Spinal Cord Injury Care Line, Michael E. DeBakey VA Medical Center, Houston Texas, USA.
Department of Psychiatry, Baylor College of Medicine, Houston Texas, USA.
J Spinal Cord Med. 2021 Nov;44(6):958-965. doi: 10.1080/10790268.2020.1754650. Epub 2020 May 14.
Following a spinal cord injury or disability (SCI/D), cognitive appraisals are a marker of psychological adjustment. The present study evaluated the clinical utility and discriminant validity of the Appraisals of DisAbility Primary and Secondary Scale - Short Form (ADAPSS-sf). The ADAPSS-sf was evaluated on 1. identification of individuals experiencing poor psychological adjustment and 2. prediction of life satisfaction beyond measures of emotional distress. A retrospective study was completed using ROC analyses and odds ratios to identify the clinical utility of the ADAPSS-sf. In addition, blocked hierarchical regression explored the ADAPSS-sf predictive characteristics for satisfaction with life beyond measures of emotional distress. Veteran's Health Administration SCI Center. Ninety outpatient veterans with SCI/Ds. Measures of psychological adjustment post-SCI/D included the PHQ-9, GAD-7, PC-PTSD, and the Diener Satisfaction with Life Scale (SWLS). The ADAPSS-sf was used as a measure of cognitive appraisals. Results indicated the ADAPSS-sf is effective in identification of poor psychological adjustment, P < .001. Diagnostic odds ratios and ADAPSS-sf cut scores were selected to prioritize sensitivity (7.17, ≤ 11), specificity (68.25, ≥ 22), or a balance of the two (16.32, ≤ 19). Hierarchical regression indicated the ADAPSS-sf accounted for unique variance in life satisfaction beyond measures of emotional distress, (Δ = .20, = -.66, (89) = 6.54, P < .001). Results indicated SCI/D specific appraisals are predictive of concurrent poor psychological adjustment and provide insight into satisfaction with life beyond measures of emotional distress.
脊髓损伤或残疾（SCI/D）后，认知评估是心理适应的标志。本研究评估了残疾初级和次级评估量表的临床效用和判别效度-短格式（ADAPSS-sf）。使用 ROC 分析和优势比评估 ADAPSS-sf 来识别经历不良心理调整的个体，并预测生活满意度，超越情绪困扰的测量。使用 ROC 分析和优势比评估 ADAPSS-sf 的临床效用。此外，分块分层回归探讨了 ADAPSS-sf 对生活满意度的预测特征，超越了情绪困扰的测量。退伍军人健康管理局 SCI 中心。90 名门诊退伍军人患有 SCI/D。SCI/D 后心理调整的测量包括 PHQ-9、GAD-7、PC-PTSD 和 Diener 生活满意度量表（SWLS）。使用 ADAPSS-sf 作为认知评估的测量。结果表明，ADAPSS-sf 能有效识别不良心理调整，P<.001。诊断优势比和 ADAPSS-sf 切割分数用于优先考虑敏感性（7.17，≤11）、特异性（68.25，≥22）或两者的平衡（16.32，≤19）。分层回归表明，ADAPSS-sf 解释了生活满意度超越情绪困扰测量的独特差异，（Δ=0.20，=-.66，（89）=6.54，P<.001）。结果表明，SCI/D 特定的评估预测了同时存在的不良心理调整，并提供了对生活满意度的洞察力，超越了情绪困扰的测量。
