title: Predicting the long-term impact of acquired severe injuries on functional health status: the role of optimism, emotional distress and pain.
abstract: METHODS
  Longitudinal.
  
  
  OBJECTIVE
  To investigate the relative importance of personality traits, emotional distress and pain as predictors of functional health status in patients with spinal cord injury (SCI) or multiple traumas (MTs).
  
  
  METHODS
  Sunnaas Rehabilitation Hospital, Norway.
  
  
  METHODS
  Data were obtained from SCI and MT patients at admission (n=101) and at discharge (n=87) from rehabilitation, as well as 4 years post injury (n=75). The primary outcome measure was the sickness impact profile (SIP). Personality traits, that is, dispositional optimism and positive/negative affectivity, were measured using the Life Orientation Test-Revised and the Positive Affect and Negative Affect Schedule, respectively.
  
  
  RESULTS
  Using hierarchical regression analysis, dispositional optimism and pain emerged as the most robust predictors of functional health status. Generally, these two variables accounted for a substantial part of the variance (that is, 20-40%) in the SIP scales. Significant correlations between pain and anxiety/depression were found in all phases of the study, and at follow-up depression level appeared as an independent predictor of functional health.
  
  
  CONCLUSIONS
  The substantial predictive power, in terms of explained variance, of dispositional optimism, pain and depression/anxiety, indicates that these variables may be of practical-clinical importance in a rehabilitation setting. Specifically, patients characterized by low optimism, combined with presence of pain and depression/anxiety, may constitute a high-risk group for disability and reduced quality of life. On the other hand, high optimism should be regarded as a resilience characteristic, protecting the individual against long-term sequelae of severe physical injury.
authors.affiliation: Department of Psychology, University of Oslo, Oslo, Norway. olav.vassend@psykologi.uio.no
authors.forename: O
authors.initials: O
authors.lastname: Vassend
authors.forename: A J
authors.initials: AJ
authors.lastname: Quale
authors.forename: O
authors.initials: O
authors.lastname: Røise
authors.forename: A-K
authors.initials: AK
authors.lastname: Schanke
mesh_terms: D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000523:psychology* / Q000534:rehabilitation; D010146:Pain / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D055500:Resilience, Psychological; D018434:Sickness Impact Profile; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation