The influence of meaning making on distress and well-being following spinal cord injury: A cross-sectional examination with military veterans
There are many risk factors that have been linked with distress following a traumatic spinal cord injury. Peritraumatic variables such as perceived life threat and dissociation have been associated with an increased risk for posttraumatic stress disorder (PTSD). The conservation of resources theory proposes that it is the loss of resources (e.g., material possessions, personal characteristics, finances) that contributes to both depression and PTSD. Appraisal processes such as global and situational meaning making have been documented as both inhibiting and facilitating posttrauma psychological health. However, research has not been conducted that combines the injury characteristics, resource loss, and meaning making influences on psychological outcomes with individuals who have experienced a spinal cord injury. This study proposes and evaluates a new model of posttrauma psychological outcomes that is based on these identified traumatogenic factors by emphasizing the individual perspective through narratives. Eighty-five spinal cord injured veterans completed semi-structured interviews assessing perceived loss of physical, personal, and energy resources; level of global meaning; PTSD; depression; and psychological well-being. Objective ratings of level and completeness of spinal cord injury were retrieved from medical records to calculate injury severity. Additionally, narratives were generated in response to open-ended questions about meaning and impact of the injury, identity and autobiography formation, and coping efficacy. This study utilized a mixed-method approach that involved a grounded theory qualitative evaluation of situational meaning making narratives. Also, quantitative analyses were used to investigate the influence of injury severity, loss of resources, and meaning making on psychological outcomes post-injury. Results revealed that the variables of interest did not differ across time since injury. Resource loss was positively associated with depression and PTSD and negatively associated with psychological well-being. However, the severity of the spinal cord injury was not associated with psychological outcomes, even though this directly relates to functionality. Global meaning and resource loss were significant predictors of psychological outcomes. Finally, consistent situational meaning making themes were generated describing causal attributions, degree of life change, identity loss and integration, and post-injury growth. Implications of these findings related to factors that are associated with quality of life and human resiliency are discussed, as are suggestions for psychological intervention.
deRoon-Cassini, Terri A, "The influence of meaning making on distress and well-being following spinal cord injury: A cross-sectional examination with military veterans" (2008). Dissertations (1962 - 2010) Access via Proquest Digital Dissertations. AAI3326755.