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Objectives: (a) To trace the historical roots of denial of illness in order to understand how the construct of denial developed; (b) to review the literature based on proposed theses; and (c) to propose a taxonomy of the unawareness syndromes. Method: Review of the literature and theory and presentation of a new theoretical model. Results: Evidence from the literature demonstrated that (a) denial and anosognosia are two forms of unawareness syndromes; (b) denial is a multidimensional construct; (c) the use of denial can be both adaptive and maladaptive; and (d) denial interacts with time to have a differential impact on outcomes. Conclusion: A taxonomy is proposed that includes anosognosia (complete and partial) and denial of illness (complete and partial). [ABSTRACT FROM AUTHOR]

Purpose/objective: Lack of patient participation and engagement remains a barrier to implementing effective online self-management and behavioral health interventions. Identifying patient characteristics associated with engagement rates may lead to interventions that improve engagement in traditional and online self-management programs. In this study, two online self-management and recovery programs were evaluated to identify factors that predict patient engagement., Research Method/design: Predictors were collected in a questionnaire at baseline before 435 participants started either of the two interventions. One or two online lessons were completed per week with seven or eight total lessons to complete in each program, and each lesson took about 20-30 min to finish. Full patient engagement was defined as completing all lessons and assessments in the program and partial engagement as attempting at least one lesson or assessment., Results: Predictors of full patient engagement were self-rated confidence in completing the program or being over 60 years of age. Predictors of at least partial patient engagement were experienced ordering online or being over 50 years of age., Conclusions/implications: Identifying profiles of individuals who predict poor engagement may improve implementation and the health outcomes of intervention programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rehabilitation psychology is based on foundational principles that can guide us toward health equity among disabled and nondisabled communities. We summarize the literature on disparities in the disability community and underscore the urgency to address underlying inequities to eliminate disparities. We include examples of population-level interventions that promote equity in the disability community. We conclude with a call for a broader mission for rehabilitation psychologists based on the field's foundational principles, and outline emerging opportunities to widen our impact and advance equity. Our foundational principles, built on systems theory, call on rehabilitation psychologist to work at macrosystemic levels. As rehabilitation psychologists, we need to widen our focus from the micro (individual) to the macro (population) level. We need to bring the respect, dignity, and collaborative spirit that inspire our work with individuals to the broader community by advocating for structures and policies that promote equity for disabled persons. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Purpose/objective: Intensive care unit (ICU) survivors frequently experience long-lasting mental health, cognitive, and physiologic challenges. Psychologists have a role in providing interventions to reduce patient distress during critical illness and improve outcomes. There is limited data regarding psychology consultations in the ICU. This brief report characterizes psychology consultations in a medical intensive care unit (MICU) in an academic medical center., Method: Psychology consultations were prospectively tracked, with patient-related data retrospectively collected and analyzed., Results: A total of 79 consecutive psychology consultations occurred at mean of 8 ± 6 days after MICU admission. Reasons for consultation were patient emotional distress (56%), rehabilitation therapy engagement (24%), family engagement (13%), cognitive disturbance (4%), and pain (4%). Patient characteristics were: mean age 56 ± 15 years, 54% women, 53% White, and 34% with psychiatric comorbidity at MICU admission. Patients referred for consultation had a longer MICU length of stay than the total MICU population (12 ± 9 days vs. 4 ± 6 days, p < .01). For consultations for emotional distress compared with limited rehabilitation therapy engagement, patient demographic characteristics were similar, with the exception of women (vs. men) being more commonly consulted for emotional distress (64 vs. 26%, p = .01)., Conclusions: Patients with a longer MICU stay more commonly had a rehabilitation psychology consultation request, typically to provide support for emotional distress or engagement in rehabilitation therapy. Future research should evaluate the effectiveness of psychology interventions in the ICU. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: Lequerica and Kortte (2010) proposed a model of therapeutic engagement in rehabilitation that indicates there are facilitators and barriers to an individual's engagement in rehabilitation. The current study examines potential personal variables that may play a role in rehabilitation engagement., Design: In this prospective cohort design, 206 adults from 3 inpatient acute rehabilitation hospitals completed the Hopkins Rehabilitation Engagement Rating Scale, Hope Scale, Benefit Finding Scale, Positive and Negative Affect Schedule, Brief Symptom Inventory, and Denial of Illness Scale., Results: Among potential facilitators (hope, benefit-finding, positive affect), positive affect was the only variable that accounted for a significant variance (β = .24, p < .01) in rehabilitation engagement. Among potential barriers (depressive symptoms, negative affect, denial of illness), only denial of illness accounted for a significant variance (β = -.24, p < .01) in rehabilitation engagement., Conclusions: The present findings suggest that specific facilitators (positive affect) and barriers (denial of illness) relate to therapeutic engagement in rehabilitation. Interventions that increase positive affect and address denial of illness may provide novel avenues to increase therapeutic engagement. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Historically, the Foundational Principles articulated by Wright (1983) and others guided theory development, research and scholarship, and practice in rehabilitation psychology. In recent decades, these principles have become more implicit and less explicit or expressive in the writings and work of rehabilitation professionals. We believe that the Foundational Principles are essential lodestars for working with people with disabilities that can guide inquiry, practice, and service. To introduce this special issues, this commentary identifies and defines key Foundational Principles, including, for example, Lewin's (1935) person-environment relation, adjustment to disability, the malleability of self-perceptions of bodily states, and the importance of promoting dignity for people with disabilities. We then consider the role the Foundational Principles play in the articles appearing in this special issue. We close by considering some new principles and their potential utility in rehabilitation settings. Readers in rehabilitation psychology and aligned areas (e.g., social-personality psychology, health psychology, rehabilitation therapist, psychiatry, and nursing) are encouraged to consider how the Foundational Principles underlie and can shape their research and practice., ((c) 2016 APA, all rights reserved).)

Objective: Although the management of acute traumatic injury has improved, long-term functional outcomes remain poor. Data suggest major improvements in outcome will require comprehensive, self-management (SM) interventions. However, little is known about trauma survivors' willingness to participate in such interventions. The goal of this study was to create and validate an instrument based on the stages of change (SOC) framework to assess readiness to engage in SM programs following acute traumatic injury., Method: The Readiness to Engage in Self-Management after Acute Traumatic Injury (RESMATI) was developed based on SOC theory. Participants (N = 150) were admitted to a Level I trauma center for treatment of severe trauma and completed the RESMATI 3 to 12 months postinjury. A random sample (n = 60) completed a reassessment 1 month later to determine item stability. A principal components analysis and an exploratory factor analysis were conducted., Results: The analyses of the 34 RESMATI items yielded a 5-factor model, collapsed into 3 domains based on SOC theory. Two factors were classified as "precontemplation," 2 factors were classified as "contemplation," and 1 factor was classified as "action/maintenance." All 3 domains had good internal consistency reliability (.71 to .92) and moderate test-retest reliability (.56 and .73)., Conclusions: The exploratory factor analysis yielded 3 domains that were consistent with the SOC model. Two notable exceptions were the lack of a "preparation" domain and lack of distinction between the action and maintenance stages. The RESMATI is a reliable instrument that requires further testing to establish validity and utility in identifying individuals' readiness to engage in SM following acute traumatic injury., ((c) 2014 APA, all rights reserved.)

Purpose/objective: The purpose of this study was to examine the association between facilitating psychological variables and functional rehabilitation outcomes following acute medical rehabilitation., Research Method/design: Using a longitudinal design and correlational and regression analyses, we studied 174 adults who were participating in inpatient rehabilitation for acute spinal cord dysfunction, stroke, amputation, or orthopedic surgery recovery. All participants completed the Hope Scale, Positive and Negative Affect Schedule, and Functional Independence Measure (FIM) during the first days of their inpatient stay, and then were contacted 3 months after discharge to complete the Craig Hospital Assessment and Reporting Technique (CHART) and FIM., Results: Hope accounted for a statistically significant amount of the variance in the prediction of functional role participation at 3 months postdischarge (as measured by the CHART) above and beyond the variance accounted for by demographic and severity variables. In contrast, positive affect was not found to contribute to the prediction of functional role participation, and neither hope nor positive affect contributed to the prediction of functional skill level (FIM)., Conclusions/implications: The results indicate that positive psychological variables present during the rehabilitation stay, such as hopefulness, may contribute to the prediction of functional outcomes after discharge in rehabilitation populations. These findings suggest that incorporating interventions that enhance hope and build on the individual's psychological strengths may be useful to improve participation outcomes following acute medical rehabilitation.

On behalf of the new editorial team, let me welcome you to this first issue of Rehabilitation Psychology under our leadership. We are excited and honored by this responsibility. We look forward to serving the readership, authors, and the entire rehabilitation community as we develop and grow the flagship journal of rehabilitation psychology. As part of the editorial transition, I want to take this opportunity to reflect on our history, define our mission, encourage our team, and explore our future. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

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 (R(2) change = .20, p < .0001) and at 3 months after discharge (R(2) change = .09, p < .029)., Conclusions: Findings suggest that positive psychological variables play a significant role in postrehabilitation subjective well-being for persons with spinal cord injury and may provide potential avenues for interventions to facilitate positive outcomes.

Objective: To establish psychometric properties of the Acceptance and Action Questionnaire (AAQ), a measure of avoidance, in medical rehabilitation populations., Study Design: Cross-sectional and longitudinal., Setting: Three acute, inpatient rehabilitation units., Participants: One hundred thirty-nine adults with spinal cord dysfunction, stroke, amputation, or orthopedic surgery., Measures: AAQ, Hope Scale, Spiritual Well-Being Scale, Positive and Negative Affect Scale, Brief Symptom Inventory, Hopkins Rehabilitation Engagement Rating Scale, Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Satisfaction with Life Scale., Results: The AAQ has adequate internal consistency (alpha = .70), is best understood with a two-factor solution, is positively correlated with depression (r = .36, p < .01) and negative affect (r = .41, p < .001), and is negatively correlated with hope (r = -.51, p < .001), positive affect (r = -.33, p < .001), and spiritual well-being (r = -.32, p < .001). Predictive relationships with life satisfaction (beta = -.40, p < .001) and level of handicap (beta = -.20, p < .014) were found at 3-month follow-up., Conclusions: Findings provide preliminary support that the AAQ is reliable and valid in medical populations and that avoidance plays an important role in rehabilitation outcomes.