Contrasting perceptions of distress by research personnel and their spinal cord injured subjects.

Theoretical approaches to the understanding of psychological adjustment in spinal cord injury have recently experienced a re-examination which seriously questions the traditional "stage theory" of adjustment. Despite limited empirical validation at best, the stage theory has not only enjoyed an unchallenged popularity amongst rehabilitation professionals but often has been imposed upon new SCI patients as a necessary criterion for hospital discharge. Experienced professionals have also been shown to exaggerate the distress of their SCI patients and these misperceptions tend to progressively worsen with length of clinical experience. The present study replicated and extended this tendency amongst research personnel and their SCI subjects. Staff members tended to over-estimate depression, anxiety, and social discomfort while under-estimating the optimism of their SCI subjects. Recommendations are made for the use of a questionnaire to measure their distress. Also, suggestions are made regarding the potential clinical utility of assessing the contrasting perceptions of distress by SCI patients and significant people in their rehabilitation and social environments.