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  1. Article ; Online: Utility of in-session assessments during cognitive behavioral therapy for depression after traumatic brain injury: Results from a randomized controlled trial.

    Erickson, Jennifer M / Williams, Ryan / Bombardier, Charles H / Fann, Jesse R

    NeuroRehabilitation

    2024  Volume 54, Issue 2, Page(s) 245–257

    Abstract: Background: The development of depression after moderate to severe traumatic brain injury (TBI) is common. Cognitive-behavioral therapy (CBT) can be used to treat post-TBI depression, but the symptoms response is poorly described.: Objective: This ... ...

    Abstract Background: The development of depression after moderate to severe traumatic brain injury (TBI) is common. Cognitive-behavioral therapy (CBT) can be used to treat post-TBI depression, but the symptoms response is poorly described.
    Objective: This secondary analysis assessed: (1) the trajectory of depression symptoms up to 12 sessions of CBT, (2) which depressive symptom clusters were responsive to in-person and phone CBT, and (3) whether interim depression thresholds predict 16-week treatment response.
    Method: This secondary analysis of the IRB-approved Life Improvement Following Traumatic Brain Injury trial included 100 adults with major depressive disorder (MDD) within ten years of moderate to severe traumatic brain injury from throughout the US. We used a combination of descriptive, graphical, and diagnostic accuracy methods.
    Results: Cardinal and cognitive-affective symptom clusters improved most from CBT over 16 weeks. At 8 and 16 weeks, the most responsive individual symptoms were anhedonia, depressed mood, and fatigue; the least responsive were sleep and appetite. PHQ-9 thresholds with a Negative Predictive Value greater than 0.7 for sessions 6, 7, and 8 were, respectively: >15, >10, and >9.
    Conclusion: In-person and phone CBT led to similar symptom responses during treatment. Additionally, using PHQ-9 thresholds for predicting intervention response within eight sessions may help identify the need for treatment adjustments.
    MeSH term(s) Adult ; Humans ; Depression/etiology ; Depression/therapy ; Depressive Disorder, Major/therapy ; Depressive Disorder, Major/complications ; Brain Injuries, Traumatic/complications ; Cognitive Behavioral Therapy/methods ; Treatment Outcome
    Language English
    Publishing date 2024-01-25
    Publishing country Netherlands
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 1087912-2
    ISSN 1878-6448 ; 1053-8135
    ISSN (online) 1878-6448
    ISSN 1053-8135
    DOI 10.3233/NRE-230218
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    Zs.A 3328: Show issues Location:
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  2. Article ; Online: Association Between Anxiety Symptoms, Depression Symptoms, and Life Satisfaction Among Individuals 1 Year After Spinal Cord Injury: Findings From the SCIRehab Project.

    Parker, Maria A / Ichikawa, Jodi K / Bombardier, Charles H / Hammond, Flora M

    Archives of rehabilitation research and clinical translation

    2022  Volume 4, Issue 3, Page(s) 100211

    Abstract: Objective: To examine the association between anxiety symptoms, depression symptoms, and life satisfaction 1 year after SCI.: Design: Cross-sectional analysis of data from the SCIRehab Project. A linear regression model estimated the association ... ...

    Abstract Objective: To examine the association between anxiety symptoms, depression symptoms, and life satisfaction 1 year after SCI.
    Design: Cross-sectional analysis of data from the SCIRehab Project. A linear regression model estimated the association between anxiety symptoms and life satisfaction and tested the moderating effect of depression symptoms on the association between anxiety symptoms and depression symptoms with an interaction term.
    Setting: Six rehabilitation facilities across the United States.
    Participants: A total to 940 persons older than 12 years who received inpatient spinal cord injury (SCI) rehabilitation between 2007 and 2009 were followed up 1 year post injury (n=940).
    Interventions: None.
    Main outcome measures: Life satisfaction 1 year after SCI measured via the Satisfaction With Life Scale.
    Results: Unadjusted analyses showed anxiety symptoms were associated with decreased life satisfaction for individuals with SCI. In adjusted analyses, anxiety symptoms were not associated with life satisfaction. In adding an interaction term, anxiety symptoms were associated with 2 points lower life satisfaction holding the other variables constant (
    Conclusions: In clinical settings, both anxiety and depression symptoms should be monitored, measured, and treated together to optimally improve life satisfaction for persons with SCI. Prioritizing interventions known to have transdiagnostic effects may achieve the best results.
    Language English
    Publishing date 2022-08-03
    Publishing country United States
    Document type Journal Article
    ISSN 2590-1095
    ISSN (online) 2590-1095
    DOI 10.1016/j.arrct.2022.100211
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  3. Article ; Online: Strategies for health care providers to help individuals experiencing grief and loss due to spinal cord injury (SCI): A qualitative study.

    LaVela, Sherri L / Kale, Ibuola / Burkhart, Elizabeth / Bombardier, Charles H

    Rehabilitation psychology

    2022  Volume 67, Issue 3, Page(s) 315–324

    Abstract: Objective: To explore health care professionals' perceptions of ideal strategies for providers to use in care provision to help individuals with spinal cord injuries (SCI) deal with injury-related grief and loss.: Method: This study used a ... ...

    Abstract Objective: To explore health care professionals' perceptions of ideal strategies for providers to use in care provision to help individuals with spinal cord injuries (SCI) deal with injury-related grief and loss.
    Method: This study used a descriptive qualitative design using semistructured interviews with 15 SCI health providers and thematic analysis.
    Results: The sample included interprofessional health providers who provided SCI care for an average of 10.3 years at six nationally distributed facilities. Participants identified eight themes around strategies that can be used by providers to help individuals with SCI experiencing grief and loss. Strategies/themes included those that are
    Conclusions: Providers identified strategies to facilitate holistic patient-centered grief care that included open communication, empathy, trust, and normalizing the grief experience, where appropriate. Providers believed that regular screenings for feelings of grief and loss are necessary to know where individuals with SCI are at in the grief process and what they need. Ideal grief care would benefit from coordinated care, support services, and patient education. These findings offer steps to guide health provider's approach to addressing grief and loss due to injury among individuals with SCI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
    MeSH term(s) Communication ; Grief ; Health Personnel ; Humans ; Qualitative Research ; Spinal Cord Injuries
    Language English
    Publishing date 2022-05-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224747-1
    ISSN 1939-1544 ; 0090-5550
    ISSN (online) 1939-1544
    ISSN 0090-5550
    DOI 10.1037/rep0000438
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    Zs.A 1934: Show issues Location:
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  4. Article ; Online: A scoping review on the effect of cannabis on pain intensity in people with spinal cord injury.

    Thomas, Pavithra A / Carter, Gregory T / Bombardier, Charles H

    The journal of spinal cord medicine

    2021  Volume 45, Issue 5, Page(s) 656–667

    Abstract: Context: This scoping review examines the current research on the effect of cannabis upon pain intensity in spinal cord injury (SCI) pain. Chronic pain is a significant secondary condition following SCI, and traditional treatments (e.g. opioids, NSAIDs) ...

    Abstract Context: This scoping review examines the current research on the effect of cannabis upon pain intensity in spinal cord injury (SCI) pain. Chronic pain is a significant secondary condition following SCI, and traditional treatments (e.g. opioids, NSAIDs) are often criticized for providing inadequate relief. As a result, there is increasing interest in and use of cannabis and cannabinoid-based medications as an alternative means of pain control.
    Objective: The purpose of this review was to examine the scientific evidence on the effect of cannabis/cannabinoids upon pain intensity in SCI by mapping the current literature.
    Methods: Two hundred and fifty-two studies were identified by searching electronic databases for articles published through February 2020. In addition, reviewers scanned the reference lists of identified articles and examined clinicaltrials.gov for unpublished data in this area. Title, abstract, and full-text reviews were completed by two independent reviewers. Data extraction was performed by a single reviewer and verified by a second reviewer.
    Results: Six articles covering five treatment studies were included. Studies yielded mixed findings likely due to large variability in methodology, including lack of standardized dosing paradigms, modes of use, and duration of trial.
    Conclusions: The current quality and level of evidence is insufficient to draw reliable conclusions of the efficacy of cannabis upon SCI-related pain itensity. We identify specific limitations of past studies and present guidelines for future research.
    MeSH term(s) Analgesics/therapeutic use ; Analgesics, Opioid/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Cannabinoids/therapeutic use ; Cannabis ; Chronic Pain/therapy ; Humans ; Pain Measurement ; Spinal Cord Injuries/complications ; Spinal Cord Injuries/drug therapy
    Chemical Substances Analgesics ; Analgesics, Opioid ; Anti-Inflammatory Agents, Non-Steroidal ; Cannabinoids
    Language English
    Publishing date 2021-01-19
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1223949-5
    ISSN 2045-7723 ; 1079-0268
    ISSN (online) 2045-7723
    ISSN 1079-0268
    DOI 10.1080/10790268.2020.1865709
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  5. Article ; Online: Facilitators to alleviate loneliness and social isolation as identified by individuals with spinal cord injuries and disorders: A qualitative study.

    LaVela, Sherri L / Motl, Robert W / Berryman, Kelsey / Wirth, Marissa / Bartle, Brian / Aguina, Keith / Solanki, Pooja / Bombardier, Charles H

    Rehabilitation psychology

    2024  

    Abstract: Purpose/objective: Individuals with spinal cord injuries and disorders (SCI/D) are at increased risk for experiencing loneliness and social isolation. The aim is to describe facilitators identified by individuals living with SCI/D to alleviate ... ...

    Abstract Purpose/objective: Individuals with spinal cord injuries and disorders (SCI/D) are at increased risk for experiencing loneliness and social isolation. The aim is to describe facilitators identified by individuals living with SCI/D to alleviate loneliness and perceived social isolation.
    Research method/design: Descriptive qualitative design using in-depth interviews with veterans with SCI/D (
    Results: Participants were male (70%), white (78%), and not currently married (35%), with an average age of 66 years (42-88). Participants had paraplegia (61%), with traumatic etiology (65%) and were injured 14 years (1-45) on average. Eight themes were identified by participants living with SCI/D that described facilitators to alleviate loneliness and perceived social isolation. (a) Engage in/pursue interests; (b) Interact with/spend time with others; (c) Embrace acceptance; (d) Take part in reciprocity; (e) Find a purpose/accomplish goals; (f) Get out of residence, get outside; (g) Connect with SCI/D community/SCI/D peers; and (h) Seek help from (mental) healthcare professionals.
    Conclusions/implications: Individuals with SCI/D identified facilitators to alleviate loneliness that encompasses changes in ways of thinking, actions to expand participation in life, and efforts focused on involving others. Findings can be used to guide healthcare delivery and develop interventions to target feelings of loneliness and social isolation in persons with SCI/D, which may be particularly impactful if they involve reciprocal interactions with peers with SCI/D. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
    Language English
    Publishing date 2024-01-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224747-1
    ISSN 1939-1544 ; 0090-5550
    ISSN (online) 1939-1544
    ISSN 0090-5550
    DOI 10.1037/rep0000540
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  6. Article ; Online: Study protocol: exercise training for treating major depressive disorder in multiple sclerosis.

    Motl, Robert W / Bombardier, Charles H / Duffecy, Jennifer / Hibner, Brooks / Wathen, Alison / Carrithers, Michael / Cutter, Gary

    BMC neurology

    2024  Volume 24, Issue 1, Page(s) 131

    Abstract: Background: Major depressive disorder (MDD) is prevalent, yet sub-optimally treated among persons with multiple sclerosis (MS). We propose that exercise training may be a promising approach for treating depression in persons with MS who have MDD. Our ... ...

    Abstract Background: Major depressive disorder (MDD) is prevalent, yet sub-optimally treated among persons with multiple sclerosis (MS). We propose that exercise training may be a promising approach for treating depression in persons with MS who have MDD. Our primary hypothesis predicts a reduction in depression severity immediately after an exercise training intervention compared with minimal change in an attention control condition, and the reduction will be maintained during a follow-up period.
    Methods: This study involves a parallel-group, assessor-blinded RCT that examines the effect of a 4-month home-based exercise training intervention on depression severity in a sample of persons with MS who have MDD based on the MINI International Neuropsychiatric Interview. The primary outcomes of depression severity are the Patient Health Questionnaire-9 and Hamilton Depression Rating Scale. Participants (N = 146) will be recruited from within 200 miles of the University of Illinois at Chicago and randomized (1:1) into either a home-based exercise training condition or control condition with concealed allocation. The exercise training and social-contact, attention control (i.e., stretching) conditions will be delivered remotely over a 4-month period and supported through eight, 1:1 Zoom-based behavioral coaching sessions guided by social-cognitive theory and conducted by persons who are uninvolved in screening, recruitment, random assignment, and outcome assessment. We will collect outcome data at 0, 4 and 8 months using treatment-blinded assessors, and data analyses will involve intent-to-treat principles.
    Discussion: If successful, the proposed study will provide the first Class I evidence supporting a home-based exercise training program for treating MDD in persons with MS. This is critical as exercise training would likely have positive secondary effects on symptoms, cognition, and quality of life, and provide a powerful, behavioral approach for managing the many negative outcomes of MDD in MS. The program in the proposed research is accessible and scalable for broad treatment of depression in MS, and provides the potential for integration in the clinical management of MS.
    Trial registration: The trial was registered on September 10, 2021 at clinicaltrials.gov with the identifier NCT05051618. The registration occurred before we initiated recruitment on June 2, 2023.
    MeSH term(s) Humans ; Multiple Sclerosis/complications ; Depressive Disorder, Major ; Quality of Life ; Exercise ; Exercise Therapy ; Treatment Outcome ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article
    ZDB-ID 2041347-6
    ISSN 1471-2377 ; 1471-2377
    ISSN (online) 1471-2377
    ISSN 1471-2377
    DOI 10.1186/s12883-024-03634-y
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  7. Article ; Online: Factors associated with perceived social isolation among veterans with spinal cord injury and disorders: Cross sectional survey.

    Wirth, Marissa / Motl, Robert W / Bombardier, Charles H / Bartle, Brian / Wong, Alex W K / Aguina, Keith / LaVela, Sherri L

    The journal of spinal cord medicine

    2024  , Page(s) 1–10

    Abstract: Context/objective: Examine demographics, injury characteristics, objective measures of social isolation and health factors that are associated with perceived social isolation (PSI) among Veterans with spinal cord injury and disorders (SCI/D).: Design!# ...

    Abstract Context/objective: Examine demographics, injury characteristics, objective measures of social isolation and health factors that are associated with perceived social isolation (PSI) among Veterans with spinal cord injury and disorders (SCI/D).
    Design: Cross-sectional survey.
    Setting: The Veterans Health Administrations (VHA) SCI/D system of care.
    Participants: Veterans with SCI/D who have used the VHA health care system.
    Intervention: Not applicable.
    Outcomes measures: We assessed unadjusted associations of high PSI (above population mean) vs low (normative/below population mean), and multivariable logistic regression for independent associations with PSI.
    Results: Out of 1942 Veterans with SCI/D, 421 completed the survey (22% response rate). Over half (56%) had PSI mean scores higher than the general population. Among the objective measures, having a smaller social network size was associated with increased odds of high PSI (OR 3.59, P < .0001); additionally, for health factors, having depression (OR 3.98, P < 0.0001), anxiety (OR 2.29, P = 0.009), and post-traumatic stress (OR 2.56, P = 0.003) in the previous 6 months, and having 4 or more chronically occurring secondary conditions (OR 1.78, P = 0.045) was associated with increased odds of high PSI. The most commonly identified contributors to feelings of PSI included mobility concerns (63%), having a SCI/D (61%), and concerns about being a burden on others (57%).
    Conclusions: Factors such as social network size may be used to identify individuals with SCI/D at risk for PSI. Additionally, by identifying mental health problems, presence of multiple chronically occurring secondary conditions, and Veteran-identified contributors of PSI, we can target these factors in a patient-centered interventions to identify and reduce PSI.
    Language English
    Publishing date 2024-02-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 1223949-5
    ISSN 2045-7723 ; 1079-0268
    ISSN (online) 2045-7723
    ISSN 1079-0268
    DOI 10.1080/10790268.2023.2299500
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  8. Article ; Online: Dynamics of Perceived Social Isolation, Secondary Conditions, and Daily Activity Patterns Among Individuals With Stroke: A Network Analysis of Ecological Momentary Assessment Data.

    Shi, Yun / Fong, Mandy W M / Metts, Christopher L / LaVela, Sherri L / Bombardier, Charles / Hu, Lu / Wong, Alex W K

    Archives of physical medicine and rehabilitation

    2024  

    Abstract: Objective: To assess contemporaneous and temporal dynamics of perceived social isolation (PSI), secondary conditions, and daily activity patterns in individuals post-stroke.: Design: Longitudinal observational study using ecological momentary ... ...

    Abstract Objective: To assess contemporaneous and temporal dynamics of perceived social isolation (PSI), secondary conditions, and daily activity patterns in individuals post-stroke.
    Design: Longitudinal observational study using ecological momentary assessment (EMA) as a real-time assessment of an individual's lived experiences. We conducted dynamic network analyses to examine longitudinal associations among EMA variables.
    Settings: Home and Community.
    Participants: 202 individuals with mild-to-moderate chronic stroke (median age=60 years; 45% women; 44% black; 90% ischemic stroke; median NIHSS score=2; N=202).
    Intervention: Not applicable.
    Main outcome measures: EMA questions measured PSI, secondary conditions (pain, tiredness, stress, anxiety, worthlessness, difficulty concentrating, and cheerfulness), and daily activity patterns (being at home, being alone, and participating in productive activities).
    Results: The median EMA response rate was 84%. The contemporaneous model showed that PSI was associated with being home, alone, and all symptoms except pain. The temporal model revealed a pathway indicating that feelings of worthlessness predicted PSI (regression coefficient=0.06, P=.019), followed by stress (regression coefficient=0.06, P=.024), and then by being not at home (regression coefficient=-0.04, P=.013).
    Conclusion: Implementing dynamic network analyses on EMA data can uncover dynamic connections among PSI, secondary conditions, and daily activity patterns after stroke. This study found a significant temporal association between PSI and negative emotions. Feeling isolated was followed by feeling stressed, which was followed by a tendency to be out of home, indicating adaptive behaviors in individuals with stroke. These findings highlight the importance of engaging in out-of-home or outdoor activities to mitigate PSI and negative emotions.
    Language English
    Publishing date 2024-03-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2024.02.733
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  9. Article ; Online: Variables Associated With Moderate to High Loneliness Among Individuals Living With Spinal Cord Injuries and Disorders.

    Berryman, Kelsey / Wirth, Marissa / Bombardier, Charles H / Motl, Robert W / Bartle, Brian / Jacob, R Lorie / Aguina, Keith / LaVela, Sherri L

    Archives of physical medicine and rehabilitation

    2024  

    Abstract: Objective: To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D).: Design: A cross-sectional, national survey of a random sample of community-dwelling ... ...

    Abstract Objective: To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D).
    Design: A cross-sectional, national survey of a random sample of community-dwelling Veterans with SCI/D in the United States. Survey methodology was used to collect data on demographic and injury characteristics, general health, chronic and SCI-secondary conditions, and loneliness.
    Setting: The VHA SCI/D System of Care including 25 regional SCI/D Centers (or Hubs).
    Participants: Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were men (91%), white (81%), not currently married (42%), had tetraplegia (33%), and on average injured for 18 years at the time of data collection (N=562).
    Interventions: Not applicable.
    Main outcome measure: The dependent variable, loneliness, was collected using the UCLA-3 instrument. Loneliness was dichotomized into never/low loneliness and moderate/high loneliness (UCLA score ≥ 4).
    Results: Bivariate analyses assessed unadjusted associations in demographics, injury characteristics, chronic disease, and SCI-secondary conditions. Multivariable logistic regression was used to identify factors independently associated with moderate/high loneliness. Participants had a mean loneliness score of 5.04, SD=1.99. The point prevalence of moderate to high loneliness was 66%. Lower duration of injury, paraplegia, being unmarried, being in fair/poor general health, having dysfunctional sleep, and having a diagnosis of bowel dysfunction were each independently associated with greater odds of moderate/high loneliness.
    Conclusions: Findings suggest that interventions to reduce/manage loneliness in the Veteran SCI/D population should focus on those who are more newly injured, have paraplegia, currently unmarried, have bowel problems, and experience dysfunctional sleep.
    Language English
    Publishing date 2024-01-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2024.01.010
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  10. Article ; Online: Depression and spinal cord injury.

    Bombardier, Charles H

    Archives of physical medicine and rehabilitation

    2014  Volume 95, Issue 2, Page(s) 413–414

    MeSH term(s) Antidepressive Agents/therapeutic use ; Counseling ; Depression/psychology ; Depression/therapy ; Humans ; Psychiatric Status Rating Scales ; Spinal Cord Injuries/psychology
    Chemical Substances Antidepressive Agents
    Language English
    Publishing date 2014-02
    Publishing country United States
    Document type Patient Education Handout
    ZDB-ID 80057-0
    ISSN 1532-821X ; 0003-9993
    ISSN (online) 1532-821X
    ISSN 0003-9993
    DOI 10.1016/j.apmr.2013.04.008
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