherent complexity of the ICU constrained implementation. Patient and clinician participants viewed the ICU psychology service as acceptable and valuable but under-resourced and insufficiently embedded. Their perspectives clarify how the service is understood in practice and what needs strengthening for effective implementation. Findings provide direction for refining the PICUP model and guiding the development of a sustainable approach to the inclusion of psychologists in Australian ICUs.
The objective of the study was to provide an in-depth bibliographic analysis of Neuropsychology's published corpus as a window into the scientific interests, approaches, and priorities of the field of neuropsychology. The primary aims were to examine the ways in which Neuropsychology's published content (a) has changed over time and (b) influences citation rates. A total of 2,403 abstracts published in Neuropsychology from 1987 to 2024 were coded according to article type, study population, design elements, methodology, ability domains, and miscellaneous topics (e.g., digital technology, everyday functioning). A university librarian provided 2024 citation data from Scopus for the 2,209 articles published during the years 1987 to 2021. Over the past 37 years, Neuropsychology has experienced a moderate increase in studies that are empirical/data-driven, employ longitudinal designs, integrate biological markers and survey/questionnaire methods, and examine executive functions, culture/social determinants of health, and everyday functioning. Studies that use true experimental designs and focus on lower order domains (e.g., sensory/perceptual), visuospatial function, and memory peaked in the mid-1990s and are associated with lower citation rates in the modern era. On the other hand, review articles, studies with longitudinal designs, and articles that examined culture/social determinants of health and everyday functioning had higher citation rates. Findings suggest a temporal shift in the field's published content toward more empirically driven, functionally relevant, and contextually informed research. Future bibliographic work is needed to understand how these historical publishing trends align with related disciplines (e.g., behavioral neurology) and to identify the core drivers of citation patterns in neuropsychology. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
There is currently no comprehensive scale suitable for assessing the rehabilitation progress of Chinese tumor patients. This study aimed to evaluate the psychometric properties of the Rehabilitation Set of the International Classification of Functioning, Disability, and Health for that purpose. The Chinese version of the International Classification of Functioning, Disability, and Health's Rehabilitation Set (ICF-RS) was used by trained health professionals to assess 1055 Chinese tumor patients. The internal consistency of the responses was assessed in terms of Cronbach's alpha coefficient. Construct validity was explored through factor analysis. Test-retest reliability, inter-rater reliability, and criterion validity were evaluated using a subset of 121 patients. Criterion validity was quantified by correlating the scores with those generated using the Hospital Anxiety and Depression scale (HADS), the Eastern Cooperative Oncology Group (ECOG) performance status evaluation and the modified Barthel Index (MBI). The Cronbach's alpha for the rehabilitation set's scores was 0.87, indicating good internal consistency. The test-retest reliability analysis showed that most categories had an intraclass correlation coefficient in excess of 0.75, suggesting good reliability when the rehabilitation set is applied with tumor patients. Inter-rater reliability also demonstrated intraclass correlation greater than 0.75 for most categories. Construct validity was supported by the finding that 18 categories had factor loadings exceeding 0.40. After removing categories with lower factor loadings, the cumulative variance explained increased to 44.6% for the Activity and Participation component and 57.3% for the Body Functions component. Criterion validity was supported by significant associations with established instruments. Specifically, 66.7% (20/30) of the ICF-RS categories correlated significantly with the MBI, with effect sizes (r) ranging from 0.19 to 0.52 (p < 0.05). In contrast, only 10% (3/30) of categories demonstrated significant correlations with the ECOG ratings (ρ = 0.21-0.22, p < 0.05). Furthermore, categories related to emotional functions and psychological demands showed significant correlations with the HADS, with moderate effect sizes (ρ = 0.37-0.41, p < 0.001). The Chinese version of the ICF-RS exhibits promising psychometric properties in tumor patients, providing preliminary evidence for its clinical application. It demonstrates good internal consistency, high test-retest reliability and reliable inter-rater consistency. The moderate correlation with MBI ratings and HADS scale scores, along with the distinct factors identified through factor analysis, further supports the instrument's validity and utility when applied to this population. The data confirm that the ICF-RS is a reliable tool for assessing tumor patients' functioning and disability. However, the construct validity results recommend further work before the instrument is widely used with tumor patients.
Geriatric rehabilitation (GR) aims to optimise functional capacity and social participation in older adults through multidisciplinary care. Healthcare professionals (HCPs) play a key role, and a deeper awareness of patients' lived experiences may enhance the quality of care. Virtual Reality (VR) offers an innovative way for HCPs to step into the perspective of older adults and experience rehabilitation through their eyes. Recent studies increasingly highlight VR's potential to foster empathy and communication skills. To explore whether a VR movie can enhance HCPs' understanding and empathy regarding older adults' experiences during GR. In a mixed-methods design we combined structured questionnaires and focus groups. HCPs from four GR organisations viewed a 15-minute VR movie showing the rehabilitation process from the viewpoint of an older adult which was scripted based on earlier studies on this topic. After viewing, participants completed a questionnaire or took part in focus groups discussing their experiences. In total, 160 HCPs completed the questionnaire and 18 participated in a total of three focus groups. Most participants (85%) reported increased awareness of older adults' experiences, and 95% indicated that they would recommend the VR movie to colleagues. Thematic analysis identified three key themes reflecting how HCPs, when adopting the older adult's perspective, perceived the rehabilitation experience: (1) feeling overwhelmed, (2) being dependent and vulnerable and (3) lack of clarity in staff routines. Participants additionally suggested practical improvements in daily care. The VR movie appears to be an effective educational tool in raising understanding and empathy among HCPs in GR.
Facial prosthetic rehabilitation following head and neck cancer (HNC) surgery plays an essential role in restoring appearance and function. However, the psychosocial consequences of living with a facial prosthesis remain underexplored and have been poorly addressed within routine care pathways. The purpose of this scoping review was to map and synthesize the existing literature on the psychosocial impact of prosthetic rehabilitation in patients with HNC, identify key themes, and highlight gaps to inform future intervention development. The review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines and was registered with the Open Science Framework. Comprehensive searches were conducted across 9 electronic databases and 7 nonpeer-reviewed literature sources, with support from a health information specialist. Inclusion criteria focused on studies reporting the psychosocial experiences of patients with HNC using extraoral prostheses. Data were extracted and thematically synthesized using an inductive approach. Thirteen sources met the inclusion criteria: 11 peer-reviewed studies and 2 clinical guidelines. Most studies used qualitative or mixed methods approaches, focusing on adult populations. Four key themes were identified: psychosocial impact of prosthesis use, influence on social relationships, variation in acceptance by prosthesis type, and the role of healthcare professionals and support systems. Patients frequently reported anxiety, shame, and social withdrawal. Central facial prostheses (nasal or orbital) were linked to lower comfort and acceptance. Psychosocial support from clinical teams was often inconsistent or lacking. There is a clear need for a multidisciplinary approach that incorporates tailored psychosocial support. Findings support the development of patient-centered interventions and standardized care pathways.
Chronic respiratory diseases are associated with psychiatric/neurocognitive comorbidities; prevalence, clinical impact and responsiveness to in-patient pulmonary rehabilitation (PR) remain poorly characterized. To assess prevalence of psychiatric and neurocognitive comorbidities in patients admitted to a PR programme, their associations with clinical and rehabilitation outcomes, and to explore sex- and age-related differences. In this multicentre-observational-prospective-cohort study, consecutive admitted to in-patient PR programmes over 12 months were classified into six groups: diagnosed psychiatric disorders, psychotropic drug use without diagnosis, respiratory disease only, diagnosed neurocognitive disorders, psychiatric/cognitive impairment detected during hospitalisation and referral for diagnostic assessment. Clinical, functional and psychological data were collected at admission and discharge. Outcomes included changes in and achievement of minimal clinically important differences (MCIDs) for CAT, MRC dyspnea scale, Barthel Dyspnea Index and Six-Minute Walki Test. A composite responder outcome required achievement of all MCIDs. Multivariable logistic regression identified predictors of response. Among 975 patients (59% males, 70.2 years old), 49% had psychiatric (N = 245) and/or neurocognitive comorbidities (N = 45). Psychiatric disorders were more frequent in women, while cognitive impairment increased with age. PR significantly improved outcomes across all groups; however, patients with cognitive impairment showed the poorest multidimensional response, with none achieving the composite endpoint. In a relatively small group (N = 395) a formal psychiatric diagnosis independently predicted a lower probability of response. Psychiatric and neurocognitive comorbidities are highly prevalent in inpatient PR. Although PR is effective overall, cognitive impairment markedly limits multidimensional benefit, highlighting need for routine mental health, cognitive screening and multidisciplinary care.
This review examines commonly used acceptance measures in cancer and rehabilitation research to evaluate their theoretical foundations, psychometric properties, and relevance to cancer populations. The goal is to identify measurement gaps and inform strength-based rehabilitation practices. A narrative review was conducted of acceptance measures used in cancer and rehabilitation research. Each measure was assessed based on alignment with rehabilitation principles, psychometric quality, cultural adaptability, and applicability to vocational outcomes. Acceptance measures used in current cancer research reflect a predominantly medical model approach. Their language and constructs may unintentionally reinforce deficit-based views. In contrast, tools developed by rehabilitation researchers, like the Adaptation to Disability Scale-Revised (ADS-R) and the Multidimensional Acceptance of Loss Scale (MALS) emphasize psychosocial adaptation and strengths, though they have been rarely used or validated in cancer populations. Rehabilitation counseling has an opportunity to lead the development of acceptance measures that are strengths-based, culturally responsive, and applicable to vocational settings. Existing measures need adaptation or replacement to better serve diverse cancer survivors. Such tools can enhance psychosocial assessment, guide interventions, and support employment-related outcomes in cancer survivorship.
To identify and characterize extreme phenotypes of injustice appraisals among individuals with recent spinal cord injury (SCI), with the goal of improving psychosocial interventions and future clinical research. Cross-sectional analysis using baseline data from a longitudinal cohort study. Four inpatient rehabilitation centers in the United States. A total of 101 adults (aged ≥18 years) with recent traumatic or non-traumatic SCI who completed baseline assessments, including the Injustice Experience Questionnaire (IEQ). Participants were classified into low (IEQ ≤ 12) and high (IEQ ≥ 26) injustice appraisal phenotypes using the 25th and 75th percentiles of IEQ. Measures included the Patient Health Questionnaire-8 (PHQ-8), Posttraumatic Stress Checklist (PCL-5), State-Trait Anger Expression Inventory (STAXI-II), Appraisals of Disability: Primary and Secondary Scale (ADAPSS), and the International Spinal Cord Injury Quality of Life Basic Data Set (SCI QOL BDS). Compared to individuals with low injustice appraisals, those with high injustice appraisals presented with significantly higher depressive symptoms (PHQ-8: 10.3 vs. 3.3, p<.001), post-traumatic stress symptoms (PCL-5: 29.8 vs. 6.6, p<.001), anger (state anger: 14.2 vs. 7.4, p<.001), and maladaptive appraisals (ADAPSS: 23.7 vs. 13.4, p<.001). They also reported lower satisfaction across all quality of life (QoL) domains (all p<.01). Effect sizes were large to very large (Hedges' |g| range: 0.89-4.61) and displayed substantial psychological and emotional differentiation between phenotypes. Extreme phenotyping of injustice appraisals revealed unique psychosocial profiles among individuals with recent SCI. High injustice appraisals were associated with elevated distress and reduced QoL, emphasizing the need for targeted interventions addressing perceptions of unfairness and loss in early rehabilitation. Identifying these phenotypes offers a framework for future studies and intervention development to improve psychological outcomes after SCI.
Non-medical use of etomidate has emerged as a novel psychoactive substance (NPS) threat in China. Although stress-related mechanisms have been widely implicated in substance use disorders, evidence specific to etomidate use disorder (EUD) remains limited. This study examined whether anxiety symptoms (AS) severity mediates the association between perceived stress and EUD severity, and whether difficulties in emotion regulation strengthen the stress-AS severity link. A total of 556 male patients diagnosed with EUD were recruited from drug rehabilitation centers in Hunan Province, China (M age = 22.19, SD = 5.96). Participants completed measures of perceived stress (CPSS), AS severity (BAI), and difficulties in emotion regulation (DERS). EUD severity was indexed by DSM-5 criterion count (0-11). A moderated mediation model was tested using PROCESS (Model 7) with bias-corrected bootstrapping (5,000 resamples), controlling for age, educational attainment, only-child status, single-parent family status, and residence (rural vs. urban). Perceived stress was positively associated with EUD severity. AS severity partially mediated the association between perceived stress and EUD severity. Moreover, DERS moderated the perceived stress-AS severity path, such that perceived stress was more strongly related to AS severity at higher levels of emotion regulation difficulties. Consistently, the indirect effect of perceived stress on EUD severity through AS severity was stronger among individuals reporting greater emotion regulation difficulties. These findings suggest that AS severity serves as a potential emotional correlate in the relationship between perceived stress and EUD severity, particularly among individuals with substantial emotion regulation difficulties. Individuals with greater deficits in emotion regulation exhibited a stronger indirect effect of stress on EUD severity via AS severity. This highlights the clinical importance of targeting emotion regulation in interventions for EUD, as improving emotional coping strategies may mitigate the impact of stress. Future longitudinal studies are needed to clarify the causal direction of these associations and investigate how changes in emotion regulation over time influence EUD progression.
Approximately 80% of individuals with Parkinson disease (PD) experience impaired balance and mobility, contributing to freezing of gait, an increased risk of falls, and reduced health-related quality of life. Mind-body interventions, such as mindfulness and yoga, may address both motor and nonmotor symptoms by enhancing mind-body coordination and reducing stress, thereby offering a scalable approach to balance rehabilitation in PD. This study aims to evaluate the effects and acceptability of Mindfulness Yoga-Practice Awareness through Cognitive-Based Exercise (MY-PACE), a mobile health-delivered, home-based intervention, on balance, mobility, and psychological well-being in individuals with PD and balance impairment. This assessor-blinded, 2-arm, randomized waitlist-controlled trial enrolled 132 individuals with PD and balance impairment, randomized to either the MY-PACE group (n=66, 50%) or the control group receiving routine outpatient care (n=66, 50%). The MY-PACE group will complete a 12-week, Zoom-delivered program incorporating mindfulness, yoga, and mindful walking practices. The control group will receive the intervention after study completion. The primary outcome is functional balance, as measured by the Berg Balance Scale. Secondary outcomes include functional mobility, gait patterns, balance confidence, freezing of gait severity, motor symptoms, anxiety and depressive symptoms, cognitive function, mindfulness, health-related quality of life, and fall incidence. Assessments will occur at baseline, 3 months (T1), and 6 months (T2). Data will be analyzed using linear mixed-effects models under the intention-to-treat principle. Ethics approval was obtained on September 18, 2019. A preliminary feasibility study with 10 participants was conducted between May and June 2020. The full randomized controlled trial was funded in January 2022 by the Early Career Scheme 2021-2022 of the Research Grants Council, Hong Kong. The trial was prospectively registered on December 10, 2021. Recruitment began in April 2022. As of manuscript submission, 132 participants have been enrolled. Data analysis has not yet commenced. The study protocol and statistical analysis plan follow the original prespecified design. The results are expected to be published in 2026. This trial will evaluate a telehealth-delivered mindful yoga intervention for improving balance and mobility in individuals with PD. By integrating cognitive-based mindful awareness and motor training, MY-PACE targets both motor and nonmotor contributors to balance impairment. If effective, it may represent a scalable intervention for individuals with PD and other populations with mobility limitations. Chinese Clinical Trial Registry ChiCTR2100054145; https://tinyurl.com/4j8f8zvn. DERR1-10.2196/97781.
The prevalence of mental illness is high among homeless populations, yet traditional clinic-based care is often inaccessible. For urban areas where housing-first models are difficult to implement because of high costs, integrated on-site psychiatric services in shelters may offer a feasible alternative. To examine clinical and demographic factors associated with housing attainment among individuals experiencing homelessness with mental illness participating in an on-site psychiatric service program. This 5-year retrospective cohort study analyzed data collected from October 2019 to October 2024. The study was conducted at the only public temporary shelter in Taipei, Taiwan. A sample of individuals with mental illness who voluntarily joined the program was identified. Participants received integrated on-site psychiatric care through the Psychiatric Assistance for Transitional Homelessness in Shelters (PATHS) program, which included psychiatric assessment, pharmacological treatment, access to social welfare, and referrals for psychiatric hospitalization, all delivered within the shelter setting. The primary outcome was housing attainment, defined a priori as relocation to residential psychiatric rehabilitation facilities, original family, or rental house upon shelter exit. Categorical variables were compared using χ2 and Fisher exact tests. Of 231 individuals initially identified, 3 individuals who died and 20 who remained in the shelter at the end of the study were excluded. Among the 208 included participants (90.0% of the initial sample; median [IQR] age, 54.0 [44.3-62.0] years; 154 male [74.0%]), alcohol use disorder predominated among men, whereas women had a higher prevalence of schizophrenia. Overall, 97 participants (46.6%) attained housing. Older age was significantly associated with housing attainment (odds ratio [OR], 1.03; 95% CI, 1.01-1.05; P = .04). In contrast, alcohol use disorder (OR, 0.54; 95% CI, 0.29-0.99; P = .045) and opioid or methamphetamine use disorders (OR, 0.29; 95% CI, 0.14-0.62; P = .001) were associated with lower likelihood of housing attainment. In this retrospective cohort study of 208 homeless individuals with mental illness, on-site psychiatric services provided a framework for bridging the gap between transitional shelters and housing attainment. These findings suggest that transitioning from universal models toward individualized interventions is essential to address the diverse needs of this population and improve housing success.
To investigate changes in care-seeking behaviors among Chinese cancer survivors following the lifting of COVID-19 control measures, identify demographic, clinical, and socioeconomic predictors of professional care use, and to assess perceived convenience and severity of care needs post-pandemic. We conducted a cross-sectional survey in Southwest China between May 2023 and January 2024. A total of 477 valid responses were collected using convenience sampling from outpatient clinics, rehabilitation units, and online survivor networks. Group differences in care-seeking before and after COVID-19 control were tested with Chi-square and Kruskal-Wallis tests. Paired Chi-square tests were applied to compare pre- and post-COVID-19 behaviors. Multivariable Poisson regression with robust error variance was used to identify independent predictors of professional care-seeking. Hospital visits declined from 54.1% before control to 40.0% after, while online consultations increased from 8.2% to 22.2% and self-care rose from 27.0% to 33.1%. Perceived convenience of care worsened, with inconvenience reports rising from 32.7% to 43.4%, and the proportion of survivors reporting severe or very severe illness increased. Older age, higher income, higher education, cohabitation, multiple comorbidities, and better functional status were significant predictors of professional care-seeking. Post-COVID-19, cancer survivors in China shifted toward online and self-care modalities, while hospital use declined. Access to professional care is shaped by socioeconomic and functional factors, which leads to disparities in survivorship care. Expanding telemedicine, strengthening community oncology services, and addressing socioeconomic and functional barriers are essential to ensure equitable access to care. Building resilient, integrated models that combine hospital, community, and digital modalities may better support survivors during future public health emergencies.
Psychological responses to injury are common after anterior cruciate ligament (ACL) injury and reconstruction (ACLR) and have been linked to knee-related pain during early recovery. However, it remains unknown whether anxiety and depression symptoms are associated with knee pain severity at later stages of recovery, when unresolved or recurrent psychological distress may persist. The purpose of this study was to examine the association of anxiety and depression symptoms with knee pain severity in individuals 3 to 12 months after ACLR. It was hypothesized that individuals who exhibited more severe anxiety and depression symptoms would report more knee pain. Cross-sectional study; Level of evidence, 3. In total, 131 individuals who were 3 to 12 months after primary, unilateral ACLR (time since ACLR = 5.7 ± 1.7 months; age = 18.3 ± 2.1 years; 37.4% male) were included. Anxiety and depression symptoms were measured with the Patient-Reported Outcomes Measurement Information System Anxiety and Depression 4-item short forms, respectively, where higher scores reflect more severe symptoms. Knee pain was measured with the Knee injury and Osteoarthritis Outcome Score Pain subscale, where higher scores indicate less or no knee pain. Separate multiple hierarchical regression analyses were conducted to examine the association of self-reported anxiety and depression symptoms with knee pain severity. Sex, age, and time since ACLR were entered in step 1 of each model. Anxiety and depression symptom scores were entered in step 2 of their respective models, and the change in R 2 was examined. Sex, age, and time since ACLR explained 3% of the variance in knee pain severity (R 2 = 0.031, P = .23). Anxiety symptoms accounted for an additional 25.7% of the variance in knee pain severity (ΔR 2 = 0.257, P < .001), while depression symptoms accounted for an additional 15.7% of the variance in knee pain severity (ΔR 2 = 0.157, P < .001). Self-reported anxiety and depression symptoms were significantly associated with knee pain severity in individuals 3 to 12 months after ACLR. These findings support assessment of anxiety, depression, and knee pain, even in the later phases of ACLR rehabilitation, to help inform clinical decision-making.
Movement sonification (i.e., translating kinematic measures into sound, providing auditory feedback), can enhance motor performance and (re)learning across both clinical and sports contexts. However, existing sonification systems vary widely, potentially affecting efficacy. Here, we categorize sonification systems based on the utilized sound (type) and onset (trigger) to elucidate potential differences in movement-, intuitiveness-, and motivation-related outcomes. Movement sonification systems, as described in 101 included studies, were classified into six sound types (specifically parameter mapping, musically informed, single tone, rhythmic, music-based, and environmental) and four trigger types (event-, error-, trajectory-based, and continuous), and effects on outcomes were compared. Overall, positive effects on all outcomes were reported for all system types and triggers, with no clear pattern of advantages for any, except that learning retention is more consistently reported for triggers involving explicit learning strategies. In general, more subtle movement learning may benefit from more direct movement-sound coupling, implicit learning, and multi-component mappings. Additionally, systems providing rhythmic sounds (musically informed, single tone, rhythm, music-based) were more commonly used for periodic movements. Intuitiveness is rated highest for parameter mapping and rhythmic sonification, and motivation strongest for musically informed sonification, although all systems increase autonomous motivation, compared to no sonification. In conclusion, movement sonification systems generally improve performance but arguably work differently for different movements. Accordingly, musically informed sonification may be preferable for rehabilitation settings where motivation is crucial, while parameter mapping sonification that inform users about subtle kinematic aspects may especially support learning highly skilled movements. Standardizing terminology in future work will facilitate systematic cross-system comparisons.
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. 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). 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. 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).
This study examined 1) longitudinal trajectories of depression and suicidal ideation (SI) trajectories over the first 10 years after traumatic brain injury (TBI) in a sample of Asian American and Pacific Islander (AAPI) individuals; 2) demographic and injury-related predictors of these trajectories; and 3) time-varying depression symptoms as predictors of SI. Participants who completed inpatient rehabilitation at a TBI Model Systems (TBIMS) center. Three hundred seven AAPI participants with moderate-to-severe TBI. Multisite, longitudinal observational cohort study. Patient Health Questionnaire (PHQ-9) completed at least once for any follow-up time point (ie, 1, 2, 5, or 10 years after TBI), demographic variables, functional characteristics, and injury characteristics. Depression was assessed using PHQ-8 total score, and SI was assessed from the PHQ-9 item 9 score. Rates of clinically significant depression symptoms ranged from 10.1% to 20.6% over 10 years across the 4 time points. Depression symptom trajectories remained flat over time. Higher education was associated with lower overall depression trajectories, whereas a prior history of mental health treatment and violent cause of injury were associated with higher depression trajectories. SI trajectories also remained stable, with higher overall levels observed among participants who were unmarried at injury, were employed at injury, and had a lifetime history of suicide attempts. Higher depression symptoms-both within individuals over time and between individuals-were associated with higher SI. The findings reinforce the importance of detection, long-term monitoring, and targeted support through culturally responsive mental health services for AAPI individuals with TBI.
Caregivers of individuals with spinal cord injury (SCI) frequently assume demanding roles immediately after SCI, placing them at risk for burden, depression, and diminished well-being. Few interventions have been tailored to support caregivers during this critical initial transition period. This randomized clinical trial developed and tested the Transition Assistance Program (TAP), which provides structured telehealth support targeting caregiver psychosocial adjustment and care quality as they learn to be caregivers for the first time. The study recruited caregiver-care recipient dyads from two acute SCI units at an academic medical center and a Veterans Affairs hospital. Dyads (N = 31 completing follow-up) were randomized to TAP or usual care. The TAP consisted of five sessions (one in person before discharge, four via telehealth-to-home) combining structured education, a caregiver guidebook, and supportive problem-solving. Primary outcomes - caregiving quality, depression, relationship satisfaction, and positive affect and well-being - were assessed at baseline, 2, and 4 months post-discharge. Caregivers in the TAP group reported higher caregiving quality across the two follow ups (P = .041, ηp² = .141), a large effect. For all other caregiver and patient outcomes, TAP participants consistently demonstrated more favorable scores with small-to-medium effect sizes, though differences did not reach statistical significance. The TAP improved caregiver-reported caregiving quality and showed promising effect sizes across multiple psychosocial outcomes. Findings support the feasibility and potential utility of telehealth-based caregiver interventions during the transition from inpatient rehabilitation to home, warranting larger-scale trials.Trial registration: ClinicalTrials.gov identifier: NCT03244098.
Hamstring strain injuries (HSI) are a leading cause of time loss and reinjury in elite sport, yet return-to-sport (RTS) decisions remain largely based on physical criteria. This scoping review aimed to map the psychological, social and contextual factors associated with RTS after HSI and to examine how psychological readiness has been conceptualised in RTS after HSI. Following Joanna Briggs Institute methodology, seven databases (MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, Scopus and ProQuest) were systematically searched for studies published until September 2025 in five languages. Eligible studies included original research identifying or describing psychological, social or contextual factors influencing RTS after HSI. Methodological quality was assessed using the Mixed Methods Appraisal Tool and the Oxford Centre for Evidence-Based Medicine. Data were synthesised thematically. 10 studies (n=663 participants, mostly in elite football) met the inclusion criteria. Three overarching domains were identified. Psychological factors were most frequently reported, including anxiety, fear of reinjury or failure and self-perceived readiness, as well as motivation and self-efficacy. Social factors encompassed therapeutic alliance, communication within the rehabilitation team and hierarchical dynamics within professional environments. Contextual factors referred to situational and organisational influences such as season timing, resource availability and operational practices. Psychological readiness was inconsistently defined and typically assessed informally rather than through validated instruments. Psychological, social and contextual factors are under-screened in RTS after HSI. Incorporating structured psychosocial screening and shared decision-making alongside physical criteria may improve RTS safety and sustainability. Athlete-centred research is warranted to refine the assessment of psychological readiness and inform holistic, context-sensitive RTS frameworks.
As fundamental primary processes in maintaining the body's health, sleep and eating habits influence reciprocally, and this relationship is also modulated by circadian rhythms. Consistently, the literature reports various levels of alterations in sleep parameters and circadian preferences among individuals exhibiting dysfunctional eating behaviors. The present review aims to provide an up-to-date overview of case-control studies conducted to date on this topic. A systematic literature search was conducted to detect case-control studies investigating both subjective and objective sleep parameters and circadian preferences in individuals with eating disorders. Thirty-three articles published between 1980 and 2025 were included. Patients with eating disorders show reduced sleep efficiency, prolonged sleep onset latency, and increased arousal levels. Specifically, individuals with anorexia nervosa experience more frequent and longer nighttime awakenings, as well as reductions in both slow-wave sleep and REM sleep. In contrast, findings related to bulimia nervosa and binge eating disorder are quite inconsistent, partly due to the limited number of studies available. Overall, individuals with eating disorders tend to exhibit a preference for evening chronotypes. This review supports the existence of an association between eating disorders and alterations in sleep and circadian rhythms. Nonetheless, current research does not provide a consistent picture of the nature, characteristics, or causality of these dysfunctions. Several factors - such as body mass index, the severity of eating disorder symptoms, and orexin levels - appear to be involved. Further investigation into these relatively understudied areas could inform the development of more effective rehabilitation strategies.
Youth and young adults with spina bifida (SB) are at risk for neurocognitive challenges and face substantial medical needs, including neurogenic bowel management. Little is known about the relationship between neurocognitive functioning and independently managing a bowel program. Understanding these associations could help tailor interventions that promote independence and long-term quality of life. To examine whether performance-based measures of intellectual functioning, academic achievement, and executive functioning are associated with bowel management program (BMP) independence in a clinical sample of youth and young adults with SB. We hypothesized that better neurocognitive and academic functioning would be associated with greater BMP independence. Cross-sectional study using secondary analysis of an institutional clinical registry. Binary logistic regression using weighted least squares mean and variance estimation tested predictors of bowel management independence, including a latent academic functioning factor and observed full-scale IQ, adjusting for age and ambulation status. Outpatient hospital pediatric rehabilitation clinic. A total of 79 individuals with SB (ages 10-25 years; 50.6% female) with data on BMP status and neuropsychological testing. Not applicable. BMP independence, as measured by a parent-reported (if under 18 years) or self-reported (if older than 18 years) questionnaire. After adjusting for age and ambulation status, higher full-scale IQ (odds ratio [OR] = 1.32 [95% CI, 1.04-1.67], p = .025) and academic functioning (as defined as a latent variable including reading, writing, and math performance) (OR = 1.35 [95% CI, 1.08-1.69], p = .009) were associated with greater BMP independence. Executive functioning (as defined by a latent variable including tasks assessing planning, problem-solving, initiation, and cognitive flexibility) was not a significant predictor. When both full-scale IQ and academic functioning were included in a multivariable model, only full-scale IQ remained a significant independent predictor (OR = 1.45 [95% CI, 1.04-1.68], p = .004), suggesting that overall intellectual ability accounts for much of the variance in self-management. Higher intellectual functioning is associated with BMP independence in youth and young adults with SB, indicating that key cognitive abilities support self-management. These findings highlight the importance of considering general intellectual ability when designing individualized treatment plans and emphasize the need to address broader contextual barriers to promote successful self-management.