Resilience and Function in Adults With Chronic Physical Disabilities: A Cross-Lagged Panel Design

Background Resilience is a psychological construct referring to one's positive adaptation in response to adversity. Evidence suggests that resilience may contribute to various function domains in adults with chronic physical disabilities. Purpose To test hypothesized temporal associations between resilience and four function domains (anxiety, depression, social role satisfaction, and physical function) in individuals with chronic physical disabilities. Methods Participants were 1,574 adults with one of four chronic physical disabilities (spinal cord injury, muscular dystrophy, multiple sclerosis, or postpolio myelitis syndrome) who were participating in a large, ongoing USA-based longitudinal survey study. Three surveys were mailed on an approximately yearly basis. Resilience was assessed using the Connor-Davidson Resilience Scale 10-item (CDRSC-10) and each function domain was assessed using the respective Patient Reported Outcome Measurement System (PROMIS) short-form. Results Cross-lagged path models evidenced statistically significant reciprocal relationships between resilience and each function domain except physical function. The standardized lagged coefficients corresponding to resilience predicting social role satisfaction (T1-T2 = 0.09, T2-T3 = 0.09) had similar effect sizes as those corresponding to social role satisfaction predicting resilience (T1-T2 = 0.11, T2-T3 = 0.04), although resilience was a slightly stronger predictor in the second lag. In models assessing psychological function, resilience was a stronger predictor of later psychological function (resilienceto-anxiety, T1 -T2 = -0.15, T2-T3 = -0.11; resilienceto-depression, T1 T2 = -0.21, T2-T3 = -0.13) than the inverse (anxiety-to-resilience, T1-T2 = -0.11, T2- T3 = -0.06; depression-to-resilience, T1-T2 = -0.12, T2-T3 = -0.05). Conclusions The study findings suggest that resilience is a significant prospective predictor of psychological and social function over time in individuals with chronic physical disabilities.