Psychological factors and risk of mortality after spinal cord injury

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2019.1690766 · Published: July 1, 2020

Spinal Cord Injury Mental Health Public Health

Simple Explanation

This study looked at how personality traits and a sense of purpose in life relate to different causes of death in people with spinal cord injuries (SCI). It builds on earlier research that examined behavioral, health, and clinical factors. The study found that certain psychological factors can predict the risk of death from specific causes, especially unintentional injuries. Having a sense of purpose was linked to protection against death from pneumonia, while being active helped protect against death from heart issues and unintentional injuries. The researchers suggest that healthcare professionals can play a key role in helping people with SCI find purpose in life, which may increase their lifespan. Also, assessing personality traits can help identify those at risk for specific causes of death, allowing for targeted prevention strategies.

Study Duration

1997–1998 and 2007–2009 with mortality status determined as of December 31, 2016

Participants

3070 adults with chronic (>1-year), traumatic SCI

Evidence Level

Prospective cohort study

Key Findings

1
Four of the six psychological factors studied were predictive of all-cause mortality, indicating their significant influence on overall survival after SCI.
2
Psychological factors, particularly personality traits, were found to be most predictive of deaths resulting from unintentional injuries, highlighting the importance of psychological well-being in preventing accidental deaths.
3
Purpose in life was identified as a protective factor against death due to pneumonia, while activity was protective against death due to diseases of the heart and blood vessels and unintentional injury, underscoring the protective role of psychological well-being and an active lifestyle in mitigating specific causes of mortality.

Research Summary

This study investigated the relationship between psychological factors (personality and purpose in life) and cause-specific mortality among individuals with spinal cord injury (SCI). The research utilized data from a prospective cohort study to identify risk and protective psychological factors for different causes of death. The findings indicated that psychological factors were differentially related to mortality based on the specific cause of death, with psychological factors being particularly predictive of deaths due to unintentional injury. Purpose in life and activity were identified as protective factors for specific causes of mortality, while certain personality traits were associated with increased risk. The study highlights the importance of assessing psychological factors in individuals with SCI and suggests that interventions targeting purpose in life and personality traits may help reduce the risk of cause-specific mortality. Rehabilitation professionals have a central role in promoting purpose in life and implementing cause-specific prevention strategies.

Practical Implications

Targeted Prevention Strategies

Rehabilitation and public health professionals can utilize the identified personality factors to target individuals at risk for specific causes of death, particularly unintentional injuries.

Promoting Purpose in Life

Rehabilitation psychologists and counselors can focus on helping individuals with SCI find meaningful activities and build a sense of purpose, potentially buffering them against the long-term effects of SCI and reducing mortality risk.

Resource Facilitation

Sharing information about psychological risk factors, performing resource facilitation, and linking people with needed resources can serve as a minimal intervention to address mortality risk.

Study Limitations

1
Left censoring of the data may affect standardized mortality ratios.
2
The findings do not generalize to the first year after SCI onset.
3
The study focused on a subset of potential psychological measures, excluding other factors like resilience and self-efficacy.

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