Abstract
Study design
Retrospective, cross-sectional study.
Objectives
To investigate the factor structure of the ADAPSS-short form (ADAPSS-SF) in an acutely injured SCI population and to assess the relationship between cognitive appraisals made in the initial phase of rehabilitation and the experience of anxiety and depression.
Setting
National Spinal Injuries Centre, UK.
Method
Participants were acutely injured patients admitted to the NSIC over 35 months. Cognitive appraisals were measured using the ADAPSS-SF; psychological distress was measured using the HADS. Individual profiles, including demographics and injury characteristics, were collected.
Results
Principle Component Analysis with oblique rotation demonstrated a coherent two-factor structure of the ADAPSS-SF: resilience and loss. Correlational analysis found that individuals who negatively appraised their injury were more likely to report lower mood. Findings identified four vulnerable subgroups that were more likely to negatively appraise their injury: females, individuals older at the time of SCI, individuals with AIS-A injuries and individuals whose SCI was acquired through assault. Hierarchical regression analysis reported that resilience and loss factors were significant predictors of depression. Gender, resilience and loss factors were significant predictors of anxiety. Cognitive appraisals accounted for more variance in mood above biological markers.
Conclusions
Findings support a two-factor structure and validity of ADAPSS-SF in acute SCI rehabilitation. The study provides support for the role of cognitive appraisals in psychological adjustment in the early phases of rehabilitation, above injury characteristics. Findings highlighted the vulnerable subgroups that are more likely to initially endorse negative appraisals, which may influence clinical practice and provides an avenue for further research.
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Acknowledgements
We would like to thank all the patients and staff at The National Spinal Injuries Centre, Stoke Mandeville Hospital, who participated in this research, and notably the Department of Clinical Psychology, who manages and coordinates the NAC and goal planning programme at the National Spinal Injuries Centre.
Author contributions
RE was responsible for designing the study, conducting data analysis, interpreting the results, writing and revising the manuscript, updating reference lists and creating summary tables, and approval of the final manuscript. KJ was responsible for designing the study, overseeing data collection, interpreting the results, writing and revising the manuscript, and approval of the final manuscript. JD was responsible for developing the research conception, overseeing data collection contributed to the revision of the manuscript and approval of the final manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Eaton, R., Jones, K. & Duff, J. Cognitive appraisals and emotional status following a spinal cord injury in post-acute rehabilitation. Spinal Cord 56, 1151–1157 (2018). https://doi.org/10.1038/s41393-018-0151-6
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DOI: https://doi.org/10.1038/s41393-018-0151-6
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