Resilience, Pain Interference and Upper-Limb Loss: Testing the Mediating Effects of Positive Emotion and Activity Restriction on Distress

Publication date: Available online 5 February 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Michaela V.V. Walsh, Trey W. Armstrong, Julia Poritz, Timothy R. Elliott, Warren T. Jackson, Tiffany Ryan
ObjectiveTo test mediating effects of positive emotion and activity restriction on the associations of resilience and pain interference to distress reported by individuals with traumatic upper-limb loss evaluated for prosthetics.DesignCross-sectional correlational study of several demographic and self-report measures of resilience, pain interference, activity restriction, positive emotions, and symptoms of depression and post-traumatic stress.SettingSix Advanced Arm Dynamics regional centers.Participants263 prospective participants consented to be evaluated for eligibility/need of upper extremity prosthetics; 202 (57 women, 145 men) sustained traumatic injuries. Average age was 41.81 (SD = 14.83; range of 18.01 - 72.95 years). Participants identified as White (70.8%) followed by Black (10.4%), Hispanic (9.4%), Asian (3.0%), and Other (1.8%).InterventionsNot applicable.Main Outcome Measure(s)Primary Care Post-traumatic Stress Disorder Screen³³, Depression screen.³⁴ResultsResilience and pain interference were significantly correlated in predicted directions with positive emotions, activity restriction and the two distress variables. A path model revealed that the associations of resilience and pain interference to both distress variables were completely mediated by positive emotions and activity restriction. There were no significant direct effects of resilience or pain interference to either distress variable.Conclusion(s)Resilience may facilitate adjustment via beneficial and predicted associations with positive emotions and active engagement with environment. These relationships are independent of the significant and inverse associations of pain interference on these same variables. Longitudinal research is needed to understand interactions between positive emotions and activity over time in promoting adjustment following traumatic limb loss. Individuals reporting depression and/or PTSD symptoms may require interventions that reduce avoidance and promote activities that may increase the likelihood of experiencing positive emotions.



from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/1mkaoRW
via IFTTT