Baseline Psychological Symptoms Among SCI Inpatients and Their Associations with SCI Characteristics and Preference for Specialized PTSD Treatment

Research Objectives: Spinal Cord Injury (SCI) is a trauma with significant psychological impact, which often extends hospitalization. Past research on the association of psychological symptoms with SCI impairment, CT level of injury, and traumatic vs. non-traumatic injury is inconclusive. This study addresses this gap in the literature and explores the relationship between psychological symptoms and treatment preference among individuals with SCI.

Design: Cross-sectional study.

Setting: Participants were recruited in 2022-2024 from an inpatient rehabilitation facility.

Participants: SCI patients admitted to the rehabilitation unit were screened for eligibility, and those meeting criteria (N=130) were enrolled in an RCT evaluating the efficacy and feasibility of Brief Prolonged Exposure therapy (BPE) relative to treatment as usual (TAU).

Interventions: N/A

Main Outcome Measures: Baseline/admission data was collected for (1) characteristics of participants’ SCI (traumatic vs. non-traumatic, CT level, AIS impairment score); (2) self-reported psychological variables (CD-RISC 10 resilience, PHQ-9 depression, GAD-7 anxiety, PSSI-5 PTSD diagnosis/severity); and (3) intervention preference (BPE, TAU, no preference).

Results: A significant minority of participants reported clinical levels of depression (20%) and anxiety (16%), with 17% meeting criteria for PTSD. ANOVAs showed that SCI CT level predicted depression (p=.001) and PTSD (p=.098) severity, such that lower (lumbar) injuries were associated with greater symptoms than higher (thoracic), with cervical SCI associated with the fewest symptoms. Compared to traumatic injury, non-traumatic SCI was related to greater anxiety (p=.026) and depression (p=.070), and lower resilience (p=.022). Participants with higher PTSD (p=.078), depression (p=.093), and anxiety (p=.078) scores tended to prefer BPE over TAU.

Conclusions: Participants with greater psychological distress were more likely to have non-traumatic and lower-level SCI and to prefer BPE treatment. These results may facilitate identification of patients who would be open to and benefit most from brief psychological intervention. Given the influence of psychological symptoms on rehabilitation outcomes, providers should consider offering focused, evidence-based treatment to those experiencing significant distress.

Author(s) Disclosures: All authors have no conflicts to report.