Adaptation during spinal cord injury rehabilitation: The role of appraisal and coping.

OBJECTIVE

To test the spinal cord injury adjustment model (SCIAM) by examining whether primary appraisals (threat or loss) and coping strategies (approach-oriented and denial) sequentially mediate the impact of functional independence, psychological resources, and social support on depressive and anxiety symptoms among individuals with spinal cord injury during inpatient rehabilitation.

METHOD

Path analyses of longitudinal data from a Swiss inception cohort study (N = 207). Models were implemented separately for depressive and anxiety symptoms.

RESULTS

The initial models based on the SCIAM yielded poor fit and were respecified. Different from the SCIAM's assumptions, psychological resources and threat appraisal showed direct effects on depressive symptoms (β = -.28, = .07, < .001 and β = .33, = .07, < .001, respectively), while social support and threat appraisal showed direct effects on anxiety symptoms (β = -.23, = .06, < .001 and β = .42, = .06, < .001, respectively). Primary appraisals and coping strategies partially mediated the effects of psychological resources on depressive symptoms and fully mediated their effect on anxiety symptoms. However, this did not only happen via the SCIAM's sequential double mediation, since indirect effects were also observed via threat appraisal only. The final models explained 40 and 30% of the variance of depressive and anxiety symptoms, respectively.

CONCLUSIONS

The findings only partially supported the SCIAM's sequential double mediation mechanism. Psychological resources, social support, and primary appraisals can have direct effects on psychological adaptation outcomes and may be suitable intervention targets during inpatient rehabilitation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).