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Sherman DS, Burnett HJ, Lindstrom D. Engagement in Meaningful Activity Mediates the Relationship Between Stressful Life Events and Functional Resilience. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2024:15394492241237746. [PMID: 38520308 DOI: 10.1177/15394492241237746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
Resilience during stressful life events is a priority for administering the most client-centered care as possible. Occupational therapy practitioners have the unique opportunity to support resilience through promoting meaningful participation. The current study aims to understand the associations between meaningful activity engagement, resilience, and stressful life events. We specifically focused on answering if meaningful participation mediates the relationship between stressful life events and resilience. 492 participants from a non-clinical convenience sample of Amazon's MTurk completed the study. Participants completed an online survey and reported their experiences of stressful life events, resilience, well-being, and meaningful participation. We used SPSS and PROCESS to analyze our data. Stressful event severity and resilience were inversely related. When accounting for the effect of meaningful participation, the relationship became non-significant, indicating evidence of mediation. Implications: Focusing on measuring meaningful participation may be worth studying in further research.
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Saba SK, Davis JP, Prindle JJ, Howe E, Tran DD, Bunyi J, Hummer JF, Castro CA, Pedersen ER. Bidirectional Associations Between Pain and Perceived Stress Among Veterans: Depressive Disorder as a Predisposing Factor. Psychosom Med 2024; 86:44-51. [PMID: 37774110 PMCID: PMC10841244 DOI: 10.1097/psy.0000000000001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
OBJECTIVE Military veterans who were injured in combat very often report pain along with co-occurring perceived stress and preexisting depressive disorder. The systems model of pain is a theoretical model suggesting that pain and perceived stress are bidirectionally associated at the within-person level, and associations are heightened among those with depressive disorder. However, the systems model of pain has not been adequately tested. Testing the systems model of pain could illuminate salient treatment targets for combat-injured veterans with pain and co-occurring psychological problems. METHODS The present study empirically tests the systems model of pain among a sample of combat-injured veterans ( N = 902) surveyed five times during an 18-month period. We used a multigroup, autoregressive latent trajectory with structured residual statistical model to test the within-person associations between pain and perceived stress and determine whether associations differ between veterans with and without a positive screen for depressive disorder. RESULTS In line with the systems model of pain, pain and perceived stress were bidirectionally associated only among combat-injured veterans with depressive disorder. Among such veterans, perceived stress was positively associated with subsequent pain ( b = 0.12; 95% confidence interval = 0.06-0.17), and pain was positively associated with subsequent perceived stress ( b = 0.44; 95% CI = 0.11-0.77). CONCLUSIONS Our work highlights the interplay between pain and its psychological correlates among a particularly at-risk population. Clinicians addressing pain and perceived stress among combat-injured veterans should be prepared to identify and address depressive disorder.
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Affiliation(s)
- Shaddy K. Saba
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 St, Los Angeles, CA 90089
| | - Jordan P. Davis
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 St, Los Angeles, CA 90089
| | - John J. Prindle
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 St, Los Angeles, CA 90089
| | - Esther Howe
- University of California, Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA 94720
| | - Denise D. Tran
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street, Suite 2200, Los Angeles, CA 90033
| | - John Bunyi
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 St, Los Angeles, CA 90089
| | | | - Carl Andrew Castro
- University of Southern California, Suzanne Dworak-Peck School of Social Work, 669 W. 34 St, Los Angeles, CA 90089
| | - Eric R. Pedersen
- University of Southern California, Keck School of Medicine, Department of Psychiatry and Behavioral Sciences, 2250 Alcazar Street, Suite 2200, Los Angeles, CA 90033
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Kinney AR, Stephenson RO, Cogan AM, Forster JE, Gerber HR, Brenner LA. Participation Mediates the Relationship Between Postconcussive Symptoms and Suicidal Ideation Among Veterans. Am J Occup Ther 2022; 76:23273. [PMID: 35486717 DOI: 10.5014/ajot.2022.048561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Veterans with mild traumatic brain injury (mTBI) and associated symptoms are at risk for suicide. Postconcussive symptoms (PCS) may heighten risk for suicidal thoughts by limiting veterans' participation. OBJECTIVE To investigate whether participation mediates the relationship between PCS and suicidal ideation. DESIGN Cross-sectional, exploratory design. Structural equation models were used to investigate whether participation mediated the relationship between PCS and suicidal ideation. SETTING Community. PARTICIPANTS Veterans with mTBI (N = 145). OUTCOMES AND MEASURES The Ohio State University TBI Identification Method was used to establish mTBI diagnosis. We identified latent variables for PCS and participation using the Neurobehavioral Symptom Inventory and select domains of the Medical Outcomes Study Short Form-36, respectively. We used the Beck Scale for Suicide Ideation to measure the presence of suicidal ideation. RESULTS Participation mediated the relationship between PCS and the presence of suicidal ideation (odds ratio [OR] = 1.09, p = .011). More severe PCS were associated with lesser participation (β = -.86, p < .001); greater participation was associated with lower odds of suicidal ideation (OR = 0.92, p = .007). CONCLUSIONS AND RELEVANCE PCS may heighten risk for suicidal thoughts among veterans by limiting successful participation, a primary target of occupational therapy intervention. Thus, the results suggest that occupational therapy practitioners can play a substantial role in suicide prevention services for veterans with mTBI. Preventive services could mitigate suicide risk among veterans with mTBI by enabling sustained engagement in meaningful and health-promoting activity (e.g., reasons for living) and targeting PCS. What This Article Adds: Researchers have proposed that occupational therapy practitioners can help prevent veteran suicide by supporting their engagement in meaningful, health-promoting activity and by targeting suicide risk factors within their scope of practice. To the best of our knowledge, this is the first study to offer empirical support for such proposed suicide prevention efforts. Although additional research is needed, these results are promising and highlight a distinct role for occupational therapy in suicide prevention.
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Affiliation(s)
- Adam R Kinney
- Adam R. Kinney, PhD, OTR/L, is Research Health Science Specialist, VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, Aurora, CO, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora;
| | - Ryan O Stephenson
- Ryan O. Stephenson, DO, is Associate Professor, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, and Medical Director of Polytrauma and Traumatic Brain Injury, Eastern Colorado Health Care System, Denver VA Medical Center, Denver, CO
| | - Alison M Cogan
- Alison M. Cogan, PhD, OTR/L, is Health Science Specialist at the Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Jeri E Forster
- Jeri E. Forster, PhD, is Director of the Data and Statistical Core, VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, Aurora, CO, and Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora
| | - Holly R Gerber
- Holly R. Gerber, MS, is Research Coordinator, VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, Aurora, CO, and Doctoral Candidate, Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA
| | - Lisa A Brenner
- Lisa A. Brenner, PhD, is Director, VA Rocky Mountain Mental Illness Research, Education, and Clinical Center, Aurora, CO, and Professor, Departments of Physical Medicine and Rehabilitation, Psychiatry, and Neurology, University of Colorado Anschutz Medical Campus, Aurora
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Rodríguez-Martínez MDC, Toledano-González A, Triviño-Juárez JM, Polonio-López B, Segura-Fragoso A, López-Martín O, Cantero-Garlito P, Rodríguez-Hernández M, Corregidor-Sánchez AI, Romero-Ayuso D. Changes in Resilience in Students of Occupational Therapy After Their First Exposure to Practice Placement Education. Front Psychol 2021; 12:658187. [PMID: 34040566 PMCID: PMC8142892 DOI: 10.3389/fpsyg.2021.658187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Resilience is a multidimensional and dynamic construct associated with positive growth and the capacity to transform stressful and negative factors into opportunities of personal development and self-improvement when faced with difficult experiences. The resilience process of each individual integrates multiple analysis levels, which range from genetic-environmental interactions to a complex process of adaptation between the individual and his/her family, friends, co-workers, society, and culture. Objective: To determine whether resilience improves in students of occupational therapy when exposed for the first time to practice placement education. Methodology: Quasi-experimental, prospective, observational, multi-center study with a sample composed of students from the Degree of Occupational Therapy of the public universities of Málaga (UMA) and Castilla-La Mancha (UCLM) (Spain). Two weeks prior to the beginning of the practice education period, the participants completed a questionnaire that included sociodemographic data and the area of their internships. They were also given the Spanish version of the Connor-Davidson's resilience scale (CD-RISC). All these instruments were also completed 1 week after the end of the clinical practice. Results: There were statistically significant differences between the variables that make up resilience and the different internship areas. On the other hand, there was a significant improvement of global resilience after the clinical practice period, in both women (13.85 points; p < 0.001) and men (7.72 points; p < 0.035), when the internship area was not considered. Conclusions: The results show that resilient students are more optimistic and work to improve a situation beyond doing simply what is expected of them, knowing how to control their feelings. This is beneficial for students in practice education, since, during these, they face difficult situations that require a resilient pattern, which helps reduce stress and the burnout syndrome.
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Affiliation(s)
| | - Abel Toledano-González
- Department of Psychology, Faculty of Health Sciences, University of Castilla La Mancha, Talavera De La Reina, Spain.,Neurological Disabilities Research Institute, Albacete, Spain
| | | | - Begoña Polonio-López
- Department of Nursing, Physical Therapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Antonio Segura-Fragoso
- Department of Medical Sciences, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Olga López-Martín
- Department of Nursing, Physical Therapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Pablo Cantero-Garlito
- Department of Nursing, Physical Therapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Marta Rodríguez-Hernández
- Department of Nursing, Physical Therapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Ana-Isabel Corregidor-Sánchez
- Department of Nursing, Physical Therapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla La Mancha, Talavera de la Reina, Spain
| | - Dulce Romero-Ayuso
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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