Flourishing after traumatic spinal cord injury: Results from a multimethod study.

Abstract

Purpose/Objective: Adverse outcomes after traumatic spinal cord injury (TSCI) are not ubiquitous; that is, it is possible to thrive in the years after injury. Accordingly, we examined both the association between various factors and psychological flourishing, or ideal mental health, after TSCI, as well as the characteristics of adults with average or higher levels of psychological flourishing in terms of personality, social support, and executive functioning. Research Design: This study included two phases. In Phase 1, we collected information on demographic, health, and psychosocial variables from 449 adults with chronic TSCI using a mail survey. In Phase 2, we completed individual in-person assessments with a subset of 58 individuals from Phase 1 who had endorsed at least average levels of psychological flourishing and collected data using standardized measures of personality, social support, and executive functioning. Results: Phase 1 data indicated that being married, viewing oneself favorably in comparison to others, and reporting better subjective health ratings were significantly associated with higher levels of psychological flourishing. Phase 2 data suggested that, as a cohort, participants tended to display a resilient personality profile, report high-average levels of social support, and perform grossly within normal limits on a measure of executive functioning. Conclusion/ Implications: Our findings highlight factors associated with positive psychological outcomes after TSCI. A resilient personality profile, good social support, and unimpaired executive functioning capabilities appear to characterize adults who flourish with chronic TSCI. Impact and ImplicationsOur data indicated that, among adults with chronic TSCI, psychosocial factors (i.e., social comparison and health self-perception) are more strongly associated with psychological flourishing than either injury-related factors (i.e., NLI, injury completeness, and time since injury), medical complications (i.e., secondary conditions), or socioeconomic factors (i.e., household income, employment), underscoring the importance of evidence-based psychotherapies that directly target these psychosocial factors (e.g., cognitive-behavioral therapy; CBT) as a key approach for achieving positive outcomes. Adults who flourish with chronic TSCI appear to display distinct psychological attributes characterized by a resilient personality profile, high levels of social support, and at least adequate levels of executive functioning. Future studies of quality of life among adults with TSCI and other disabilities should include standardized measures of personality, social support, and cognitive functioning to explore the role these potentially modifiable variables have in influencing outcomes.

Feasibility and acceptability of a remote, hands-free cognitive battery for adults with traumatic spinal cord injury.

“…The wide range of scores obtained by participants in this study seems broadly consistent with the heterogeneity of cognitive testing data observed among adults with TSCI (Allaire et al, 2022; Craig et al, 2017; Sachdeva et al, 2018). Using this approach, we were able to engage and evaluate a highly diverse sample of adults living with TSCI.…”

“…This stems from research that has shown a significant risk for new cognitive difficulties following TSCI due to factors like depression (Snyder, 2013), concomitant traumatic brain injury (TBI; Badhiwala et al, 2019; Richards et al, 1988), medication side effects (Carlozzi et al, 2021), and various age-related neurodegenerative conditions (Mahmoudi et al, 2021). It is also consistent with findings from research indicating that above-average cognitive abilities may be important contributors to positive psychological outcomes for adults with TSCI (Allaire et al, 2022; Craig et al, 2017). Thus, developing an enhanced understanding of remote teleconference-based administration of cognitive testing to adults with TSCI may be particularly useful for health care providers tasked with evaluating and treating members of this clinical population.…”