Resilience and well-being among persons with spinal cord injury/disorders.

Abstract

Purpose: We examined positive behavioral resources and characteristics that might distinguish resilient personality prototypes among persons with chronic spinal cord injury/disorder (SCID). Positive psychology variables with clear linkages to existing psychological interventions were examined as potential mediators of the resilience–well-being relationship. Research Method and Design: A cross-sectional, self-report study was conducted. Two hundred and ninety-eight consenting members of the Paralyzed Veterans of America (268 male; 236 self-identified as white) provided useable survey data for analysis (including 161 veterans with tetraplegia, 107 with paraplegia, 30 with cauda equina). Cluster analysis of Big Five personality traits identified resilient and nonresilient personality profiles. Tests of mean differences between resilient and nonresilient participants on behavioral resources and characteristics were performed. Path models predicting well-being and health-related quality of life (HRQL) were conducted. Results: One hundred and sixty-three respondents had resilient personality profiles and 135 had nonresilient profiles. Resilient individuals reported significantly more optimal scores on every positive psychology variable, and greater well-being and HRQL than nonresilient respondents. Path models found the relationship of resilience to well-being was explained through its beneficial associations with psychological flexibility, use of personal strengths, meaning in life (MIL), and gratitude. Psychological flexibility also mediated the resilience–HRQL relationship. Cauda equina was significantly associated with higher pain interference and lower HRQL. Conclusions: Higher gratitude, MIL, use of personal strengths, and psychological flexibility appear to characterize resilience and well-being among persons with chronic SCID. Further studies are needed to understand the impact of pain interference on HRQL among individuals with cauda equina.

Perceived stress and pain interference in acute rehabilitation following spinal cord injury: Resilience as a moderator.

“…Indeed, positive emotions mediate the relationship between high levels of resilience and adjustment to stress (Ong et al, 2006) as well as pain catastrophizing (Ong et al, 2010). In individuals with SCI, psychological inflexibility was found to partially explain greater pain interference when resilience was low (Wade et al, 2023), and may be one process by which low resilience allows for a more profound impact of perceived stress on pain interference as found in the current study.…”

“…Including subtypes of pain would clarify whether resilience has stronger or weaker moderating effects on NP versus nociceptive forms of pain. Third, the current study does not include other important factors such as self-efficacy (Driver et al, 2016; Guest et al, 2015; Kilic et al, 2013) or components of psychological flexibility (Wade et al, 2023; Waldron-Perrine et al, 2022) that may more broadly illuminate the role of resilience and more fully inform interventional research. Relatedly, we did not control for mental health diagnoses such as posttraumatic stress disorder and these could conceivably impact resilience and perceived stress during the acute rehabilitation timeframe following traumatic injury.…”