Psychological factors and mental health in persons with spinal cord injury: An exploration of change or stability.

OBJECTIVES To examine the course of mental health and psychological factors over time in persons with a recent spinal cord injury and to determine whether change in psychological factors is associated with change in mental health. DESIGN Prospective cohort study in the Netherlands with 3 measurement time-points. SUBJECTS A total of 60 persons with recently acquired spinal cord injury. METHODS Standardized validated measurement instruments were used to assess mental health, self-efficacy, mastery, optimism, illness cognitions, purpose in life, and social comparison. Descriptive statistics and multilevel analysis were used. RESULTS Multilevel regression analyses showed that neither mental health nor psychological factors, except for social comparison-upward identification, showed statistically significant change over time. However, increasing scores for self-efficacy, mastery, acceptance cognitions, and purpose in life were significantly associated with increasing mental health. In contrast, increasing scores for optimism, social comparison, helplessness cognitions, and disease benefits cognitions were not significantly associated with increasing mental health in persons with spinal cord injury. CONCLUSION Most psychological factors showed stability up to 6 months post-discharge. Purpose in life, acceptance cognitions, self-efficacy, and mastery showed more variability and seem to be most promising as targets for interventions, which may lead to an improvement in mental health in persons with spinal cord injury.