Advertisement

Coping Flexibility as Predictor of Distress in Persons With Spinal Cord Injury

  • Tijn van Diemen
    Correspondence
    Corresponding author Tijn van Diemen, MSc, Department of Rehabilitation, Sint Maartenskliniek, P.O. Box 9011, 6500 GM Nijmegen, the Netherlands.
    Affiliations
    Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands

    Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands

    University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
    Search for articles by this author
  • Ilse J.W. van Nes
    Affiliations
    Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands
    Search for articles by this author
  • Jan H.B. Geertzen
    Affiliations
    University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
    Search for articles by this author
  • Marcel W.M. Post
    Affiliations
    Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands

    University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Center for Rehabilitation, Groningen, the Netherlands
    Search for articles by this author

      Abstract

      Objectives

      Examine whether coping flexibility at admission to first spinal cord injury (SCI) rehabilitation was predictive of distress 1 year after discharge.

      Design

      Longitudinal inception cohort study.

      Setting

      Rehabilitation center.

      Participants

      Of the 210 people admitted to their first inpatient SCI rehabilitation program, 188 met the inclusion criteria. n=150 (80%) agreed to participate; the data of participants (N=113) with a complete dataset were used in the statistical analysis.

      Interventions

      Not applicable.

      Main Outcome Measures

      Coping flexibility was operationalized by (1) flexible goal adjustment (FGA) to given situational forces and constraints and (2) tenacious goal pursuit (TGP) as a way of actively adjusting circumstances to personal preference. The Assimilative-Accommodative Coping Scale was used to measure FGA and TGP. The Hospital Anxiety and Depression Scale was used to assess distress.

      Results

      Scores on FGA and TGP measured at admission were negatively associated with the scales depression (r= −.33 and −.41, respectively) and anxiety (r= −.23 and −.30, respectively) 1 year after discharge. All demographic and injury-related variables at admission together explained a small percentage of the variance of depression and anxiety. FGA, TGP, and the interaction term together explained a significant additional 16% of the variance of depression and 10% of anxiety.

      Conclusions

      The tendency to pursue goals early postonset of the injury seems to have a protecting effect against distress 1 year after discharge. People with low TGP may experience protection against distress from high FGA.

      Keywords

      List of abbreviations:

      FGA (flexible goal adjustment), HADS (Hospital Anxiety and Depression Scale), QoL (quality of life), SCI (spinal cord injury), TGP (tenacious goal pursuit), VAS (visual analog scale)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Chhabra H.S. ISCoS text book on comprehensive management of spinal cord injuries. Wolters Kluwer, New Delhi2015
        • van Lankveld W.
        • van Diemen T.
        • van Nes I.
        Coping with spinal cord injury: tenacious goal pursuit and flexible goal adjustment.
        J Rehabil Med. 2011; 43: 923-929
        • Williams R.
        • Murray A.
        Prevalence of depression after spinal cord injury: a meta-analysis.
        Arch Phys Med Rehabil. 2015; 96: 133-140
        • Le J.
        • Dorstyn D.
        Anxiety prevalence following spinal cord injury: a meta-analysis.
        Spinal Cord. 2016; 54: 570-578
        • Craig A.
        • Tran Y.
        • Middleton J.
        Psychological morbidity and spinal cord injury: a systematic review.
        Spinal Cord. 2009; 47: 108-114
        • Post M.W.
        • van Leeuwen C.M.
        Psychosocial issues in spinal cord injury: a review.
        Spinal Cord. 2012; 50: 382-389
        • Elfström M.L.
        • Kreuter M.
        • Rydén A.
        • Persson L.-O.
        • Sullivan M.
        Effects of coping on psychological outcome when controlling for background variables: a study of traumatically spinal cord lesioned persons.
        Spinal Cord. 2002; 40: 408-415
        • Kennedy P.
        • Kilvert A.
        • Hasson L.
        A 21-year longitudinal analysis of impact, coping, and appraisals following spinal cord injury.
        Rehabil Psychol. 2016; 61: 92-101
        • Livneh H.
        • Martz E.
        Coping strategies and resources as predictors of psychosocial adaptation among People with spinal cord injury.
        Rehabil Psychol. 2014; 59: 329-339
        • Chevalier Z.
        • Kennedy P.
        • Sherlock O.
        Spinal cord injury, coping and psychological adjustment: a literature review.
        Spinal Cord. 2009; 47: 778-782
        • van Leeuwen C.M.
        • Kraaijeveld S.
        • Lindeman E.
        • Post M.W.
        Associations between psychological factors and quality of life ratings in persons with spinal cord injury: a systematic review.
        Spinal Cord. 2012; 50: 174-187
        • Brandtstädter J.
        • Renner G.
        Tenacious goal pursuit and flexible goal adjustment: explication and age-related analysis of assimilative and accommodative strategies of coping.
        Psychol Aging. 1990; 5: 58-67
        • Boerner K.
        • Jopp D.
        Improvement/maintenance and reorientation as central features of coping with major life change and loss: contributions of three life-span theories.
        Hum Dev. 2007; 50: 171-195
        • Brandtstädter J.
        Goal pursuit and goal adjustment: self-regulation and intentional self-development in changing developmental contexts.
        Adv Life Course Res. 2009; 14: 52-62
        • Coffey L.
        • Gallagher P.
        • Desmond D.
        Goal pursuit and goal adjustment as predictors of disability and quality of life among individuals with a lower limb amputation: a prospective study.
        Arch Phys Med Rehabil. 2014; 95: 244-252
        • Darlington A.S.
        • Dippel D.W.
        • Ribbers G.M.
        • van Balen R.
        • Passchier J.
        • Busschbach J.J.
        A prospective study on coping strategies and quality of life in patients after stroke, assessing prognostic relationships and estimates of cost-effectiveness.
        J Rehabil Med. 2009; 41: 237-241
        • Bailly N.
        • Gana K.
        • Hervé C.
        • Joulain M.
        • Alaphilippe D.
        Does flexible goal adjustment predict life satisfaction in older adults? A six-year longitudinal study.
        Aging Ment Health. 2014; 18: 662-670
        • van Diemen T.
        • van Leeuwen C.
        • van Nes I.
        • Geertzen J.
        • Post M.
        Body image in patients with spinal cord injury during inpatient rehabilitation.
        Arch Phys Med Rehabil. 2017; 98: 1126-1131
        • Anton H.A.
        • Miller W.C.
        • Townson A.F.
        Measuring fatigue in persons with spinal cord injury.
        Arch Phys Med Rehabil. 2008; 89: 538-542
        • Bryce T.N.
        • Norrbrink Budh C.
        • Cardenas D.D.
        • et al.
        From the 2006 NIDRR SCI measures meeting pain after spinal cord injury: an evidence-based review for clinical practice and research.
        J Spinal Cord Med. 2007; 30: 421-440
        • Sakakibara B.M.
        • Miller W.C.
        • Orenczuk S.G.
        • Wolfe D.L.
        A systematic review of depression and anxiety measures used with individuals with spinal cord injury.
        Spinal Cord. 2009; 47: 841-851
        • Hallin P.
        • Sullivan M.
        • Kreuter M.
        Spinal cord injury and quality of life measures: a review of instrument psychometric quality.
        Spinal Cord. 2000; 38: 509-523
        • Spinhoven P.
        • Ormel J.
        • Sloekers P.P.
        • Kempen G.I.
        • Speckens A.E.
        • Van Hemert A.M.
        A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects.
        Psychol Med. 1997; 27: 363-370
        • Zigmond A.S.
        • Snaith R.P.
        The hospital anxiety and depression scale.
        Acta Psychiatr Scand. 1983; 67: 361-370
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        Lawrence Erlbaum Associates Publishers, Hillsdale, NJ1988
        • Bailly N.
        • Joulain M.
        • Hervé C.
        • Alaphilippe D.
        Coping with negative life events in old age: the role of tenacious goal pursuit and flexible goal adjustment.
        Aging Ment Health. 2012; 16: 431-437
        • Coffey L.
        • Gallagher P.
        • Desmond D.
        • Ryall N.
        Goal pursuit, goal adjustment, and affective well-being following lower limb amputation.
        Br J Health Psychol. 2014; 19: 409-424
        • Henselmans I.
        • Fleer J.
        • van Sonderen E.
        • Smink A.
        • Sanderman R.
        • Ranchor A.V.
        The tenacious goal pursuit and flexible goal adjustment scales: a validation study.
        Psychol Aging. 2011; 26: 174-180
        • Van Damme S.
        • De Waegeneer A.
        • Debruyne J.
        Do flexible goal adjustment and acceptance help preserve quality of life in patients with multiple sclerosis?.
        Int J Behav Med. 2016; 23: 333-339
        • Muller R.
        • Landmann G.
        • Bechir M.
        • et al.
        Chronic pain, depression and quality of life in individuals with spinal cord injury: mediating role of participation.
        J Rehabil Med. 2017; 49: 489-496