Spinal cord injury and aging: an exploration of the interrelatedness between key psychosocial factors contributing to the process of resilience

Abstract

Context: Extant literature highlights how many individuals display resilient trajectories following spinal cord injury (SCI), exhibiting positive psychological adjustment. In the absence of a universal definition, it is agreed that resilience is demonstrated when individuals have better-than-projected outcomes when considering the level of adversity experienced. Previous research has focused on traits connected to vulnerability and maladaptive trajectories following SCI rather than the psychosocial factors that contribute to resilience, which can be cultivated over the lifetime. Individuals living with SCI are now aging and have lifespans paralleling that of the broader older adult population. Aging with SCI can result in a sequela of concomitant pathophysiologic conditions and social challenges, which can undermine resiliency. Objective: The purpose of the current commentary is to explore some of the psychosocial factors contributing to resilience within the context of aging with SCI. Methods: Commentary Findings: Psychosocial factors contributing to resilience within the SCI population include self-efficacy, social supports, and spirituality. However, these factors are complex and their interconnectedness is not well-understood at the intersection of SCI and aging. Conclusion: Understanding the complexities of the contributing psychosocial factors can allow for the development of targeted and innovative multi-pronged rehabilitative strategies that can support resilient trajectories across the lifetime. Future research should move towards the inclusion of additional psychosocial factors, adopting longitudinal research designs, and prudently selecting methods.

Neuroinflammation and Scarring After Spinal Cord Injury: Therapeutic Roles of MSCs on Inflammation and Glial Scar

“…Spinal cord injury (SCI) is a permanent and disabling disorder that generates great personal loss and social burden ( 1 ). It is estimated that the global incidence of SCI ranges from 10.4 and 83 per million per year, and will continue to rise with the rapid development of transportation and aging population ( 2 , 3 ). In general, we customarily divide the pathophysiology process of SCI into primary injury and secondary injury; the former commonly occurs owing to vertebral fracture or dislocation caused by a mechanical insult, which would destroy the nervous tissue directly ( 4 , 5 ).…”

Psychosocial Consequences of Spinal Cord Injury: A Narrative Review

“…The larger social–psychological consequences affect all aspects of a person’s life following an SCI [ 1 , 14 ]. Surprisingly, little has changed regarding the social influences on the experience for people with SCI.…”

“…When present, these relationships add substantial meaning to the person’s life [ 12 , 31 ] and can significantly lessen feelings of grief and loss related to their injury [ 34 ]. Quality relationships have also been found to offer additional psychosocial benefits for people with SCI by buffering against mental and bodily stress [ 39 ] as well as financial stress [ 30 , 37 ], all of which are integral to daily coping and retaining resilience [ 1 ].…”

“…SCI and associated challenges with physical discomfort and impairments, societal inconveniences and disappointments, perceived stigma, financial strain, and perceived limitations on autonomy impart immense and demanding challenges on one’s coping resources. Despite the vast complexities of living with SCI, many people have better than projected outcomes [ 1 ] and do not experience significant problems. However, some people do experience significant problems with mood and coping following SCI.…”

“…Acquiring a spinal cord injury (SCI) involves more than damage to the spinal cord; the lives of people with SCI along with those around them experience profound long-lasting changes [ 1 , 2 ]. Depending upon the level and completeness of SCI, medical comorbidities besides paralysis may likely include neurogenic bradycardia, neurogenic orthostatic hypotension, circulatory hypokinesis, adaptive cardiomyopathy, neurogenic restrictive lung disease, neurogenic obstructive lung disease, obstructive sleep apnea, neuropathic pain, spasticity, reflex neurogenic bladder, reflex neurogenic bowel, neurogenic erectile dysfunction, neurogenic infertility, neurogenic skin, neurogenic obesity, heterotopic ossification, osteopenia/osteoporosis, and the metabolic syndrome including diabetes mellitus, dyslipidemia and hypertension [ 3 ].…”