了解新获得性脊髓损伤的极端不公正评价表型。

IF 4 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation Pub Date : 2026-10-01 Epub Date: 2026-06-01 DOI:10.1016/j.apmr.2026.05.019

Angela Hanks PhD, Susan J. Knight MA, Jessica M. Ketchum PhD, Subhan Amir, Mirza R. Baig, Sean Hushagen MA, Muhammad Tayyab Ihsan MBBS, Jenna Javorina BA, Quinn D. Kellerman PhD, Scott D. McDonald PhD, Ayyub Mohamed, Lillian D. Sidky BS, Abby Welch BS, BA, Kimberley R. Monden PhD

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引用次数: 0

摘要

目的：识别和描述近期脊髓损伤（SCI）患者中不公正评价的极端表型，以改进社会心理干预和未来的临床研究。设计：采用纵向队列研究的基线数据进行横断面分析。环境：美国的四个住院康复中心。参与者：101名近期创伤性或非创伤性脊髓损伤的成年人（年龄≥18岁）完成了基线评估，包括不公正体验问卷（IEQ）。主要结局指标：采用IEQ第25和75百分位将参与者分为低（IEQ≤12）和高（IEQ≥26）不公正评价表型。测量方法包括患者健康问卷-8 （PHQ-8）、创伤后应激检查表（PCL-5）、状态-特质愤怒表达量表（STAXI-II）、残疾评估：主要和次要量表（ADAPSS）和国际脊髓损伤生活质量基本数据集（SCI QOL BDS）。结果：与低不公正评价的个体相比，高不公正评价的个体表现出明显更高的抑郁症状（PHQ-8: 10.3 vs. 3.3）。结论：不公正评价的极端表型揭示了近期脊髓损伤个体独特的社会心理特征。高不公正评价与痛苦增加和生活质量降低有关，强调需要有针对性的干预措施，解决早期康复中不公平和损失的看法。识别这些表型为未来的研究和干预开发提供了一个框架，以改善脊髓损伤后的心理结果。

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Understanding Extreme Injustice Appraisal Phenotypes in Newly Acquired Spinal Cord Injury

Objective

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.

Design

Cross-sectional analysis using baseline data from a longitudinal cohort study.

Setting

Four inpatient rehabilitation centers in the United States.

Participants

A total of 101 adults (aged ≥18y) with recent traumatic or nontraumatic SCI who completed baseline assessments, including the Injustice Experience Questionnaire (IEQ).

Main Outcome Measures

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, Posttraumatic Stress Checklist (PCL-5), State-Trait Anger Expression Inventory-II, Appraisals of Disability: Primary and Secondary Scale, and the International Spinal Cord Injury Quality of Life Basic Data Set.

Results

Compared with individuals with low injustice appraisals, those with high injustice appraisals presented with significantly higher depressive symptoms (Patient Health Questionnaire-8: 10.3 vs 3.3; P<.001), posttraumatic stress symptoms (PCL-5: 29.8 vs 6.6; P<.001), anger (state anger: 14.2 vs 7.4; P<.001), and maladaptive appraisals (Appraisals of Disability: Primary and Secondary Scale: 23.7 vs 13.4; P<.001). They also reported lower satisfaction across all quality of life 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.

Conclusions

Extreme phenotyping of injustice appraisals revealed unique psychosocial profiles among individuals with recent SCI. High injustice appraisals were associated with elevated distress and reduced quality of life, 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.

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来源期刊

Archives of physical medicine and rehabilitation 医学-康复医学

CiteScore

6.20

自引率

4.70%

发文量

495

审稿时长

38 days

期刊介绍： The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.