Psychological defense mechanisms and coping strategies in people with disability and traumatic spinal cord injury with different levels of neuropsychiatric adaptation

Abstract

BACKGROUND:Despite the multitude of publications on the mechanisms of psychological adaptation in people with spinal and spinal cord injuries, there is a shortage of complex studies that explore the features of these mechanisms depending on the level of neuropsychic adaptation.
 AIM:This study aimed to explore the relationships between the mechanisms of psychological adaptation and the level of neuropsychic adaptation in patients with traumatic spinal cord injury.
 Material and methods:Altogether, 80 patients with 3 years of traumatic spinal cord injury were examined: 65 (81.2%) were men, and 15 (18.8%) were women. The mean age was 37.511.61 years, and 46 (57.5%) patients had paraplegia and 34 (42.5%) had tetraplegia. The level of neuropsychic adaptation was determined using the I.N. Gurvich test: a person is considered psychologically adapted if the sum score ranges from 0 to 20, and a person is considered maladapted if the sum score is 20. Psychological defense mechanisms were assessed using the Lifestyle Index of PlutchikKellerman. To determine strategies for coping with stress, we used the Ways of Coping Questionnaire of Folkman and Lazarus.
 Results:According to the findings, 64.6% of the participants had manifestations of neuropsychiatric maladaptation due to aspects of personality development and personal background. Psychologically maladapted individuals had a higher intensity of defense mechanisms (regression, compensation/identification, substitution, and projection) and coping strategies (escapeavoidance, search for social support, and confrontation). Positive correlations were found between the total index of defense intensity and levels of maladaptive coping (escapeavoidance, confrontation, distancing, acceptance of responsibility, and self-control).
 Conclusion:People with traumatic spinal cord disease and symptoms of neuropsychiatric maladaptation tend to have a combination of an increased level of tension of psychological defenses with the actualization of regression, substitution, compensation/identification, and projection. People with traumatic spinal cord disease were also found to have a preference for coping strategies aimed primarily at avoiding the problem and reducing emotional discomfort.