Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Creating a spinal injury and forming a lesion can affect all aspects of an individual's life, and this impact is more pronounced on the psychological, emotional, and social aspects of life. One of the psychological consequences of a spinal injury is the feeling of loneliness. In individuals with spinal injuries, the feeling of loneliness can lead to premature physiological aging, cardiovascular diseases, and psychological problems such as depression. Therefore, paying attention to the feeling of loneliness in individuals with spinal injuries is essential. Additionally, another common psychological issue in individuals with spinal injuries is the feeling of rejection. Most individuals with spinal injuries are more sensitive to the emotional reactions of others, which creates a kind of attention bias toward rejection. As a result, this group of individuals is more sensitive to rejection than others. Heightened sensitivity to rejection may lead to an increase in feelings of loneliness. Therefore, identifying effective intervention approaches to improve loneliness and sensitivity to rejection in individuals with spinal injuries will be very beneficial.
Methods: This quasi–experimental research employed a pretest–posttest and follow–up design with a control group. The statistical population of the present study included all people with spinal cord injuries living in Lordegan and Khanmirza cities, Iran, in 2023. With the purposeful sampling method, 45 people were selected and randomly assigned to two test groups and one control group. Data collection tools included the Social–Emotional Loneliness Scale (DiTommaso et al., 2004) and the Interpersonal Sensitivity Questionnaire (Boyce & Parker, 1989). Emotion–focused psychotherapy was performed face–to–face in nine 90–minute sessions (two sessions per week). Cognitive restructuring therapy was also performed in person in 8 sessions of 90 minutes (two sessions per week). Data analysis was done using analysis of variance with repeated measures and Tukey's post hoc test in SPSS v21 software.
Results: In the repeated measures analysis of variance, the within–subject effect on the loneliness variable indicates that a significant change has occurred over time (from pretest to follow–up) in the overall loneliness score (p<0.001) and the overall rejection sensitivity score (p<0.001). The follow–up Tukey test results also indicated a significant difference in the overall loneliness score between cognitive restructuring therapy (p=0.016) and emotion–focused psychotherapy (p=0.004) compared to the control group at the posttest stage. However, the two interventions did not differ significantly in terms of effectiveness on the overall loneliness score (p=0.145). In the follow–up stage, the difference between the two interventions and the control group remained stable, indicating the stability of the results obtained in the overall loneliness score (p<0.05). A significant difference was also observed in the overall rejection sensitivity score between cognitive restructuring therapy (p=0.042) and emotion–focused psychotherapy (p<0.001) compared to the control group at the posttest stage, indicating the effectiveness of these two interventions. Emotion–focused psychotherapy was more effective than cognitive restructuring therapy in the rejection sensitivity score (p=0.015). The effectiveness of emotion–focused psychotherapy on rejection sensitivity was stable (p<0.05); however, cognitive restructuring therapy did not show stability in the overall rejection sensitivity score (p=0.060).
Conclusion: According to the results, two interventions have a significant impact on improving the feelings of loneliness and sensitivity to rejection in individuals with spinal cord injuries. Furthermore, emotion–focused therapy is more effective than cognitive restructuring therapy in improving feelings of loneliness and sensitivity to rejection. Moreover, the effectiveness of both interventions in reducing feelings of loneliness and sensitivity to rejection is sustainable.