Project

well-being; spinal cord injury; mental health; resilience; adjustment process; depression; anxiety; life satisfaction; positive psychology; critical life events; longitudinal studies; trauma

Lead
Trotz der schwerwiegenden Auswirkungen einer Querschnittlähmung berichten viele betroffene Menschen von einem stabilen, hohen Wohlbefinden. Unter dem Blickwinkel der Resilienz wird die Entwicklung der Lebenszufriedenheit und psychischen Gesundheit während der Rehabilitation genauer untersucht.
Lay summary
Ziel des Forschungsprojekts Resilienz steht für Widerstandsfähigkeit und sinnbildlich für einen konstruktiven Bewältigungsprozess im Umgang mit kritischen Lebensereignissen. Eine hohe Lebenszufriedenheit und eine gute psychische Gesundheit werden häufig als Merkmale der Resilienz gesehen. Studien zeigen, dass viele Menschen nach einer Querschnittlähmung trotz der schwerwiegenden Folgen psychisch gesund und mit ihrem Leben zufrieden sind. Die Unterschiede zwischen den Betroffenen sind allerdings erheblich. Um besser zu verstehen, wie die Lebenszufriedenheit und die psychische Gesundheit durch die Verletzung beeinflusst werden und wie sie sich im weiteren Lebensverlauf entwickeln, müssen sie in Längsschnittstudien zu mehreren Zeitpunkten gemessen werden. Das vorliegende Projekt legt den Fokus auf den Rehabilitationskontext und somit auf die ersten Monate nach einer Querschnittlähmung. Es wird untersucht, wie sich die Lebenszufriedenheit und die psychische Gesundheit bei den Betroffenen während der Rehabilitation verändert. Der zentrale Leitgedanke besteht darin, die Ursachen dieser Veränderungen zu verstehen und Faktoren zu identifizieren, welche den Bewältigungsprozess positiv beeinflussen und Resilienz fördern.  Wissenschaftlicher und gesellschaftlicher Kontext Zu verstehen, wie sich die Lebenszufriedenheit und die psychische Gesundheit innerhalb der Rehabilitation verändern und welche Faktoren eine positive Entwicklung begünstigen, bildet die Grundlage für gezielte Interventionen.

Direct link to Lay Summary

Last update: 25.05.2016

Active participation

Active participation

Number	Title	Start	Funding scheme

People cope differently with adverse life events. Resilience broadly refers to a positive adjustment in the context of significant threats to an individual’s life or function. Within the field of stress and trauma, the focus on resilience represents a shift from a purely deficit-oriented approach towards a competence-based model aiming to maintain and build strengths in addition to address psychopathology. Research on the impact of acute adverse life events, such as widowhood, divorce, or disaster, suggests that individuals can preserve resilience in the aftermath of these events. Advocating a thorough, population-based examination of resilience following disability onset and using spinal cord injury (SCI) as a case in point for the severe impact of the sudden-onset of chronic disability, it is the aim of this research project (1) to understand resilience and the adjustment process following SCI, and (2) to identify the factors that influence this process.Research on resilience and the adjustment process to disability onset are coupled together, because resilience is best understood by thoroughly examining the adjustment process. However, current disability-related research is subject to two major shortcomings, which will be tackled in the current research project. First, a main limitation lies in the use of average scores to describe how individuals adjust to disability onset because in the context of an adjustment process over time average scores fail to capture both changes within and variability among the individuals. Statistical methods that facilitate the testing of this heterogeneity, and hence allow for the identification of different trajectories as well as resilient and vulnerable subgroups at a population level, need to be applied. Second, only few studies have used and tested adjustment models, and their findings are largely limited by the cross-sectional study design impeding causal statements, and a focus on specific model components only. An in-depth scientific understanding of resilience and the underlying multi-factorial process requires the use of a theory-guided, multi-factorial approach and testing of an adjustment model using a longitudinal study design.The overarching aim of this research project is to gain a thorough understanding of resilience and the adjustment process following the onset of SCI. Resilience will be operationalized with several indicators of well-being and mental health, including life satisfaction, symptoms of depression, anxiety and general distress. Three studies will be conducted. First, we will test whether different subgroups can be identified across all indicators assessed at rehabilitation discharge. Second, the longitudinal development of well-being and mental health following the onset of SCI will be investigated, and predictors distinguishing the observed trajectories identified. Third, an adjustment model and inherent mediation mechanisms will be tested to understand the longitudinal impact of psychological, biological and social factors on well-being and mental health.This project is nested within the Swiss Spinal Cord Injury study (SwiSCI), a multi-center, longitudinal inception cohort study. The findings will have a strong representative character for the Swiss SCI population because all four major specialized SCI rehabilitation centers in Switzerland participate in SwiSCI. A close investigation of resilience and the identification of different trajectories and resilient and vulnerable subgroups can support clinical decision making and set the ground for targeted interventions.