Do spinal chord injured have a higher rate of depression, anger and negative psycho-social behaviors
image Virginia Commonwealth University
Over the past several years I have experienced more negative social interactions with spinal chord injured (SCI) persons than any other defined group of the disabled. I wondered if this was pathological to SCI, that is a normal symptom of their condition, or just a personal cluster of difficult relationships.
It appears to be a researched finding that SCI have significantly higher levels of depression, anger and other negative psycho-social behaviours. The solution suggested in the studies include more assistance in cognitive behavioral therapy beyond the normal one year of intense physiotherapy. These behaviors do cause serious relationship problems for SCI that may not be openly acknowledged or discussed.
Most people with disabilities go through pain, adjustment, loss, personal financial crisis that are abnormal for the non-disabled population. SCI is usually caused by an accident so after the usual legal battles, SCI persons should have their finances in reasonably good shape. That assumes they act with some caution and don’t spend their court settlement in a hurry. The SCI event tends to disrupt their emotional equilibrium for a period until they get adjusted. It’s hard to get adjusted to constant pain. The difficulties with normal bodily functions like elimination and sex are additional emotional burdens for SCI.
None of this reflects the cluster of negative, aggressive SCI people I’ve run into. I currently have three internet stalkers in Charlottetown, two of whom are content with a regular stream of diatribes and invective. The writing usually defies logic but expresses a single emotion of hatred and anger. Another sent me a death threat. Last year a fourth SCI used my advocacy role to perpetrate a potentially damaging scam. What is odd is the level of invective and aggression from these SCI people.
My research confirms that SCI people exhibit negative behaviours such as depression at almost three times the general population. Only persons disabled with MS showed higher rates of depression. Brain injury concurrent with the spinal injury can cause additional cognitive problems.
Kemp & Krause (1999) compared depression and life satisfaction amongst people with spinal cord injury, post-polio syndrome, and non-disabled population. The post-polio group tended to score better on both depression and life satisfaction; only 22% of the post-polio group had depressive symptoms compared to 41% of the spinal cord injury group and 15% of the non-disabled group.(1)
Suicide rates among SCI , range from twice the rate in the non-SCI population to 10 times among US military veterans with SCI. Again brain injury and or psychosis like schizophrenia appear at abnormally high rates.
Depression is common in people with spinal cord injury although not as common as in multiple sclerosis (Shnek, et al., 1997). Krause, et al. (2000) suggests that 48% of patients with spinal cord injury in 1997 had clinical symptoms of depression at a year or more after injury. (1)
Blame and self-blame for the SCI event appear to impact social behaviour.
A large majority of people either totally blame themselves or others for their injury (Brown, et al. 1999). Paradoxically, people who are blameless for the accident tend to be less successful coping (Stensman, 1994).(1)
Apparently differing cultures provide variance in family life and social adaption to SCI. According the report, “Canadians had more health and disability related complications.”
While mental health counselors bandy the words “adjustment phase”, the same study found “…that spinal cord injury causes significant personality and behavior changes.” These problems can get worse as time progresses.
“Davies (1993) interviewed people with spinal cord injury and found that goal-directed hope based on realistic perceptions of life, focusing on progress, positive interpretation of events, and goal setting are important in helping people and families cope with spinal cord injury,” the report concluded.
It’s important to show sensitivity when dealing with SCI and their exhibited negative psycho-social behaviors. Toleration should be used to the extent possible. At a certain level of abuse, most people just turn away. Enough is enough. More mental health therapy is important for SCI as it is for all persons living with disability.
We will publish the entire report in a separate post.
References:
Family and Spinal Cord Injury Wise Young, Ph.D., M.D., W. M. Keck Center for Collaborative Neuroscience, Rutgers University, Piscataway, New Jersey, USA, December 4, 2006
still wondering
Years ago, in my very early twenties, I met a man who was SCI at a party held at a mutual friend’s house. Early in the evening we hit it off great and had some very stimulating conversations on various topics and laughed and joked about our mutual friends, normal party chit-chat all around. I asked what he did for a living and he told me and in turn he asked me what my job was and i told him that I was a carpenter in the house building trade at the time. He was probably in his thirties at the time and his wife was at his side throughout our conversations, adding her own thoughts and the whole scene was very pleasant.
Because of my profession at the time, he proceeded to tell me about how an SCI friend of his and himself had built his garage at home with no assistance whatsoever from any fully able bodied person whatsoever and very proud of that fact indeed.
So being completely intrigued I proceeded to ask him questions on how they performed different parts of the task, not insinuating anything but merely out of professional curiosity.
For some reason ,it was like a switch turned on in the man and he became very defensive and belligerent towards me so, being so young at the time I tried to smooth things over and change the subject but to no avail. He carried on in his rant towards me as if I had challenged him in his very existence on this planet.
I had no recourse other than moving away from him and trying desperately to avoid him the rest of the evening. Later on his wife came to me as they were leaving and tried to apologize for his behavior towards me stating that he can get very moody at times and assuring me that I had said nothing to provoke him whatsoever.
For weeks after, I recall going over the scene in my mind and trying to pinpoint where I might have said something offensive to the man but later just chalked it all up to beer and other substances going around at the party.
It’s not fair that these people suffered accidents and lost some functions. We have to be very careful not to add more pain to these people with insensitive comments. But I hope they can also show a little tolerance towards twenty something year olds who might think their all grown up but still have a lot to learn.