Feasibility and acceptability of a remote, hands-free cognitive battery for adults with traumatic spinal cord injury.

PURPOSE/OBJECTIVE: To evaluate the acceptability and feasibility of testing the cognitive abilities of adults with traumatic spinal cord injury (TSCI) via teleconference. RESEARCH DESIGN: Data were collected prospectively at two study sites from 75 adults living with TSCI. Participants completed a series of self-report measures via an online survey platform, in addition to a brief battery of cognitive testing administered via audio-video teleconference. Modifications were made to select measures to allow for hands-free administration of all tasks. RESULTS: Feasibility was demonstrated by a 97.4% completion rate among the 77 participants who began the cognitive testing and approximately normal distributions for nearly all cognitive testing variables examined. No ceiling or floor effects were observed across cognitive testing variables. Review of acceptability ratings indicated that participants found this approach to cognitive testing to be highly acceptable. CONCLUSION/IMPLICATIONS: Our findings provide evidence for the feasibility and acceptability of administering cognitive testing via teleconference to adults living with TSCI. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Advocacy: The seventh foundational principle and core competency of rehabilitation psychology.

PURPOSE/OBJECTIVE: Advocacy has received increasing attention in the field of psychology over the past few years, including in the subfield of rehabilitation psychology. Psychology has been criticized for over-focusing on individual responses to complex sociopolitical problems. Rehabilitation psychology has tended to do this in much the same way, by placing the onus on individual disabled persons' responses to disability and overlooking the systemic and structural concerns of the environment. Advocacy has a long and important history as a competency for the practice of Rehabilitation Psychology. Yet, rehabilitation psychologists rarely receive formal training or guidance about performing effective advocacy efforts. The original six Foundational Principles include the person-environment relation, the insider-outsider distinction, adjustment to disability, psychological assets, self-perception of bodily states, and human dignity. Beatrice Wright advised that the guiding principles must be subject to review and open to expansion. RESEARCH METHOD/DESIGN: N/A. RESULTS: N/A. CONCLUSIONS/IMPLICATIONS: These authors believe that advocacy should be officially adopted as the seventh foundational principle of Rehabilitation Psychology. Rather than define advocacy narrowly as efforts within individual patient or family contexts, we argue that advocacy should be a broad construct of work done alongside the disability community and follow the lead of those with lived experience to avoid unintended consequences of well-intentioned advocacy efforts. We share models of advocacy in the field of psychology, including those most pertinent to rehabilitation psychology. Current disability advocacy priorities are highlighted at the individual, institutional, and discipline levels including interfacing with policymakers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID-19 and the spinal cord injury community: Concerns about medical rationing and social isolation.

PURPOSE/OBJECTIVE: To provide a descriptive account of the impact of the COVID-19 pandemic on the spinal cord injury (SCI) community focused on participants' concerns about medical discrimination and medical rationing, the impact of the pandemic on access to personal care attendants and medical supplies, and the impact of the pandemic on overall and mental health. Research Method/Design: Cross sectional, observational study among community-dwelling adults with SCI. Data were collected online between May 1, 2020 and August 31, 2020 (n = 187). The online questionnaire included questions regarding medical discrimination and rationing, the impact of the pandemic on access to care and medical supplies, and the impact of the pandemic on overall and mental health. RESULTS: Individuals with SCI have experienced difficulty accessing medical supplies due to the pandemic, and approximately half of our participants (52%) perceived that discrimination through medical rationing was occurring. Furthermore, compared to the general U.S. population, our sample reported that the pandemic had a greater negative impact on their mental health and access to medical supplies. CONCLUSION/IMPLICATIONS: Our findings suggest that the COVID-19 pandemic has negatively impacted mental health and increased concerns of social isolation as well as access to medical supplies among those with SCI. Rehabilitation psychologists must advocate alongside the disability community to limit health disparities and to conduct outreach, specifically with regard to mental health issues. Future research should focus on the effects of pandemic-related fears and social isolation, as well as resilience in the context of public health care threats. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Resilience and mental health in individuals with spinal cord injury during the COVID-19 pandemic.

STUDY DESIGN: Cross-sectional, observational study. OBJECTIVES: To understand how resilience, access to personal care attendants (PCAs) and medical supplies, and concerns about medical rationing, finances, and social isolation are related to overall and mental health in individuals with spinal cord injury (SCI) in the context of the COVID-19 pandemic. SETTING: Community dwelling adults (N = 187) with SCI. METHODS: Data were collected online between May 1, 2020 and August 31, 2020. Outcomes were overall and mental health, depression and anxiety symptoms, and quality of life (QoL). Predictors were resilience, access to PCAs and medical supplies, and concerns about medical rationing, finances, and social isolation. RESULTS: Incomplete injury, concern about medical rationing, medical supply disruption, and social isolation predicted a greater perceived impact of the pandemic on overall heath. Younger age, decreased resilience, and concern about medical rationing and social isolation predicted greater perceived impact of the pandemic on mental health. Decreased resilience and concern about medical rationing and finances predicted increased anxiety symptoms. Incomplete injury, believing that medical rationing was occurring, decreased resilience, and concern about finances and social isolation predicted increased depressive symptoms. Decreased resilience and concern about finances, medical rationing, and social isolation predicted lower QoL. CONCLUSIONS: The negative effects of the pandemic on the overall and mental health of individuals with SCI may be ameliorated by resilience. In future crises, it may be beneficial to screen individuals for resilience so that those with decreased resilience are offered the appropriate resources to enhance resilience and improve overall wellbeing.

No body is expendable: Medical rationing and disability justice during the COVID-19 pandemic.

The health threat posed by the novel coronavirus that caused the COVID-19 pandemic has particular implications for people with disabilities, including vulnerability to exposure and complications, and concerns about the role of ableism in access to treatment and medical rationing decisions. Shortages of necessary medical equipment to treat COVID-19 have prompted triage guidelines outlining the ways in which lifesaving equipment, such as mechanical ventilators and intensive care unit beds, may need to be rationed among affected individuals. In this article, we explore the realities of medical rationing, and various approaches to triage and prioritization. We discuss the psychology of ableism, perceptions about quality of life, social determinants of health, and how attitudes toward disability can affect rationing decisions and access to care. In addition to the grassroots advocacy and activism undertaken by the disability community, psychology is rich in its contributions to the role of attitudes, prejudice, and discriminatory behavior on the social fabric of society. We call on psychologists to advocate for social justice in pandemic preparedness, promote disability justice in health care settings, call for transparency and accountability in rationing approaches, and support policy changes for macro- and microallocation strategies to proactively reduce the need for rationing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

#SaytheWord: A disability culture commentary on the erasure of "disability".

PURPOSE: To inform the field of rehabilitation psychology about the sociocultural implications of the term "disability," and explain the rationale behind the #SaytheWord movement, a social media call to embrace disability identity. METHOD: Review of the literature on disability terminology, the history of language use, and the relationship between attitudes toward disability and language. We reflect on the role of disability within the field of psychology and within the American Psychological Association (APA), including the underrepresentation of disabled psychologists and trainees with disabilities and the lack of mentorship opportunities available in the field. IMPLICATIONS: The authors argue that erasure of the word "disability" can have unintended and adverse consequences. We describe how erasure of disability identity in the context of current sociopolitical efforts to reduce and eliminate public services and supports for people with disabilities is especially threatening to members of the disability community. To move forward, the authors postulate that the disability movement must reconcile its own history of exclusion and adopt a disability justice framework. CONCLUSION: The field of psychology has a rich tradition of appreciation of cultural diversity and individual difference; yet, disability has largely been left out of these efforts. The disability movement is moving toward the status of a diverse cultural group with a social justice agenda parallel to those of other marginalized communities. The authors posit that psychology must play a stronger role in advancing the human rights of people with disabilities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Providing culturally competent supervision to trainees with disabilities in rehabilitation settings.

OBJECTIVE: Very little is known about the supervision experiences of psychology trainees with disabilities in rehabilitation training settings. It is clear from the lack of literature, however, that a gap exists in training and education for supervisors about working with disabled trainees and providing culturally competent supervision. The purpose of this article is to explore legal and ethical concerns, cultural considerations of disability as an aspect of human diversity, attitudinal barriers, and mentorship during the professional journey of training future psychologists with disabilities. METHOD: This article was developed by reviewing the pertinent literature. The authors utilized a sample vignette and pertinent points from their own experiences as trainees, psychologists, and supervisors with disabilities in rehabilitation settings. RESULTS: A thorough discussion of the diversity and cultural aspects of supervising disabled trainees is included, along with a discussion of the importance of mentorship. IMPLICATIONS: A summary of recommendations is provided for supervisors of trainees with disabilities.

Personality and performance-based measures in the prediction of alcohol use.

Research has demonstrated a variable relationship between alcohol consumption and self-report personality measures of novelty seeking and harm avoidance. Research has also demonstrated a relationship between performance-based measures of risk taking and substance use. The current study compared the utility of personality measures and performance-based measures in the prediction of alcohol use. The authors hypothesized that the domains would contribute uniquely and would also interact in the prediction of alcohol consumption. Data on alcohol consumption were collected on a daily basis for 2 weeks. Performance-based measures included the Bechara Gambling Task and the Balloon Analogue Risk Task. The Tridimensional Personality Questionnaire was the primary personality measure. Results partially supported hypotheses, in that personality measures showed strong relationships with alcohol use and interacted with performance-based measures in predicting alcohol consumption. Thus, both behavioral and personality measures contributed to prediction of alcohol consumption, and performance-based measures played a moderating role. Results suggest that a combination of behavioral and self-report personality measures may be useful for those screening groups for risk factors for excessive alcohol consumption.