The moderation of resilience on the negative effect of pain on depression and post-traumatic growth in individuals with spinal cord injury.

PURPOSE: To determine the moderating effect of resilience on the negative effects of chronic pain on depression and post-traumatic growth. METHOD: Community-dwelling individuals with SCI (n = 37) were recruited at short-term admission for yearly regular health examination. Participants completed self-rating standardized questionnaires measuring pain, resilience, depression and post-traumatic growth. Hierarchical linear regression analysis was performed to identify the moderating effect of resilience on the relationships of pain with depression and post-traumatic growth after controlling for relevant covariates. RESULTS: In the regression model of depression, the effect of pain severity on depression was decreased (ß was changed from 0.47 to 0.33) after entering resilience into the model. In the final model, both pain and resilience were significant independent predictors for depression (ß = 0.33, p = 0.038 and ß = -0.47, p = 0.012, respectively). In the regression model of post-traumatic growth, the effect of pain severity became insignificant after entering resilience into the model. In the final model, resilience was a significant predictor (ß = 0.51, p = 0.016). CONCLUSIONS: Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.

Resilience as a possible predictor for psychological distress in chronic spinal cord injured patients living in the community.

OBJECTIVE: To investigate whether higher resilience level predicts low levels of psychological distress in chronic SCI patients living in the community. METHOD: Thirty seven patients (mean age 41.5±10.9, male : female=28 : 9) with chronic spinal cord injury (duration 8.35±7.0 years) living in the community are included, who were hospitalized for annual checkups from November, 2010 to May, 2011. First, their spinal cord injury level, completeness and complications were evaluated. The patients completed questionnaires about their educational status, religion, employment status, marital status, medical and psychological history and also the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), Alcohol Use Disorders Identification Test-alcohol consumption questions (AUDIT-C) and Health-related quality of life (EQ-5D). The patients were divided into two subgroups: patients with HADS ≥13 are classified as high psychological distress group and others as low psychological distress group. We compared the two groups to find statistically significant differences among the variables. RESULTS: CD-RISC, EQ-5D and employment status are significantly different between two groups (p<0.05). In a forward stepwise regression, we found that EQ-5D had a greater contribution than CD-RISC to the psychological distress level. CONCLUSION: In addition to health-related quality of life, resilience can be suggested as a possible predictor of psychological distress in chronic SCI patients.