Department of Health Sciences and Medicine.
Swiss National Center of Competence in Research LIVES.
Rehabil Psychol. 2021 Nov;66(4):507-519. doi: 10.1037/rep0000410. Epub 2021 Oct 7.
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.
Path analyses of longitudinal data from a Swiss inception cohort study (N = 207). Models were implemented separately for depressive and anxiety symptoms.
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.
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).
通过检验主要评估（威胁或丧失）和应对策略（积极应对和否认）是否依次调节脊髓损伤调整模型（SCIAM），来检验该模型。研究对象为在住院康复期间的脊髓损伤个体，考察其功能独立性、心理资源和社会支持对抑郁和焦虑症状的影响。
对瑞士队列研究（n = 207）的纵向数据进行路径分析。分别为抑郁和焦虑症状建立模型。
基于 SCIAM 的初始模型拟合度较差，需要重新指定。与 SCIAM 的假设不同，心理资源和威胁评估对抑郁症状有直接影响（β=-.28，p<.07，<.001 和 β=-.33，p<.07，<.001），而社会支持和威胁评估对焦虑症状有直接影响（β=-.23，p<.06，<.001 和 β=-.42，p<.06，<.001）。主要评估和应对策略部分调节了心理资源对抑郁症状的影响，完全调节了其对焦虑症状的影响。然而，这不仅仅是通过 SCIAM 的顺序双重中介发生的，因为仅通过威胁评估也观察到了间接影响。最终模型分别解释了 40%和 30%的抑郁和焦虑症状的方差。
研究结果仅部分支持 SCIAM 的顺序双重中介机制。心理资源、社会支持和主要评估可以对心理适应结果产生直接影响，并且在住院康复期间可能是合适的干预目标。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
