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Trajectories of resilience, depression and anxiety following spinal cord injury
Department of Counseling and Clinical Psychology, Teachers College, Columbia University, USA.
Oxford Doctoral Course in Clinical Psychology, Oxford University and Stoke Mandeville Hospital, The National Spinal Injuries Centre, Department of Clinical Psychology, United Kingdom.
Department of Psychiatry, New York University School of Medicine, USA.
Swiss Paraplegic Research and Swiss Paraplegic Center, Notwil, Switzerland.
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2012 (English)In: Rehabilitation Psychology, ISSN 0090-5550, E-ISSN 1939-1544, Vol. 57, no 3, p. 236-247Article in journal (Refereed) Published
Abstract [en]

Purpose/Objective: To investigate longitudinal trajectories of depression and anxiety symptoms following spinal cord injury (SCI) as well as the predictors of those trajectories. Research Method/Design: A longitudinal study of 233 participants assessed at 4 time points: within 6 weeks, 3 months, I year, and 2 years from the point of injury. Data were analyzed using latent growth mixture modeling to determine the best-fitting model of depression and anxiety trajectories. Covariates assessed during hospitalization were explored as predictors of the trajectories. Results: Analyses for depression and anxiety symptoms revealed 3 similar latent classes: a resilient pattern of stable low symptoms, a pattern of high symptoms followed by improvement (recovery), and delayed symptom elevations. A chronic high depression pattern also emerged but not a chronic high anxiety pattern. Analyses of predictors indicated that compared with other groups, resilient patients had fewer SCI-related quality of life problems, more challenge appraisals and fewer threat appraisals, greater acceptance and fighting spirit, and less coping through social reliance and behavioral disengagement. Conclusion/Implications: Overall, the majority of SCI patients demonstrated considerable psychological resilience. Models for depression and anxiety evidenced a pattern of elevated symptoms followed by improvement and a pattern of delayed symptoms. Chronic high depression was also observed but not chronic high anxiety. Analyses of predictors were consistent with the hypothesis that resilient individuals view major stressors as challenges to be accepted and met with active coping efforts. These results are comparable to other recent studies of major health stressors.

Place, publisher, year, edition, pages
2012. Vol. 57, no 3, p. 236-247
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Applied Psychology
Identifiers
URN: urn:nbn:se:mdh:diva-17814DOI: 10.1037/a0029256ISI: 000308281500006Scopus ID: 2-s2.0-84873248154OAI: oai:DiVA.org:mdh-17814DiVA, id: diva2:588323
Available from: 2013-01-15 Created: 2013-01-15 Last updated: 2021-08-27Bibliographically approved

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Elfström, Magnus

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