The Impact of Stigma on Psychosocial Outcomes Following Spinal Cord Injury: A Cross-Sectional Analysis of Stigma-Mediated Relationships

Kimberley R. Monden, Angela Philippus, Bria MacIntyre, Abby Welch, Mitch Sevigny, Christina Draganich, Stephanie Agtarap, Leslie R. Morse

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Purpose/Objective: The purpose of this study was to (a) assess the relationship between stigma and psychosocial outcomes and (b) examine the potential mediating influence of stigma on the relationship between sociodemographic and injury-related characteristics and psychosocial outcomes after spinal cord injury (SCI). Research Method/Design: This cross-sectional, observational study included participants enrolled in the Rocky Mountain Regional Spinal Cord Injury Model System. Questionnaires were administered via telephone. Stigma was assessed using the Spinal Cord Injury Quality of Life Stigma Short Form. Results: Questionnaires were completed by 225 participants (78% male; 22% female). Stigma was significantly, positively associated with depression symptoms, perceived disability, injustice appraisals, and participation (physical independence and mobility). Stigma was significantly, negatively associated with quality of life and self-efficacy. Stigma partially mediated several relationships between sociodemographic or injury-related characteristics and psychosocial outcomes. Stigma fully mediated the relationships between each time since injury and self-efficacy, length of rehabilitation stay and injustice appraisals, wheelchair use and self-efficacy, and wheelchair type and quality of life. Conclusions/ Implication: Stigma is an important psychological factor associated with several person-and injuryrelated characteristics and psychosocial outcomes. Furthermore, stigma mediates particular relationships between sociodemographic or injury-related characteristics and outcomes. These findings will inform the development of interventions designed to mitigate stigma’s negative impact on outcomes such as mood, quality of life, and participation after SCI.

Original languageEnglish (US)
Pages (from-to)202-212
Number of pages11
JournalRehabilitation Psychology
Volume66
Issue number2
DOIs
StatePublished - 2021

Bibliographical note

Funding Information:
We have no known conflicts of interest to disclose. Our work was funded by the Scott and Paul Pearsall Grant from the American Psychological Foundation

Publisher Copyright:
© 2020 American Psychological Association

Keywords

  • Psychosocial outcomes
  • Spinal cord injury
  • Stigma

PubMed: MeSH publication types

  • Journal Article
  • Observational Study

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