A Narrative Review of Research on Adjustment to Spinal Cord Injury and Mental Health: Gaps, Future Directions, and Practice Recommendations

Psychology Research and Behavior Management, 2022 · DOI: https://doi.org/10.2147/PRBM.S259712 · Published: August 5, 2022

Spinal Cord Injury Mental Health Rehabilitation

Simple Explanation

Spinal cord injury (SCI) can affect mental health, but many people with SCI don't develop a diagnosable mental health disorder. Understanding how people adjust psychologically after SCI is crucial. This review examines existing mental health guidelines for SCI and explores topics like adjustment, coping, grief, and resilience, including mild cognitive impairment, which can affect adjustment. Current guidelines mainly focus on mental health disorders and may not address the positive ways people adjust to SCI. More research is needed to understand these adjustment processes and how to help people with SCI.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Narrative Review

Key Findings

1
Existing guidelines focus on mental health disorders and neglect positive adjustment processes after SCI.
2
Research on adjustment-enhancing processes is often cross-sectional, varied, and doesn't effectively inform guideline development.
3
Researchers need to agree on how to define key adjustment processes and move beyond just looking at outcomes.

Research Summary

This narrative review examines research on adjustment, coping, grief, and resilience in individuals with spinal cord injury (SCI), highlighting gaps in existing mental health guidelines and suggesting areas for future research and clinical practice. The review emphasizes the need to shift from deficit-based models to focus on positive processes of adjustment, such as understanding SCI-related limitations, appraising manageability, and accommodating beliefs about self and the world. The authors identify gaps in research, including the need for longitudinal studies, consensus on definitions, and process-focused rather than outcome-focused approaches to understanding adjustment after SCI.

Practical Implications

Clinical Assessment

Clinicians should assess and support patients' understanding of SCI, evaluate appraisals of manageability, and recognize diverse paths to adjustment.

Therapeutic Interventions

Promote behavioral and psychological flexibility, employ 'watchful waiting' for grief, and consider loss-oriented CBT for protracted grief.

Resilience Building

Address cognitive deficits, support stress management, and strengthen interpersonal relationships and support systems.

Study Limitations

1
Definitional and conceptual heterogeneity across studies
2
Lack of studies on processes central to resilience
3
Neglect of assessments and descriptions of adversity and hardship specific to SCI

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