title: Coping with spinal cord injury: tenacious goal pursuit and flexible goal adjustment.
abstract: OBJECTIVE
  To investigate the correlation of higher-order coping strategies of tenacious goal pursuit and flexible goal adjustment with adjustment after rehabilitation in spinal cord injury.
  
  
  METHODS
  Cross-sectional correlational study.
  
  
  METHODS
  All 397 eligible patients entered for spinal cord rehabilitation between 1999 and 2009 were contacted and 130 (33%) agreed to complete a self-report questionnaire.
  
  
  METHODS
  Partial correlations were computed between tenacious goal pursuit and flexible goal adjustment and affective and cognitive psychological adjustment. Demographics, spinal cord injury related variables, social support and coping were used as control variables.
  
  
  RESULTS
  After controlling for relevant demographic, medical and social support indices, partial correlations between tenacious goal pursuit and indices of adaptation were not significant. Significant partial correlations were observed between flexible goal adjustment and each of the indices of adjustment (r = -0.33, -0.42, 0.51, -0.38, respectively, for depression, anxiety, acceptance, and helplessness) after controlling for all relevant variables in the model. Flexible goal adjustment explained significant additional proportions of variance for each of the adjustment indices (7%, 11%, 18%, and 7%, respectively).
  
  
  CONCLUSIONS
  Flexible goal adjustment, but not tenacious goal pursuit, is associated with psychological adjustment in spinal cord injury. Further research is needed to understand the mechanisms of flexible goal adjustment. Interventions targeting flexible goal adjustment might be of benefit for the patient.
authors.affiliation: Department of Research, Development & Education, Post Box 9011, Sint Maartenskliniek. w.vanlankveld@maartenskliniek.nl
authors.forename: Wim
authors.initials: W
authors.lastname: van Lankveld
authors.forename: Tijn
authors.initials: T
authors.lastname: van Diemen
authors.forename: Ilse
authors.initials: I
authors.lastname: van Nes
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis; D003071:Cognition; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report; D012944:Social Support; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000209:etiology / Q000523:psychology* / Q000534:rehabilitation; D055815:Young Adult