Flourishing After Traumatic Spinal Cord Injury: Results From a Multimethod Study

Impact and Implications Our 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. 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.

Automated summary

The study revealed the factors associated with positive psychological outcomes in adults with chronic spinal cord injury, highlighting a resilient personality profile, good social support, and unimpaired executive functioning capabilities as key characteristics of individuals who thrive with chronic TSCI.