Rebuilding after trauma: George Mason psychologist hopes to improve early care for survivors of violently acquired spinal cord injuries

A fall from a ladder, a car crash, a gunshot: In the blink of an eye, a spinal cord injury can change someone's life forever. Adapting to these new circumstances can take some patients years. Leah M. Adams, associate professor of clinical psychology in the College of Humanities and Social Sciences, is hoping to discover what might make that process easier.

Alongside colleagues Renee Madathil from University of Rochester and Chris Hilderbrant of the Rochester Spinal Association, Adams, a clinical rehabilitation psychologist, is researching early psychosocial adaptation in survivors of violently acquired spinal cord injuries to determine what and when interventions are most beneficial. This spring, they received $285,000 from the Craig H. Neilsen Foundation to support their research.

Violently acquired spinal cord injuries refer to a subset of spinal cord injuries that are caused by interpersonal violence, such as gunshot wounds, stabbing, or other person-to-person contact. These injuries commonly affect a different demographic than nonviolently acquired spinal cord injuries.

"Violence is the second leading cause for Latinx folks and one of the top two causes for Black folks. Long-term trends suggest that young Black men make up nearly half of all people with violently acquired spinal cord injuries," said Adams. "They're also younger, on average, and may be less traditionally established than their counterparts without violently acquired injuries." Adams also noted that people with violently acquired injuries are more likely to have greater social vulnerabilities due to systemic factors like poverty and the criminal/legal system.

Adams describes that, with violently acquired injuries, "there's a different buzzing in the atmosphere of the care team." There can be increased safety risks to the patient and the healthcare team even while in the hospital, as well as additional risks to the patient once discharged, that can impact how a patient receives care.

"Our hope is to narrow down what's helpful and what's not for these patients, so providers can offer optimal care at the right time," said Adams.

Using the National Spinal Cord Injury Database, Adams, her doctoral students, and collaborators will look at patients from 2016 to present with violently acquired spinal cord injuries and their progression over the first five years living with the injury.

"We're looking at difference trajectories of adaptation and seeing if we can identify which kinds of factors put people in positions to have better outcomes or potentially worse outcomes," she said. "With that baseline, we can start identifying risk factors and create pathways for earlier and more effective interventions."

This quantitative data will be combined with qualitative data from patient and spinal cord injury specialist mental health provider interviews, the latter of which is a unique addition to the project. Their direct experience in caring for patients over multiple sessions and years means they understand what works well, what kinds of gaps exist, and how health care delivery could be improved.

"We wanted to make sure we got multiple perspectives on the project, which is why we have multiple collaborators," said Adams, "including folks with lived experience with spinal cord injuries as part of the study team."

This multi-method approach is one that Adams sees as essential. For individuals who have undergone a traumatic and life-altering injury, these varied perspectives help paint a fuller, more vibrant picture of the varied pathways patients might take in their healing journey, she said.

"This population is so important. They face unique stressors and barriers, and they're deserving of focused attention and support," said Adams. "I'm really hopeful that our work can spotlight some of the strengths and resources and ideas that they have, as well as help medical teams make decisions about where to put their valuable resources."

This intersectionality is part of Adams' overall research philosophy, reflected in her role as core faculty for the Women and Gender Studies Program. And as a two-time George Mason alum-MA Psychology '10, PhD Psychology '14-it's a methodology she's refined through her time at George Mason as both student and faculty in the Department of Psychology.

"Both the tangible and intangible resources have made George Mason a really phenomenal place to study and work," said Adams. "This community respects and invests in research all across the continuum, from basic science to translational."

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