Author(s)

Paul E. Plonski^1,2*, Jasmin Vassileva^1,3,4, Ryan Shahidi¹, Paul B. Perrin^4,5, William Carter⁵, Lance L. Goetz^2,5, Amber Brochetti⁶, James M. Bjork^1,2,3,7

¹Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA.
²Richmond Veterans Affairs Medical Center, Richmond, VA, USA.
³Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
⁴Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
⁵Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
⁶Department of Spinal Cord Injury, Cleveland Veterans Affairs Medical Center, Cleveland, OH, USA.
⁷Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA.

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary; more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Spinal Cord Injury, Self-Care, Decision-Making, Paraplegia, Impulsive Behavior, Health Care

Plonski, P. , Vassileva, J. , Shahidi, R. , Perrin, P. , Carter, W. , Goetz, L. , Brochetti, A. and Bjork, J. (2024) Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study. Journal of Behavioral and Brain Science, 14, 47-63. doi: 10.4236/jbbs.2024.142005.