Psychological adjustment to spinal cord injury: the contribution of coping, hope and cognitive appraisals

This study explored the degree to which current cognitions, in terms of appraisals and hope, are associated with the use of coping strategies and psychological adjustment to spinal cord injury (SCI). A cross-sectional survey design was used. A range of comprehensive, standard self-report measures were administered to 54 newly injured people with SCI. Correlation analyses were used to explore associations between factors. Forward hierarchical multiple regression analyses were also employed to examine the degree to which appraisals and hope predicted coping and adjustment. Hope and primary appraisals of threat were significantly correlated with the coping strategy of fighting spirit. Hope was a better predictor of coping than appraisals were. Of all the variables considered, appraisals showed the strongest association with adjustment, accounting for 12 per cent of the variance in anxiety and 34 per cent of the variance in depression. Coping variables did not explain more variance in depression than threat and challenge appraisals. Current cognitions, in particular primary appraisals of threat, are important in the process of psychological adjustment to SCI. Greater emphasis needs to be placed on appraisals in future coping research and interventions.