Psychopathology and resilience following traumatic injury: A latent growth mixture model analysis.

Objective: To investigate trajectories of PTSD and depression following traumatic injury using latent class growth curve modeling. Method: A longitudinal study of 330 injured trauma survivors was conducted and participants were assessed during hospitalization, and at 1, 3, and 6 months follow-up. Acute Stress Disorder (ASD) was assessed during hospitalization using the Acute Stress Disorder Interview (ASD-I), PTSD was measured at all follow-up with the Post-Traumatic Stress Diagnostic Scale (PDS) and depression was measured at hospitalization with the (BSI) and at follow-up with the Center for Epidemiologic Studies Depression Scale (CESDS). Covariates were explored, including coping self-efficacy, anger, education level, and mechanism of injury. Results: Four latent classes were identified for PTSD and Depression symptoms: chronic distress, delayed distress, recovered, and resilience. When compared to the resilient group, individuals with chronic distress were more likely to have been assaulted, had higher levels of anger, and had less coping self-efficacy. The delayed distress group had lower education levels, higher levels of coping self-efficacy, and higher levels of anger. Individuals in the recovered group had fewer years of education, and higher levels of anger. Conclusion: The majority of the injured trauma sample demonstrated resiliency, with those exhibiting distress doing so as a delayed, chronic, or recovered trajectory. Coping self efficacy, education, assaultive trauma type, and anger were important covariates of depression and PTSD trajectories. These results are similar to studies of individuals who experienced a major health threat and with survivors from the World Trade Center attacks in the U.S. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological well-being after spinal cord injury: Perception of loss and meaning making.

Objective: This study examined the influence of medical injury severity, perceived loss of physical functioning (conceptualized as physical resource loss), and global meaning making on psychological well-being among 79 veterans living with a spinal cord injury. Measures: Structured interviews were completed to assess perceived loss of physical abilities using the Conservation of Resources—Evaluation and SF-36 Health Survey, global meaning making (Purpose in Life scale), and psychological well-being (Sense of Well-Being Inventory). Medical injury severity was calculated from medical records. Results: Medical injury severity was not related to psychological well-being, whereas perceived loss of physical functioning was inversely associated. Global meaning making was significantly related to and accounted for a large portion of the variance in psychological well-being. Results suggest that global meaning making partially mediates perceived loss of physical resources and psychological well-being. Conclusion: The perceived loss of physical abilities and the generation of meaning and purpose in life are important variables that relate to positive adaptation following spinal cord injury. Treatment implications related to factors that increase quality of life following spinal cord injury are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)