Mindset correlates with health-related quality of life assessment in patients with adolescent idiopathic scoliosis



 Mindset theory describes two different belief systems regarding ability: “fixed”, in which a particular personal characteristic is seen as unchangeable, and “growth”, in which the characteristic is viewed as malleable and subject to improvement. The purpose of this study is to evaluate how that mindset toward one’s health correlates with health-related quality of life assessments (HRQoL) in patients with adolescent idiopathic scoliosis (AIS).


 Patients undergoing brace treatment for AIS were prospectively recruited for this study and completed both an SRS-30 and Health Mindset Scale questionnaire. Inclusion criteria for patients are based on Scoliosis Research Society standardized criteria for bracing studies: diagnosis of AIS, a prescribed TLSO brace for full-time wear, skeletal immaturity at brace initiation (Risser 0–2), Cobb angles 25–50 degrees, no prior treatment, and, if female, no more than 1 year post-menarchal at the time of brace initiation. Statistical analysis was performed utilizing Mann–Whitney U tests for skewed data and two-sample t tests for normally distributed data. Multivariable models were also used to evaluate the relationships of SRS-30 subscores with health mindset, adjusting for age, gender, and pre-treatment curve magnitudes.


 Among the 110 enrolled patients, a stronger growth mindset was associated with significantly higher SRS-30 scores overall (p = 0.001), as well as in the appearance (p = 0.003), and mental (p = 0.001) subscores.


 We demonstrate that health mindset affects an AIS patients’ HRQoL. Prior studies have demonstrated that mindset is malleable and can be altered. Further studies are required to determine whether changing health mindset from a fixed to a growth mindset can also improve HRQoL in patients with scoliosis.

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This research was funded by the Stanford Maternal & Child Health Research Institute.

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All authors read and approved the final manuscript to be published and have agreed to be accountable for all aspects of the work, ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. GPJ: data curation, investigation, visualization, writing—original draft, writing—review and editing. NAS: data curation, formal analysis, software, validation, visualization, writing—original draft, writing—review and editing. RCW: conceptualization, formal analysis, methodology, writing—original draft, writing—review and editing. CM *co-senior author: conceptualization, investigation, methodology, project administration, resources, supervision, validation, writing—original draft, writing—review and editing. KRT *co-senior author: conceptualization, funding acquisition, investigation, methodology, project administration, resources, supervision, validation, writing—original draft, writing—review and editing.

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Correspondence to Gabriel P. Joseph.

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The questionnaire and methodology for this study was approved by Stanford’s Institutional Review Board (IRB-48215).

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Appendix A. Health Mindset Scale

Appendix A. Health Mindset Scale


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Joseph, G.P., Segovia, N.A., Wright, R.C. et al. Mindset correlates with health-related quality of life assessment in patients with adolescent idiopathic scoliosis. Spine Deform (2020). https://doi.org/10.1007/s43390-020-00243-w

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  • Adolescent
  • Idiopathic
  • Scoliosis
  • Mindset
  • Pediatrics
  • Bracing