Psychological factors after stroke: Are they stable over time?

Abstract

Every person has a distinct personality. Personality traits may influence how people recover from stroke. This study followed 324 patients in the first 2 years after stroke and examined whether these personality traits are stable over time. We found changes to less favourable outcomes, such as less extraversion, less optimism and more neuroticism. Clinicians should be aware of these changes and stimulate the use of more adaptive psychological factors, such as proactive coping and optimism. Objective: Psychological factors influence stroke outcomes, such as participation and quality of life. Although important for clinical practice, not much is known about the temporal stability of these factors. This study explored whether psychological factors are stable post-stroke. Methods: Prospective longitudinal cohort study. The following psychological factors were assessed using self-report questionnaires at 2 months and at 2 years post-stroke: proactive coping, self-efficacy, extraversion, optimism, passive coping, neuroticism and pessimism. Changes over time, associations and dimensions among psychological factors were considered. Results: Data for 324 participants were available. Only passive coping scores showed no change between 2 months and 2 years post-stroke. Participants showed less proactive coping, lower self-efficacy, less extraversion, less optimism, more neuroticism and more pessimism over time. All but one inter-correlation of psychological factors, r = [-0.14; 0.71], and all correlations over time, r = [0.42-0.64], were significant. At both time-points, the psychological factors clustered into an "adaptive psychological factor" (proactive coping, self-efficacy, extraversion) and a "maladaptive psychological factor" (passive coping, neuroticism). Conclusion: Across all psychological factors, changes toward less favourable scores were found. Clinicians should pay attention to adaptive and maladaptive psychological factors among stroke patients during long-term care.

Effect of a dialogue-based intervention on psychosocial well-being 6 months after stroke in Norway: A randomized controlled trial

“…This result is consistent with Antonovsky's (16) theory on salutogenesis, which explains how some people manage well despite adverse health experiences. This finding is also supported by a recent study on how personal factors, such as proactive coping, influence stroke outcomes, seem to be stable over time (33) and demonstrated that in the period from 2 months to 2 years after stroke personal factors did not improve naturally.…”

Differences in self-perceived general health, pain, and depression 1 to 5 years post-stroke related to work status at 1 year

“…Regardless of work status, the total population in the present study showed an overall significant worsening in self-perceived general health and pain, and a slight but non-significant worsening in depression from 1 to 5 years post-stroke. Several studies have shown that the recovery after a stroke is not only increasing over time, but it can also decrease after the first improvement [7][8][9]26 . The fact that the participants were 4 years older at the 5-years follow-up compared with 1-year follow-up could affect their recovery; for example, older age is a risk factor for neuropathic pain 27 .…”

“…In line with this, improvements in activities of daily living the first year post-stroke has been reported, but between 1 and 3 years post-stroke there seems to be a small decline 7 . Participants in another study reported less self-efficacy, less optimism and less proactive coping 2 years post-stroke compared with 2 months post-stroke 8 . A decline in several self-reported functional aspects such as strength, activities of daily living, and mobility between 1 and 6 years post-stroke has also been reported 9 .…”

The influence of psychological factors and mood on the course of participation up to four years after stroke

“…We clustered adaptive and maladaptive psychological factors, based on theoretical arguments and findings of exploratory factor analyses as described in an earlier study [36]. Passive coping, neuroticism and pessimism are maladaptive psychological factors associated with decreased quality of life after stroke, whereas proactive coping, self-efficacy, extraversion and optimism are adaptive psychological factors associated with increased quality of life after stroke [21,[37][38][39][40].…”