Resilience in the face of coping with a severe physical injury: a study of trajectories of adjustment in a rehabilitation setting.

OBJECTIVE

Despite the popularity of the concept of resilience, little research has been conducted on populations in physical rehabilitation settings. Our purpose was to identify three trajectories of psychological adjustment to an acquired severe physical injury characterized by resilience, recovery, or distress in a longitudinal design.

PARTICIPANTS

Eighty inpatients with a severe injury at a rehabilitation hospital. The participants had spinal cord injury or multiple traumas.

DESIGN

Classification into the three trajectories was based on symptoms of psychological distress (posttraumatic stress disorder, depression, anxiety, and negative affect) and participants' level of positive affect at admission to and discharge from the rehabilitation hospital.

RESULTS

The most common trajectory was the resilience trajectory (54%), followed by the recovery trajectory (25%) and the distress trajectory (21%). The most interesting differences between the trajectories were the result of optimism, affect, social support, and pain. Trait negative and positive affect predicted classification into the trajectories.

CONCLUSIONS

An adaptation pattern characterized by resilience was found to be the most common response to an acquired severe injury, and trait affect predicts the outcome pattern. Interventions based on resilience are discussed.