Effects of coping on psychological outcome when controlling for background variables: a study of traumatically spinal cord lesioned persons

Study design: Cross-sectional.Objectives: In a previous study we found spinal cord lesion (SCL)-related coping factors to be distinctly related to levels of SCL-related psychological outcome. However, we did not control for other potentially confounding variables. In this study we investigated effects of coping strategies on psychological outcome reactions in traumatically spinal cord lesioned persons controlling for sociodemographic, disability-related and social support variables.Setting: The Gothenburg Spinal Injuries Unit in Sweden.Methods: The study sample comprised 255 persons and a subsample of 157 persons. A series of stepwise multiple regression analyses were performed.Results: SCL-related coping factors clearly predicted psychological outcome even when background variables were controlled. Higher levels of acceptance coping predicted decreased psychological distress and increased positive morale. Elevated social reliance coping predicted heightened distress. Higher levels of social support predicted lower feelings of helplessness. Sociodemographic and disability-related variables were weak predictors of psychological outcome with one exception: higher education predicted less bitterness and brooding.Conclusion: SCL-related coping remained the most important predictor of psychological outcome even when a wide range of variables was controlled. Thus we conclude that psychosocial interventions aimed at helping individuals develop their coping strategies might be of substantial value in their adjustment to SCL.

[1]  J. Krause,et al.  Chronologic age, time since injury, and time of measurement: effect on adjustment after spinal cord injury. , 1991, Archives of physical medicine and rehabilitation.

[2]  R. Schulz,et al.  Long-term adjustment to physical disability: the role of social support, perceived control, and self-blame. , 1985, Journal of personality and social psychology.

[3]  W. Donovan,et al.  The International Standards Booklet for Neurological and Functional Classification of Spinal Cord Injury , 1994, Paraplegia.

[4]  T. Elliott,et al.  Social Support and Depression Following Spinal Cord Injury , 1992 .

[5]  S. Folkman,et al.  Stress, appraisal, and coping , 1974 .

[6]  P. Kennedy,et al.  Coping effectiveness training for people with spinal cord injury: preliminary results of a controlled trial. , 1999, The British journal of clinical psychology.

[7]  R. G. Frank,et al.  Spinal cord injury and health locus of control beliefs , 1989, Paraplegia.

[8]  N. Westgren,et al.  Quality of life and traumatic spinal cord injury. , 1998, Archives of physical medicine and rehabilitation.

[9]  M. Sullivan,et al.  Swedish Obese Subjects (SOS)--an intervention study of obesity. Measuring psychosocial factors and health by means of short-form questionnaires. Results from a method study. , 1995, Journal of clinical epidemiology.

[10]  S. Folkman,et al.  Journal of Personality and Social Psychology If It Changes It Must Be a Process: Study of Emotion and Coping during Three Stages of a College Examination , 2022 .

[11]  C. Carver,et al.  Assessing coping strategies: a theoretically based approach. , 1989, Journal of personality and social psychology.

[12]  S. Folkman,et al.  Positive psychological states and coping with severe stress. , 1997, Social science & medicine.

[13]  S. Folkman,et al.  The Ways of Coping Questionnaires , 1988 .

[14]  P. Duncan-Jones,et al.  Measuring social relationships The Interview Schedule for Social Interaction , 1980, Psychological Medicine.

[15]  S. Folkman,et al.  Ways of Coping Questionnaire Manual , 1988 .

[16]  Graham H. Creasey,et al.  International Standards for Neurological and Functional Classification of Spinal Cord Injury. American Spinal Injury Association. , 1997 .

[17]  S. Wonderlich,et al.  Differences in coping styles among persons with spinal cord injury: a cluster-analytic approach. , 1987, Journal of consulting and clinical psychology.

[18]  P. Kennedy,et al.  Traumatic spinal cord injury and psychological impact: a cross-sectional analysis of coping strategies. , 1995, The British journal of clinical psychology.

[19]  Å. Seiger,et al.  The Stockholm spinal cord injury study: 4. Psychosocial and financial issues of the Swedish annual level-of-living survey in SCI subjects and controls , 1996, Paraplegia.

[20]  R. Steiner,et al.  A comparative analysis of coping behaviors in persons with multiple sclerosis or a spinal cord injury. , 1994, Research in nursing & health.

[21]  R. Dawis,et al.  Prediction of life satisfaction after spinal cord injury: A four-year longitudinal approach. , 1992 .

[22]  M. Mishel Uncertainty in illness. , 1988, Image--the journal of nursing scholarship.

[23]  M. Sullivan,et al.  Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures , 2002, Spinal Cord.

[24]  N. Endler,et al.  If it changes, it might be unstable: examining the factor structure of the ways of coping questionnaire , 1993 .

[25]  M. Nash,et al.  The Stockholm spinal cord injury study: 1. Medical problems in a regional SCI population , 1995, Paraplegia.

[26]  P. Kennedy,et al.  Correlates of stress in long-term spinal cord injury , 1999, Spinal Cord.

[27]  P. Kennedy,et al.  A longitudinal analysis of psychological impact and coping strategies following spinal cord injury , 2000 .