Context/Objective: Following a spinal cord injury or disability (SCI/D), cognitive appraisals are a marker of psychological adjustment. The present study evaluated the clinical utility and discriminant validity of the Appraisals of DisAbility Primary and Secondary Scale – Short Form (ADAPSS-sf). The ADAPSS-sf was evaluated on 1. identification of individuals experiencing poor psychological adjustment and 2. prediction of life satisfaction beyond measures of emotional distress.

Design: A retrospective study was completed using ROC analyses and odds ratios to identify the clinical utility of the ADAPSS-sf. In addition, blocked hierarchical regression explored the ADAPSS-sf predictive characteristics for satisfaction with life beyond measures of emotional distress.

Setting: Veteran’s Health Administration SCI Center.

Participants: Ninety outpatient veterans with SCI/Ds.

Outcome Measures: Measures of psychological adjustment post-SCI/D included the PHQ-9, GAD-7, PC-PTSD, and the Diener Satisfaction with Life Scale (SWLS). The ADAPSS-sf was used as a measure of cognitive appraisals.

Results: Results indicated the ADAPSS-sf is effective in identification of poor psychological adjustment, P < .001. Diagnostic odds ratios and ADAPSS-sf cut scores were selected to prioritize sensitivity (7.17, ≤ 11), specificity (68.25, ≥ 22), or a balance of the two (16.32, ≤ 19). Hierarchical regression indicated the ADAPSS-sf accounted for unique variance in life satisfaction beyond measures of emotional distress, (ΔR² = .20, β = −.66, t(89) = 6.54, P < .001).

Conclusion: Results indicated SCI/D specific appraisals are predictive of concurrent poor psychological adjustment and provide insight into satisfaction with life beyond measures of emotional distress.

背景/目标：在脊髓损伤或残疾 (SCI/D) 之后，认知评估是心理调整的标志。本研究评估了残疾初级和次级评估量表 - 简表 (ADAPSS-sf) 的临床效用和区分效度。ADAPSS-sf 的评估包括 1. 识别心理调整不佳的个体和 2. 预测情绪困扰之外的生活满意度。

设计：使用 ROC 分析和优势比完成了一项回顾性研究，以确定 ADAPSS-sf 的临床效用。此外，块状层次回归探索了 ADAPSS-sf 预测特征，以超越情绪困扰的测量对生活的满意度。

地点：退伍军人健康管理局 SCI 中心。

参与者： 90 名患有 SCI/D 的门诊退伍军人。

结果测量： SCI/D 后心理调整测量包括 PHQ-9、GAD-7、PC-PTSD 和 Diener 生活满意度量表 (SWLS)。ADAPSS-sf 被用作认知评估的量度。

结果：结果表明 ADAPSS-sf 在识别不良心理适应方面是有效的，P < .001。选择诊断优势比和 ADAPSS-sf 分数以优先考虑敏感性（7.17，≤11）、特异性（68.25，≥22）或两者的平衡（16.32，≤19）。分层回归表明 ADAPSS-sf 解释了生活满意度的独特差异，超出了情绪困扰的测量值（Δ R ²  = .20，β  = -.66，t (89) = 6.54，P < .001）。

结论：结果表明 SCI/D 特定评估可以预测同时存在的心理调整不佳，并提供对情绪困扰测量之外的生活满意度的洞察。