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Adaptation to and coping with disability one year after spinal cord injury: An epidemiological study


In a 4-year study in Connecticut patients with acute spinal cord injuries were interviewed at discharge from their acute care hospital and 1 year after injury in order to ascertain their psychological adaptation to, and coping with, injury and disability. This report analyzes the 1-year data which was available on 96 patients and describes their psychological status at 1 year in terms of its relationship with selected socio-demographic characteristics, and neurological and functional (activities of daily living) status at discharge and 1 year. It is concluded that although patients have started to cope with their disability 1 year after injury this process is far from complete. Affective reactions to disability have not declined between discharge and one year. Longer follow-up is required to document more complete resolution of psychological reactions to this type of disability.

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  1. 1.

    Adams, J. E., Lindemann, E.: Coping with long-term disability. In: Coping and adaptation. (eds. G. V. Coelho, D. A. Hamburg, J. E. Adams). New York: Basic Books (1974)

  2. 2.

    Block, J.: Challenge of response sets: Unconfounding meaning, acquiescence and social desirability in MMPI. New York: Appleton (1965)

  3. 3.

    Bracken, M. B., Webb, S. B., Wagner, F. C.: Classification of the severity of acute spinal cord injury: Implications for management. Paraplegia15, 319–326 (1978)

  4. 4.

    Bracken, M. B., Shepard, M. J.: Coping and adaptation following acute spinal cord injury: A theoretical analysis. Paraplegia. In press 1979a

  5. 5.

    Bracken, M. B., Shepard, M. J., Webb, S. B.: Psychological response to acute spinal cord injury: An epidemiological study. Paraplegia. In press 1979b

  6. 6.

    Bracken, M. B., Hildreth, N., Freeman, D. H., Webb, S. B.: Relationship between neurological and functional status after acute spinal cord injury: An epidemiological study. J. Chronic Dis. In press (1979c)

  7. 7.

    Chodoff, P., Friedman, S. B., Hamburg, D. A.: Stress, defenses, and coping behavior: Observations in parents of children with malignant disease. Am. J. Psychiatry120, 743–749 (1964)

  8. 8.

    Cogswell, B. E.: Self socialization — the adjustment of paraplegics in the community. J. Rehabil.34, 11–13 (1968)

  9. 9.

    Croog, S. H., Levine, S., Lurie, Z.: The heart patient and the recovery process. A review of the directions of research on social and psychological factors. Soc. Sci. Med.2, 111–164 (1968)

  10. 10.

    Granger, C. V., Greer, D. S.: Functional status measurement and medical rehabilitation outcomes. Arch. Phys. Med. Rehabil.57, 103–109 (1976)

  11. 11.

    Guttman, L.: Spinal cord injuries: Comprehensive management and research. Oxford: Blackwell (1976)

  12. 12.

    Hamburg, D. A., Adams, J. E.: A perspective on coping behavior. Arch. Gen. Psychiatry17, 277–284 (1967)

  13. 13.

    Lipp, L., Kolstoe, R., James, W.: Denial of disability and internal control of reinforcement: A study using a perceptual defense paradigm. J. Consult. Clin. Psychol.32, 72–75 (1968)

  14. 14.

    Lubin, B.: Adjective check lists for measurement of depression. Arch. Gen. Psychiatry12, 57–62 (1965)

  15. 15.

    Mechanic, D.: Social structure and personal adaptation: Some neglected dimensions. Coping and Adaptation op. cit., 1974

  16. 16.

    Moos, R. H. (ed.): Coping with physical illness. New York and London: Plenum (1977)

  17. 17.

    Murphy, L. B.: Coping, vulnerability and resilience in childhood. Coping and Adaptation, op. cit., 1974

  18. 18.

    Parsons, T.: The social system. Glencoe: The Free Press 1951

  19. 19.

    Petrus, J., Balaban, A. B.: Special psychiatric problems of the paraplegic. Am. J. Psychiatry109, 693–695 (1953)

  20. 20.

    Roberts, A. H.: Spinal cord injury — some psychological considerations. Minn. Med.55, 1115–1117 (1972)

  21. 21.

    Rotter, J. B.: Generalized expectancies for internal versus external control of reinforcement. Psychol. Monographs80, 1–28 (1966)

  22. 22.

    Schlesinger, L.: Disruptions in the personal-social system resulting from traumatic disability. J. Health Human Behav.6, 91 (1965)

  23. 23.

    Siller, J.: Psychological situation of the disabled with spinal cord injuries. Rehabil. Lit.30, 290–296 (1969)

  24. 24.

    Stern, P. H., Slattery, K.: Spinal cord injury rehabilitation. NY State J. Med.75, 1029–1034 (1975)

  25. 25.

    Stewart, T. D.: Coping behaviour and the moratorium following spinal cord injury. Paraplegia15, 338–342 (1978)

  26. 26.

    Thorn, D. A., von Salzen, C. F., Fromme, A.: Psychological aspects of the paraplegic patient. Med. Clin. North Am.30, 473 (1946)

  27. 27.

    Vincent, P. J.: Treatment of patients with spinal cord injuries. Can. Nurse71, 26–30 (1975)

  28. 28.

    Weller, D. J., Miller, P. M.: Emotional reactions of patient, family and staff in acute-care period of spinal cord injury: Part 1. Social Work in Health Care2, 369–377 (1977)

  29. 29.

    Wittkower, E. D., Gingras, G., Merglev, L., Wigdov, B., Lepine, A.: A combined psychosocial study of spinal cord lesions. Can. Med. Assoc. J.71, 109–115 (1954)

  30. 30.

    Zborowski, M.: People in pain. San Francisco: Jossey-Bass 1969

  31. 31.

    Zuckerman, M.: The development of an affect adjective check list for the measurement of anxiety. J. Consult. Psychol.24, 457–462 (1960)

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This study was supported by a grant (3 PO1 NS-10174-04) from the National Institute of Neurological and Communicative Disorders and Stroke

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Bracken, M.B., Bernstein, M. Adaptation to and coping with disability one year after spinal cord injury: An epidemiological study. Soc Psychiatry 15, 33–41 (1980).

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  • Public Health
  • Spinal Cord
  • Epidemiological Study
  • Spinal Cord Injury
  • Daily Living