Brief Symptom Inventory norms for spinal cord injury.

Investigated the effects of spinal cord injury (SCI) upon a person's response to the Brief Symptom Inventory (BSI) by analyzing differences across item-response distributions from 225 Ss with SCI (aged 17–68 yrs) vs a nonpatient normative sample of 719 Ss. The study also developed more appropriate BSI normative data for persons with SCI. Because Ss' time since injury varied at time of BSI administration, normative scores were provided within 3 groupings: at discharge from the hospital; 0–24 mo post-discharge; and beyond 24 mo. Results show that SCI Ss had higher BSI scores when compared with Ss in the normative sample. These differences were particularly significant across 8 BSI items that reflected actual SCI physical and psychosocial symptoms. SCI Ss reported more distress during the period immediately following discharge to 24 mo. Overall, BSI scores tended to be lower at discharge and after 24 mo post-discharge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent variable structure of the Brief Symptom Inventory in a sample of persons with spinal cord injuries.

Investigated the presence of underlying factors which may be helpful in understanding Brief Symptom Inventory (BSI) item responses with 215 inpatientsresponse with spinal cord injuries. BSI scores were analyzed with principal components and maximum-likelihood factor estimation, and 6 factors were retained: anxiety, depression, mental blocks, interpersonal sensitivity, spinal cord injury, and hostile suspiciousness. Examination of factor content indicated their relevance to aspects of the rehabilitation process. Evidence for construct validity was examined by comparing the factor scores of persons who were rehospitalized versus persons who were not rehospitalized in the first year following initial rehabilitation. The rehospitalized group had higher BSI depression, mental blocks, and spinal cord injury factor scores prior to discharge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief screening for psychological and substance abuse disorders in veterans with long-term spinal cord injury.

Objective: To determine rates of positive screens for psychological and substance use disorders in persons with long-term spinal cord injury (SCI). Study Design: A naturalistic cohort design wherein consecutive admissions during an 8-month period completed the screening battery. Setting: Veterans Affairs SCI Center. Participants: One hundred fifteen men, 2 women, mean age 57.4 years, injured an average of 20 years, readmitted for various reasons. Main Outcome Measures: The Alcohol Use Disorders Identification Test (AUDIT) and screening items for depression and anxiety disorders. Results: Rates of positive screens ranged from 6.2% for alcohol problems to over 40% for anxiety disorders. Positive screens for depression and anxiety correlated positively with the number of recent hospital admissions. Conclusions: Systematic brief screening for psychological and substance abuse disorders in this population revealed rates of positive screens at least equal to those in other medical patient populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of emotional distress following a spinal cord injury.

Evaluated a new instrument, the Medical-Based Emotional Distress Scale (MEDS). The MEDS assesses emotional reactions (dysphoria, irritability) in response to a severe physical illness or disability, excluding symptoms that could be the direct result of a physical condition or problem, and includes subscales measuring affective reactions, behavioral changes, and cognitive distortions. A sample of 81 adults with a spinal cord injury was evaluated with the MEDS as well as the SCL-90, Zung Self-Rating Depression Scale, Hopelessness Scale, and Rosenberg Self-Esteem Scale. The MEDS subscales displayed moderately high internal consistency. Positive evidence of validity was found for MEDS subscales in the assessment of emotional distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the Beck Depression Inventory in veterans with spinal cord injury.

Hypothesized that 7 Beck Depression Inventory items would be poor discriminators between depressed and nondepressed spinal cord injury Ss. To test this hypothesis, 124 veterans (aged 19–79 yrs) with spinal cord injury were administered the Beck Depression Inventory and evaluated for the presence of a major depressive episode. Ss were first administered the Mini-Mental Status Examination, interviewed and then administered the Beck Depression Inventory. Discriminant function analysis revealed that 3 of the 7 items were poor discriminators. Since clinicians are faced with the dilemma of deciding whether endorsement of Beck Depression Inventory items is indicative of depressive symptomatology or the sequelae of spinal cord injury, the authors derived cut scores appropriate for spinal cord injury patients. Data on the sensitivity and specificity of these cut scores are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring cancer patients' psychological distress and well-being: A factor analytic assessment of the Mental Health Inventory.

This study examined the psychometric structure of the Mental Health Inventory (MHI) in 433 cancer patients. Using structural equation modeling, confirmatory factor analyses (CFAs) were conducted. Next, exploratory factor analysis (EFA) was used to explore an alternative MHI factor structure with a randomly chosen subsample. Finally, CFAs were conducted on 6 MHI models with the second subsample. Convergent validity was examined by administering the Positive and Negative Affect Schedule (PANAS) and the Dyadic Adjustment Scale (DAS). The CFAs with the original MHI factor structure indicated inadequate fit, supporting the need to conduct an EFA. Results of the EFA indicated support for a 5-factor solution but numerous differences in item factor loadings. The CFA indicated that the 5-factor correlated model was the best fitting model. Correlations between the PANAS and the DAS with the MHI provided preliminary support for the convergent validity of the MHI. Together, these results indicate that the original MHI factor structure may require modification for use in patients with cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Catastrophizing mediates associations between pain severity, psychological distress, and functional disability among persons with spinal cord injury.

Objective: To examine associations between pain severity, psychological distress, catastrophizing, and indices of functional disability in a sample of persons with spinal cord injury (SCI). Catastrophizing was examined as a potential mediator of associations between pain severity, psychological distress, and functional disability. Design and Participants: Questionnaires assessing pain severity, psychological distress, catastrophizing, pain interference, and community integration were completed by 237 persons with SCI. Results: Psychological distress and pain severity were associated significantly with greater functional disability. Moreover, the association between pain severity and functional disability was strongest among persons with high psychological distress. Catastrophizing appeared to mediate the associations between pain severity, psychological distress, and functional disability. Conclusions: Pain severity and psychological distress have the potential for both direct and interactive effects on functional disability, possibly through the mediating effects of catastrophizing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Longitudinal construct validity of Brief Symptom Inventory subscales in schizophrenia.

Longitudinal validity of Brief Symptom Inventory subscales was examined in a sample (N = 318) with schizophrenia-related illness measured at baseline and every 6 months for 3 years. Nonlinear factor analysis of items was used to test graded response models (GRMs) for subscales in isolation. The models varied in their within-time and between-times parameter constraints, with the homogeneous model being the least constrained, followed by the 2-parameter GRM and 1-parameter GRM. Results show that 4 subscales (Interpersonal Sensitivity, Hostility, Paranoid Ideation, Psychoticism) were consistent with the 1-parameter GRM, and 5 subscales (Somatization, Obsessive-Compulsive, Depression, Anxiety, Phobic Anxiety) were consistent with the 2-parameter GRM. There is evidence that the 9 subscales may be validly used to study change in single constructs over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Norms for the elderly on the Brief Symptom Inventory.

Administered the Brief Symptom Inventory to 364 females (mean age 73.54 yrs) and 201 males (mean age 73.92 yrs). The mean scores on the 9 primary symptom dimensions were compared with the mean scores from a normative sample of younger adults. Results indicate that the elderly reported higher levels of distress on most symptom dimensions. It is recommended that age-relevant norms be employed when using the Brief Symptom Inventory to assess self-reported psychopathology in the elderly. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traumatic spinal cord injury, alcohol, and the Minnesota Multiphasic Personality Inventory.

Investigated whether use of selected Minnesota Multiphasic Personality Inventory (MMPI) scales can identify personality characteristics in male patients with traumatic spinal cord injury and a positive blood alcohol concentration (BAC) at the time of injury. 20 males (aged 16–53 yrs) with a positive and 9 age-matched males with a negative BAC and 101 normal control males (aged 20–29 yrs) were contrasted on the MMPI Hysteria, Psychopathic Deviate, and Mania clinical scales and derived subscales reflecting traits such as rebelliousness and impulsivity. Results indicate that the average BAC when Ss arrived at the emergency room was 1,507 μg/ml. 75% of the positive BAC group had BAC concentrations above the legally defined limit of 1,000 μg/ml. Except for the MacAndrews Alcoholism Scale, none of the MMPI clinical scales or their corresponding derived subscales were significantly different between groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive psychological variables in the prediction of life satisfaction after spinal cord injury.

Objective: To examine relationships between select positive psychological variables and life satisfaction in persons with spinal cord injury during acute rehabilitation and 3 months after discharge. Design: Prospective observational design; correlational and regression analyses. Eighty-seven adults who were participating in in-patient, acute rehabilitation for spinal cord injury in two metropolitan hospitals completed the following measures: Benefit finding Scale, Hope Scale, Brief Symptom Inventory, COPE, Positive and Negative Affect Schedule, and Satisfaction with Life Scale. Results: Hypothesized relationships of hope and positive affect (facilitator variables) with greater life satisfaction during the initial acute rehabilitation period were supported. Facilitators, as measured at baseline, accounted for a significant amount of variance in life satisfaction above and beyond barrier variables (depression, negative affect, and avoidant coping) both during the acute rehabilitation phase (R2 change = .20, p R2 change = .09, p     

Adjustment following spinal cord injury.

Investigated specific coping strategies associated with psychological adjustment following spinal cord injury with a battery of assessments administered to 57 patients (median age 26.5 yrs) participating in a spinal cord injury rehabilitation program. Ss were divided into 3 groups based on degree of psychological distress. High-distress Ss reported using more Wish-Fulfilling Fantasy, Emotional Expression, Self-Blame, and Threat Minimization Coping strategies relative to the low and moderate distress groups. The Self-Blame Coping strategy was significantly correlated with psychological distress over and above age, time since injury, or level of injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Minnesota Multiphasic Personality Inventory indicator of psychological distress in male students.

Investigated the relationship of moderately elevated MMPI Scales 2 and 7 (Depression and Psychasthenia) to psychological help seeking, problem type, and academic progress for 4 successive classes at a small selective men's college. 21% of 755 entering students had both scales elevated (T?≥?60); these students were significantly more likely to seek psychological counseling, tended to have personal rather than other types of problems, and were more likely to take leaves of absence. Results suggest the MMPI 2-7 elevation is a simple indicator of psychological distress in the setting studied, but its utility in other college settings requires consideration of local base rates for psychological help and test results. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communal behaviors and psychological adjustment of family caregivers and persons with spinal cord injury.

Objective: Examined the influence of mutual communal behaviors on the adjustment reported by persons with spinal cord injury (SCI) and their family caregivers. Previous research has found that persons who have a history of mutually communal behaviors in relationships may react differently to relationship changes after an acquired physical disability than dyads with few communal behaviors. Method: Family caregivers and persons with SCI were administered measures of mutual communal behaviors, depression, and life satisfaction. Structural equation modeling was used to test the relations among caregivers' communal behaviors and care recipients' communal behaviors, depression, and life satisfaction. Results: Caregiver and care recipient reports of communal behaviors were not significantly correlated. Significant paths indicated that care recipients' communal behavior scores were positively associated with their life satisfaction, and care recipients' depression was inversely associated with their life satisfaction. Caregivers' communal behavior scores were unrelated to their self-reported adjustment. Conclusions: Caregiver-care recipient dyads may differ in their perceptions of communal behaviors in their relationships. Although care recipient reports of communal behavior may be related to their life satisfaction, communal behaviors may not serve a similar function among caregivers of persons with SCI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The acute abdomen in spinal cord injury individuals

A review of 1300 patients with spinal cord injury (SCI), over a period of 14 years, revealed 12 patients with an 'acute abdomen'. Seven events occurred during the initial admission, ranging from 10 days to 9 months from injury, and five during readmission of 'chronic' SCI patients. Four were in the acute stage 10-30 days from injury, all with peptic ulcer perforations. The remainder had either an intestinal obstruction, appendicitis or peritonitis. All of the neurological levels were above T6 except for one patient who had a low level paraplegia. The classical signs of an 'acute abdomen' may be missing in such patients thus delaying diagnosis by 1-4 days. The most important signs were autonomic dysreflexia, referred shoulder tip pain, abdominal pain, abdominal distension, increased spasticity and abdominal pain with nausea and vomiting. Less importance was given to the classical signs of abdominal tenderness, abdominal muscle rigidity, rebound, fever and of leukocytosis. Prompt diagnosis and treatment will minimise morbidity and mortality.     

Measuring appraisals following acquired spinal cord injury: A preliminary psychometric analysis of the appraisals of disability.

Objectives: The current study aimed to develop a reliable and valid appraisal scale (The Appraisals of DisAbility: Primary and Secondary Scale; ADAPSS) for adult spinal cord injury (SCI) populations. Method: Items for the ADAPSS were generated using themes and quotes from a qualitative study exploring appraisals made by individuals with SCI. The ADAPSS was administered with 2 additional appraisal measures, a measure of anxiety and depression, a measure of social desirability and demographic information. The study used a cross-sectional questionnaire design with a test–retest component, sampling community-based individuals with SCI. Data analysis was undertaken on 237 completed questionnaires. Results: Factor analysis revealed the ADAPSS to have a 6-factor structure and the following subscales identified: (a) Fearful Despondency, (b) Overwhelming Disbelief, (c) Determined Resolve, (d) Growth and Resilience, (e) Negative Perceptions of Disability, and (f) Personal Agency. Conclusion: Preliminary analyses suggest the ADAPSS demonstrates reasonable reliability and validity and has potential as a therapeutic outcome measure. Future research should focus on the relationship between appraisals identified on the ADAPSS and their relationship to the coping strategies that individuals employ and adjustment to SCI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of hyperarousal in the manifestation of posttraumatic psychological distress following injury.

The authors examined the temporal relation among posttraumatic stress disorder symptom clusters, using data derived from a longitudinal study of survivors of orofacial injury (N = 264). They conducted cross-lagged panel analyses, with self-reported symptom data collected at 1, 6, and 12 months postinjury. Results demonstrate that hyperarousal was a potent predictor of subsequent symptoms of reexperiencing and avoidance as well as hyperarousal. By contrast, neither reexperiencing nor avoidance was significantly related to other symptom clusters other than themselves over time. These findings underscore the distinctive nature of hyperarousal in the manifestation of posttraumatic psychological distress over time. Implications for theory, clinical intervention, and future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in vocational interests after spinal cord injury.

117 males (aged 20–72 yrs) with spinal cord injury (SCI) completed an SCI questionnaire and 2 versions of the Strong-Campbell Interest Inventory (SCII), one with standardized instructions and one with instructions to recall interests from an earlier, preinjury age. Strong Vocational Interest Blanks taken prior to injury were located for 14 Ss. These provided direct evidence concerning stability of interests and suggested that the larger group was relatively accurate in the recall of preinjury interests. 130 age-matched males without SCI also completed the SCII twice to assess the presence of any variance uniquely associated with the preinjury recall method. Results show that the interests of SCI Ss were as stable as those of the non-SCI Ss and that changes that did occur were consistent with those found in nondisabled samples. It is suggested that the recall method is potentially useful for future research. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The skeleton after spinal cord injury. Part 1. Theoretical aspects

Sublesional osteoporosis occurs after acute spinal cord injury (SCI), preferentially weakening the skeleton below the level of the neurological lesion. Although its pathogenesis is unclear, it resembles post-menopausal, high turnover osteoporosis. Physical and pharmacologic therapies are currently being tested for their ability to prevent early loss and restore lost bone. Although treatment strategies hold promise, preservation of skeletal strength after injury may ultimately rest on lifestyle decisions made early in life. If skeletal strength is to be maintained after SCI, ways must be found to optimize skeletal strength prior to injury, arrest early losses, and stabilize, if not restore, lost bone over time.     

Psychological problems of spinal cord injury patients: Emotional distress as a function of time and locus of control.

A scale assessing psychological problems was developed and administered to 136 male VA hospital spinal cord injury (SCI) patients (under 30 yrs of age). Results suggest that reaction to SCI was dominated by emotional distress and was best predicted by external locus of control and by recent injury. The scale was correlated with self-reports of anxiety, adjustment, affiliation, and sociability in a college population. Results do not support a simple stage theory of reaction to SCI but are consistent with other studies of coping patterns in SCI patients. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)