Abstract
Objective
To test mediating effects of positive emotion and activity restriction on the associations
of resilience and pain interference with distress reported by individuals with traumatic
upper limb loss evaluated for prosthetics.
Design
Cross-sectional correlational study of several demographic and self-report measures
of resilience, pain interference, activity restriction, positive emotions, and symptoms
of depression and posttraumatic stress.
Setting
Six regional centers throughout the United States.
Participants
A total of 263 prospective participants consented to be evaluated for eligibility
and need for upper extremity prosthetics; participants (N=202; 57 women [28.2%] and
145 men [71.8%]; mean age, 41.81±14.83y; range, 18.01–72.95y) who sustained traumatic
injuries were retained in this study. Most of them were identified as white (70.8%;
n=143), followed by black (10.4%; n=21), Hispanic (9.9%; n=20), Asian (3.0%; n=6),
other (1.5%; n=3), and missing (4.5%; n=9).
Interventions
Not applicable.
Main Outcome Measures
Primary Care Posttraumatic Stress Disorder Screen and depression screen.
Results
Resilience and pain interference were significantly correlated in predicted directions
with positive emotions, activity restriction, and the 2 distress variables. A path
model revealed that the associations of resilience and pain interference with both
distress variables were completely mediated by positive emotions and activity restriction.
There were no significant direct effects of resilience or pain interference on either
distress variable.
Conclusions
Resilience may facilitate adjustment via beneficial and predicted associations with
positive emotions and active engagement with the environment. These relations are
independent of the significant and inverse associations of pain interference with
these same variables. Longitudinal research is needed to understand interactions between
positive emotions and activity over time in promoting adjustment after traumatic limb
loss. Individuals reporting depression and/or posttraumatic stress disorder symptoms
may require interventions that reduce avoidance and promote activities that may increase
the likelihood of experiencing positive emotions.
Keywords
List of abbreviations:
CFI (comparative fit index), PTSD (posttraumatic stress disorder), RMSEA (root mean square error of approximation), SRMR (standardized root mean square residual), TLI (Tucker-Lewis index)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 05, 2016
Footnotes
Disclosures: W.T.J. reports personal fees from Advanced Arm Dynamics, both during the conduct of the study and outside the submitted work. T.R. reports her position as a salaried employee of Advanced Arm Dynamics, outside the submitted work. The other authors have nothing to disclose.
Identification
Copyright
© 2016 The American Congress of Rehabilitation Medicine.
