Correlates of stress in long-term spinal cord injury

Study Design: Longitudinal. Objectives: To characterize long-injured SCI persons with high reported str ess; to assess the relationship between severity of disability and perceive d stress; to identify correlates of future stress and outcomes of previous stress. Setting: Two SCI centres in England: Stoke Mandevillle Hospital in Aylesbur y, and the District General Hospital in Southport. Methods: In 1990, 1993 and 1996 187 persons who sustained spinal cord injur ies prior to 1971 underwent comprehensive physical evaluations and health s tatus interviews and completed a battery of tests to measure psychosocial f unctioning. Using mean scores on the Perceived Stress Scale (PSS) as the re ference, a range of outcomes were analyzed to identify concurrent, previous , and future variables that were significantly correlated with perceived st ress. Results: No associations were found between stress and any of the proxy var iables that represented injury severity. Such common SCI-related medical co nditions as pressure sores and upper extremity pain were not related to str ess; not even fatigue was significantly associated with stress in both time periods studied. However, depressive symptoms, poorer life satisfaction, a nd poorer perceived well being were associated with future stress and were outcomes that appeared to be related to earlier stress. Conclusion: Perceived stress in long-term SCI is not closely related to the severity of the disability or physical independence. It is, however, relat ed to scores on several measures of adjustment and coping. Though mean stre ss scores in this sample did not appear to differ substantially from scores in the general nondisabled population, further controlled study is needed to definitively answer the question: Do SCI survivors report more stress th an their nondisabled counterparts? Sponsorship: This research was supported by a Rehabilitation Research and T raining Center on Aging with Spinal Cord Injury (1993-1997), which was fund ed by the National Institute on Disability and Rehabilitation Research of t he US Department of Education under grant number H133B30040. The opinions c ontained in this publication are those of the authors and no not necessaril y represent those of the US Department of Education.