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

Objectives. This study longitudinally examines the relationships between ps ychological impact and coping in a cohort of 87 traumatic spinal cord injur ed individuals. Trieschmann (1988) emphasized che need to adopt a more long itudinal method of enquiry, elaborating not only on aspects of psychologica l 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 conceptuali zed 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 observ ational periods from onset of injury to community placement. Forward stepwi se 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 pred icted 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 depressi on ac 1 year post-discharge. This study not only elaborates on the pattern of adjustment pst-traumatic SCI. but specifies the relationship between cop ing and adjustment. Moderating variables did not account For significant va riance. Conclusions. This study demonstrates a predictive relationship between copi ng and adjustment and highlights a number of dispositional factors that req uire further examination.