Psychological factors and risk of mortality after spinal cord injury

Abstract

Objective: Identify the association of personality and purpose in life with competing risks of multiple causes of death after spinal cord injury (SCI), using data from the SCI Longitudinal Health Study.

Design: Prospective cohort study with data collected in 1997–1998 and 2007–2009. Mortality status determined as of December 31, 2016.

Setting: Specialty hospital in the Southeastern United States.

Participants: 3070 adults with chronic (>1-year), traumatic SCI.

Interventions: N/A.

Outcome Measures: We examined 6 psychological factors (Purpose in Life and 5 scales of the Zuckerman-Kuhlman Personality Questionnaire) and risk of mortality due to 6 specific causes of death, building on published analyses of behavioral and health/clinical risk and protective factors.

Results: There were 803 deaths. Four of the 6 psychological factors were predictive of all-cause mortality. All except 1 personality scale were related to cause-specific mortality. Psychological factors were most predictive of unintentional injury deaths. Purpose in life was protective of death due to pneumonia; whereas, Activity was protective of death due to diseases of heart and blood vessels and to unintentional injury. Sociability, Impulsive-Sensation Seeking, and Neuroticism-Anxiety were risk factors for death due to unintentional injury. Neuroticism-Anxiety was related to death due to septicemia. There were no significant psychological predictors of cancer.

Conclusions: Rehabilitation professionals have a central role in promoting purpose in life as a means of increasing longevity. By assessing personality factors predictive of specific causes of mortality, those at risk may be targeted for cause-specific prevention strategies.

Keywords:

• Spinal cord injuries
• Mortality
• Risk
• Personality
• Efficacy

Data availability statement

The datasets generated and/or analyzed during the current study are not publicly available due to the privacy concerns of study participants and are not standardized to be in a publicly interpretable format.

Disclaimer statements

Contributors None.

Funding The contents of the publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90IF0066). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Conflicts of interest No potential conflict of interest was reported by the authors.