A longitudinal analysis of psychological impact and coping strategies following spinal cord injury

Abstract

Objectives.This study longitudinally examines the relationships between psychological impact and coping in a cohort of 87 traumatic spinal cord injured individuals. Trieschmann (1988) emphasized the need to adopt a more longitudinal method of enquiry, elaborating not only on aspects of psychological impact following spinal cord injury (SCI), but exploring the relationship between psychological well‐being coping strategies and adjustment. Within the framework proposed by Folkman and Lazarus (1988), coping is conceptualized as a mediator of emotional reactions, and Leventhal, Nerenz, and Steele (1984) suggest an interaction between coping and emotional outcomes. Design. A prospective longitudinal multiple wave panel design was utilized. Methods. Repeated, standardized measures were collected across nine observational periods from onset of injury to community placement. Forward stepwise variable selection multiple regression analyses were employed to examine concurrent predictive factors and prediction over time. Results. At 6 weeks post‐injury, 64% of the variance in depression was predicted by the use or non‐use of three coping strategies. The coping measures collected at 6 weeks post‐injury predicted 67% of the variance in depression at 1 year post‐discharge. This study not only elaborates on the pattern of adjustment post‐traumatic SCI, but specifies the relationship between coping and adjustment. Moderating variables did not account for significant variance. Conclusions. This study demonstrates a predictive relationship between coping and adjustment and highlights a number of dispositional factors that require further examination.