Examination and measurement of coping among adolescents with spinal cord injury

Abstract

Study design: Cross-sectional survey. Objectives: To describe coping strategy use in adolescents with spinal cord injury (SCI), to explore the underlying factor structure of a measure of coping among adolescents with SCI and to assess relationships between coping and psychosocial outcomes. Setting: Multiple pediatric SCI centers in the United States. Methods: One hundred and eighty-two participants aged 13-17 years who experienced an SCI completed measures including the Kidcope, Children's Depression Inventory, Revised Children's Manifest Anxiety Scale and the Pediatric Quality of Life Inventory. Results: Participants reported that cognitive restructuring and resignation are the most used coping strategies, whereas social support, emotional regulation (calming) and cognitive restructuring are the most effective coping strategies. An exploratory factor analysis revealed that a three-factor solution provided the most parsimonious model for the relationships between the different coping strategies. However, only one of the three factors had acceptable internal consistency. This factor comprised escape-oriented coping strategies or an avoidant approach to coping with the sequelae of SCI. After controlling for demographic/injury-related factors, higher scores on the escape-oriented factor were associated with the lower quality of life and higher levels of depression and anxiety symptomatology. Conclusion: Escape-oriented coping is associated with maladaptive psychosocial outcomes in adolescents with SCI. These adolescents report that active coping strategies are most effective in reducing SCI-related distress. Coping strategy use may mediate psychosocial outcomes in adolescents with SCI and represent an intervention target in adolescents who overly rely on escape-oriented coping.

Exploring narratives of resilience among seven males living with spinal cord injury: a qualitative study

“…In addition, the participants emphasised that their ability to face challenges evolved and changed over time. On the other hand, they demonstrated that they alternated between strategies when needed, confirming the findings of deRoon-Cassini et al [ 21 ] and studies exploring situational coping [ 41 , 42 ]. Additionally, they described the importance of exerting flexibility.…”

Pediatric Spinal Cord Injury

“…Social support increased participation. Youth who reported greater self-efficacy in using coping strategies had more positive psychosocial outcomes [71,89]. Adolescents aged 13-17 years who sustained an SCI report the most effective coping strategies are social support, emotional regulation, and cognitive restructuring.…”

“…Adolescents aged 13-17 years who sustained an SCI report the most effective coping strategies are social support, emotional regulation, and cognitive restructuring. The use of escape-oriented or avoidant coping was linked to lower psychosocial QOL and heightened symptoms of depression and anxiety [89]. Coping interventions may therefore emphasize training in and harnessing cognitive restructuring and social support while decreasing long-term reliance on escape-oriented coping strategies.…”

Diferencias de sexo en el uso de estrategias de afrontamiento en personas con lesión medular

“…A pesar de la falta de consenso existe bastante acuerdo entre los autores en que el afrontamiento activo y centrado en la resolución de problemas está asociado a menores índices de depresión en los primeros momentos en el entorno rehabilitador (3, 15), mientras que el afrontamiento pasivo, que incluye principalmente las estrategias de evitación o centradas en la emoción, suele ir acompañado de un mayor malestar psicológico (7,(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). En general, las estrategias de afrontamiento se mantienen más o menos estables a pesar del tiempo que pase desde la lesión (1, 9, 13, 27, 28) y hay evidencia de que el uso de estrategias activas favorece la adaptación y el ajuste social a una LM (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28).…”