title: Examination and measurement of coping among adolescents with spinal cord injury.
abstract: METHODS
  Cross-sectional survey.
  
  
  OBJECTIVE
  To describe coping strategy use in adolescents with spinal cord injury (SCI), to explore the underlying factor structure of a measure of coping among adolescents with SCI and to assess relationships between coping and psychosocial outcomes.
  
  
  METHODS
  Multiple pediatric SCI centers in the United States.
  
  
  METHODS
  One hundred and eighty-two participants aged 13-17 years who experienced an SCI completed measures including the Kidcope, Children's Depression Inventory, Revised Children's Manifest Anxiety Scale and the Pediatric Quality of Life Inventory.
  
  
  RESULTS
  Participants reported that cognitive restructuring and resignation are the most used coping strategies, whereas social support, emotional regulation (calming) and cognitive restructuring are the most effective coping strategies. An exploratory factor analysis revealed that a three-factor solution provided the most parsimonious model for the relationships between the different coping strategies. However, only one of the three factors had acceptable internal consistency. This factor comprised escape-oriented coping strategies or an avoidant approach to coping with the sequelae of SCI. After controlling for demographic/injury-related factors, higher scores on the escape-oriented factor were associated with the lower quality of life and higher levels of depression and anxiety symptomatology.
  
  
  CONCLUSIONS
  Escape-oriented coping is associated with maladaptive psychosocial outcomes in adolescents with SCI. These adolescents report that active coping strategies are most effective in reducing SCI-related distress. Coping strategy use may mediate psychosocial outcomes in adolescents with SCI and represent an intervention target in adolescents who overly rely on escape-oriented coping.
authors.affiliation: Division of Behavioral Genetics, Rhode Island Hospital, Providence, RI, USA.
authors.forename: T F
authors.initials: TF
authors.lastname: Smith
authors.forename: H F
authors.initials: HF
authors.lastname: Russell
authors.forename: E H
authors.initials: EH
authors.lastname: Kelly
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahey
authors.forename: R R
authors.initials: RR
authors.lastname: Betz
authors.forename: L C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D002648:Child; D003627:Data Interpretation, Statistical; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012919:Social Behavior; D012944:Social Support; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult