{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:48:11Z","timestamp":1776826091999,"version":"3.51.2"},"reference-count":60,"publisher":"American Spinal Injury Association","issue":"Supplement1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Resilience plays a critical role in adaptation following spinal cord injury (SCI), yet there is no consensus on how resilience is defined or measured. Current unidimensional approaches may miss important patterns in resilience responses that could inform targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify distinct subgroups of individuals with SCI based on resilience patterns using latent class analysis (LCA) and examine their associations with demographic, injury-related, and psychosocial factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a cross-sectional analysis of 10,634 adults with SCI from the National SCI Model System Database who completed the Spinal Cord Injury\u2013Quality of Life Resilience short form (SCI-QOL-R-SF) between 2016 and 2021. LCA identified response patterns across the 8 SCI-QOL-R-SF items. Polytomous logistic regression examined factors related to class membership. Linear regression assessed relationships between resilience classes and life satisfaction and depression symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A 3-class solution provided optimal fit: high resilience (40.5%), medium resilience (38.4%), and low resilience (21.1%). Classes demonstrated a clear gradient pattern of responses from \u201calways\u201d to \u201csometimes\u201d on the SCI-QOL items. Significant predictors of class membership included sex, age, employment status, self-care behaviors, health status, time since injury, and social support. Resilience class was the strongest predictor of both life satisfaction (accounting for 14% of variance) and depression symptoms (12.2% of variance), with large effect sizes between classes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Distinct resilience patterns exist among individuals with SCI and strongly predict psychosocial outcomes. These findings support tailored interventions targeting specific resilience profiles to improve life satisfaction and reduce depression in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00108","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:17:19Z","timestamp":1776824239000},"page":"137-148","source":"Crossref","is-referenced-by-count":0,"title":["Beyond One Size Fits All: Identifying Distinct Resilience Profiles in Spinal Cord Injury"],"prefix":"10.46292","volume":"32","author":[{"given":"Angela Hanks","family":"Philippus","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary D.","family":"Sammel","sequence":"additional","affiliation":[{"name":"Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan V.","family":"Prochazka","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberley R.","family":"Monden","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"25425","reference":[{"issue":"4","key":"b1","series-title":"J Spinal Cord Med","first-page":"493","volume":"39","author":"Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance","year":"2016","unstructured":"Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance. J Spinal Cord Med. 2016;39(4):493-494."},{"issue":"8","key":"b2","series-title":"Am J Phys Med Rehabil","first-page":"752","article-title":"Resilience after spinal cord injury: A scoping review","volume":"99","author":"McDonald SD","year":"2020","unstructured":"McDonald SD, Pugh M, Mickens MN. Resilience after spinal cord injury: A scoping review. Am J Phys Med Rehabil. 2020;99(8):752-763."},{"issue":"1","key":"b3","series-title":"Rehabil Psychol","first-page":"9","article-title":"Considering resilience in the rehabilitation of people with traumatic disabilities","volume":"53","author":"White B","year":"2008","unstructured":"White B, Driver S, Warren AM. Considering resilience in the rehabilitation of people with traumatic disabilities. Rehabil Psychol. 2008;53(1):9-17."},{"issue":"3","key":"b4","series-title":"Prof Psychol Res Pr","first-page":"227","article-title":"APA's resilience initiative","volume":"36","author":"Newman R","year":"2005","unstructured":"Newman R. APA's resilience initiative. Prof Psychol Res Pr. 2005;36(3):227-229."},{"issue":"2","key":"b5","series-title":"Depress Anxiety","first-page":"76","article-title":"Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)","volume":"18","author":"Connor KM","year":"2003","unstructured":"Connor KM, Davidson JRT. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82."},{"issue":"4","key":"b6","series-title":"J Adolesc Health Care","first-page":"262","article-title":"The children of Kauai: Resiliency and recovery in adolescence and adulthood","volume":"13","author":"Werner E","year":"1992","unstructured":"Werner E. The children of Kauai: Resiliency and recovery in adolescence and adulthood. J Adolesc Health Care. 1992;13(4):262-268."},{"issue":"3","key":"b7","series-title":"Rehabil Psychol","first-page":"200","article-title":"The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model","volume":"56","author":"Catalano D","year":"2011","unstructured":"Catalano D, Chan F, Wilson L, Chiu CY, Muller VR. The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model. Rehabil Psychol. 2011;56(3):200-211."},{"issue":"3","key":"b8","series-title":"Rehabil Couns Bull","first-page":"163","article-title":"Resilience and quality of life: An investigation of Kumpfer's resilience model with persons with spinal cord injuries","volume":"60","author":"Tansey TN","year":"2017","unstructured":"Tansey TN, Bezyak J, Kaya C, Ditchman N, Catalano D. Resilience and quality of life: An investigation of Kumpfer's resilience model with persons with spinal cord injuries. Rehabil Couns Bull. 2017;60(3):163-174."},{"issue":"8","key":"b9","series-title":"Arch Phys Med Rehabil","first-page":"1426","article-title":"Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury","volume":"96","author":"Craig A","year":"2015","unstructured":"Craig A, Nicholson Perry K, Guest R, et al. Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury. Arch Phys Med Rehabil. 2015;96(8):1426-1434."},{"key":"b10","series-title":"Psychol Res Behav Manag","first-page":"1997","article-title":"A narrative review of research on adjustment to spinal cord injury and mental health: Gaps, future directions, and practice recommendations","volume":"15","author":"Sandalic D","year":"2022","unstructured":"Sandalic D, Arora M, Pozzato I, Simpson G, Middleton J, Craig A. A narrative review of research on adjustment to spinal cord injury and mental health: Gaps, future directions, and practice recommendations. Psychol Res Behav Manag. 2022;15:1997-2010."},{"issue":"2","key":"b11","series-title":"Rev Clin Gerontol","first-page":"152","article-title":"What is resilience? A review and concept analysis","volume":"21","author":"Windle G","year":"2011","unstructured":"Windle G. What is resilience? A review and concept analysis. Rev Clin Gerontol. 2011;21(2):152-169."},{"issue":"3","key":"b12","series-title":"Int J Behav Med","first-page":"194","article-title":"The Brief Resilience Scale: Assessing the ability to bounce back","volume":"15","author":"Smith BW","year":"2008","unstructured":"Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The Brief Resilience Scale: Assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200."},{"issue":"3","key":"b13","series-title":"J Spinal Cord Med","first-page":"366","article-title":"Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form","volume":"38","author":"Victorson D","year":"2015","unstructured":"Victorson D, Tulsky DS, Kisala PA, Kalpakjian CZ, Weiland B, Choi SW. Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form. 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J Gen Intern Med. 2001;16(9):606-613."},{"issue":"11","key":"b21","series-title":"Arch Phys Med Rehabil.","first-page":"1749","article-title":"Symptoms of major depression in people with spinal cord injury: Implications for screening","volume":"85","author":"Bombardier CH","year":"2004","unstructured":"Bombardier CH, Richards JS, Krause JS, Tulsky D, Tate DG. Symptoms of major depression in people with spinal cord injury: Implications for screening. Arch Phys Med Rehabil. 2004;85(11):1749-1756."},{"issue":"1","key":"b22","series-title":"J Pers Assess","first-page":"71","article-title":"The Satisfaction With Life Scale","volume":"49","author":"Diener E","year":"1985","unstructured":"Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. 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Trans Issues Psychol Scie. 2018;4(4):440-461."},{"issue":"3","key":"b25","series-title":"Rehabil Couns Bull","first-page":"213","article-title":"Resilient coping types in people with spinal cord injury: Latent class analysis","volume":"65","author":"Chiu C","year":"2022","unstructured":"Chiu C, Brooks J, Jones A, et al. Resilient coping types in people with spinal cord injury: Latent class analysis. Rehabil Couns Bull. 2022;65(3):213-222."},{"issue":"1","key":"b26","series-title":"BMC Psychiatry","first-page":"60","article-title":"Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study","volume":"18","author":"Bhattarai M","year":"2018","unstructured":"Bhattarai M, Maneewat K, Sae-Sia W. Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study. BMC Psychiatry. 2018;18(1):60."},{"issue":"4","key":"b27","series-title":"Rehabil Psychol","first-page":"311","article-title":"Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation","volume":"60","author":"Guest R","year":"2015","unstructured":"Guest R, Craig A, Nicholson Perry K, et al. Resilience following spinal cord injury: A prospective controlled study investigating the influence of the provision of group cognitive behavior therapy during inpatient rehabilitation. Rehabil Psychol. 2015;60(4):311-321."},{"issue":"7","key":"b28","series-title":"Spinal Cord","first-page":"553","article-title":"Examining factors that contribute to the process of resilience following spinal cord injury","volume":"51","author":"Kilic SA","year":"2013","unstructured":"Kilic SA, Dorstyn DS, Guiver NG. Examining factors that contribute to the process of resilience following spinal cord injury. Spinal Cord. 2013;51(7):553-557."},{"issue":"12","key":"b29","series-title":"Arch Phys Med Rehabil","first-page":"1643","article-title":"Relationship Between Quality of Life and Self-Efficacy in Persons With Spinal Cord Injuries","volume":"88","author":"Middleton J","year":"2007","unstructured":"Middleton J, Tran Y, Craig A. Relationship Between Quality of Life and Self-Efficacy in Persons With Spinal Cord Injuries. Arch Phys Med Rehabil. 2007;88(12):1643-1648."},{"issue":"2","key":"b30","series-title":"Spinal Cord","first-page":"126","article-title":"Representativeness of the Spinal Cord Injury Model Systems National Database","volume":"56","author":"Ketchum JM","year":"2018","unstructured":"Ketchum JM, Cuthbert JP, Deutsch A, et al. Representativeness of the Spinal Cord Injury Model Systems National Database. Spinal Cord. 2018;56(2):126-132."},{"issue":"4","key":"b1","series-title":"J Spinal Cord Med","first-page":"493","volume":"39","author":"Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance","year":"2016","unstructured":"Spinal Cord Injury (SCI) 2016 Facts and Figures at a Glance. J Spinal Cord Med. 2016;39(4):493-494."},{"issue":"8","key":"b2","series-title":"Am J Phys Med Rehabil","first-page":"752","article-title":"Resilience after spinal cord injury: A scoping review","volume":"99","author":"McDonald SD","year":"2020","unstructured":"McDonald SD, Pugh M, Mickens MN. Resilience after spinal cord injury: A scoping review. Am J Phys Med Rehabil. 2020;99(8):752-763."},{"issue":"1","key":"b3","series-title":"Rehabil Psychol","first-page":"9","article-title":"Considering resilience in the rehabilitation of people with traumatic disabilities","volume":"53","author":"White B","year":"2008","unstructured":"White B, Driver S, Warren AM. Considering resilience in the rehabilitation of people with traumatic disabilities. Rehabil Psychol. 2008;53(1):9-17."},{"issue":"3","key":"b4","series-title":"Prof Psychol Res Pr","first-page":"227","article-title":"APA's resilience initiative","volume":"36","author":"Newman R","year":"2005","unstructured":"Newman R. APA's resilience initiative. Prof Psychol Res Pr. 2005;36(3):227-229."},{"issue":"2","key":"b5","series-title":"Depress Anxiety","first-page":"76","article-title":"Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC)","volume":"18","author":"Connor KM","year":"2003","unstructured":"Connor KM, Davidson JRT. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82."},{"issue":"4","key":"b6","series-title":"J Adolesc Health Care","first-page":"262","article-title":"The children of Kauai: Resiliency and recovery in adolescence and adulthood","volume":"13","author":"Werner E","year":"1992","unstructured":"Werner E. The children of Kauai: Resiliency and recovery in adolescence and adulthood. J Adolesc Health Care. 1992;13(4):262-268."},{"issue":"3","key":"b7","series-title":"Rehabil Psychol","first-page":"200","article-title":"The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model","volume":"56","author":"Catalano D","year":"2011","unstructured":"Catalano D, Chan F, Wilson L, Chiu CY, Muller VR. The buffering effect of resilience on depression among individuals with spinal cord injury: A structural equation model. Rehabil Psychol. 2011;56(3):200-211."},{"issue":"3","key":"b8","series-title":"Rehabil Couns Bull","first-page":"163","article-title":"Resilience and quality of life: An investigation of Kumpfer's resilience model with persons with spinal cord injuries","volume":"60","author":"Tansey TN","year":"2017","unstructured":"Tansey TN, Bezyak J, Kaya C, Ditchman N, Catalano D. Resilience and quality of life: An investigation of Kumpfer's resilience model with persons with spinal cord injuries. Rehabil Couns Bull. 2017;60(3):163-174."},{"issue":"8","key":"b9","series-title":"Arch Phys Med Rehabil","first-page":"1426","article-title":"Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury","volume":"96","author":"Craig A","year":"2015","unstructured":"Craig A, Nicholson Perry K, Guest R, et al. Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury. Arch Phys Med Rehabil. 2015;96(8):1426-1434."},{"key":"b10","series-title":"Psychol Res Behav Manag","first-page":"1997","article-title":"A narrative review of research on adjustment to spinal cord injury and mental health: Gaps, future directions, and practice recommendations","volume":"15","author":"Sandalic D","year":"2022","unstructured":"Sandalic D, Arora M, Pozzato I, Simpson G, Middleton J, Craig A. A narrative review of research on adjustment to spinal cord injury and mental health: Gaps, future directions, and practice recommendations. Psychol Res Behav Manag. 2022;15:1997-2010."},{"issue":"2","key":"b11","series-title":"Rev Clin Gerontol","first-page":"152","article-title":"What is resilience? A review and concept analysis","volume":"21","author":"Windle G","year":"2011","unstructured":"Windle G. What is resilience? A review and concept analysis. Rev Clin Gerontol. 2011;21(2):152-169."},{"issue":"3","key":"b12","series-title":"Int J Behav Med","first-page":"194","article-title":"The Brief Resilience Scale: Assessing the ability to bounce back","volume":"15","author":"Smith BW","year":"2008","unstructured":"Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The Brief Resilience Scale: Assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200."},{"issue":"3","key":"b13","series-title":"J Spinal Cord Med","first-page":"366","article-title":"Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form","volume":"38","author":"Victorson D","year":"2015","unstructured":"Victorson D, Tulsky DS, Kisala PA, Kalpakjian CZ, Weiland B, Choi SW. Measuring resilience after spinal cord injury: Development, validation and psychometric characteristics of the SCI-QOL Resilience item bank and short form. J Spinal Cord Med. 2015;38(3):366-376."},{"key":"b14","author":"Spinal Cord Injury (SCI) Model System | MSKTC","unstructured":"Spinal Cord Injury (SCI) Model System | MSKTC. https:\/\/msktc.org\/about-model-systems\/sci."},{"issue":"7","key":"b15","series-title":"Arch Phys Med Rehabil","first-page":"1289","article-title":"Measurement properties of the Spinal Cord Injury-Functional Index (SCI-FI) short forms","volume":"95","author":"Heinemann AW","year":"2014","unstructured":"Heinemann AW, Dijkers MP, Ni P, Tulsky DS, Jette A. Measurement properties of the Spinal Cord Injury-Functional Index (SCI-FI) short forms. Arch Phys Med Rehabil. 2014;95(7):1289-1297.e5."},{"key":"b16","series-title":"SF-36 Physical and Mental Health Summary Scales: A User's Manual","author":"Ware J","year":"1995","unstructured":"Ware J, Ma K, Keller SD. SF-36 Physical and Mental Health Summary Scales: A User's Manual. 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Arch Phys Med Rehabil. 1992;73(6):519-526."},{"issue":"8","key":"b19","series-title":"Arch Phys Med Rehabil","first-page":"1018","article-title":"The use of proxies in community integration research","volume":"82","author":"Cusick CP","year":"2001","unstructured":"Cusick CP, Brooks CA, Whiteneck GG. The use of proxies in community integration research. Arch Phys Med Rehabil. 2001;82(8):1018-1024."},{"issue":"9","key":"b20","series-title":"J Gen Intern Med","first-page":"606","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke K","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613."},{"issue":"11","key":"b21","series-title":"Arch Phys Med Rehabil.","first-page":"1749","article-title":"Symptoms of major depression in people with spinal cord injury: Implications for screening","volume":"85","author":"Bombardier CH","year":"2004","unstructured":"Bombardier CH, Richards JS, Krause JS, Tulsky D, Tate DG. Symptoms of major depression in people with spinal cord injury: Implications for screening. Arch Phys Med Rehabil. 2004;85(11):1749-1756."},{"issue":"1","key":"b22","series-title":"J Pers Assess","first-page":"71","article-title":"The Satisfaction With Life Scale","volume":"49","author":"Diener E","year":"1985","unstructured":"Diener E, Emmons RA, Larsen RJ, Griffin S. The Satisfaction With Life Scale. J Pers Assess. 1985;49(1):71-75."},{"issue":"10","key":"b23","series-title":"Arch Phys Med Rehabil","first-page":"1832","article-title":"Validity of the Life Satisfaction Questions, the Life Satisfaction Questionnaire, and the Satisfaction With Life Scale in Persons With Spinal Cord Injury","volume":"93","author":"Post MW","year":"2012","unstructured":"Post MW, van Leeuwen CM, van Koppenhagen CF, de Groot S. Validity of the Life Satisfaction Questions, the Life Satisfaction Questionnaire, and the Satisfaction With Life Scale in Persons With Spinal Cord Injury. Arch Phys Med Rehabil. 2012;93(10):1832-1837."},{"issue":"4","key":"b24","series-title":"Trans Issues Psychol Scie","first-page":"440","article-title":"Ten frequently asked questions about latent class analysis","volume":"4","author":"Nylund-Gibson K","year":"2018","unstructured":"Nylund-Gibson K, Choi AY. Ten frequently asked questions about latent class analysis. Trans Issues Psychol Scie. 2018;4(4):440-461."},{"issue":"3","key":"b25","series-title":"Rehabil Couns Bull","first-page":"213","article-title":"Resilient coping types in people with spinal cord injury: Latent class analysis","volume":"65","author":"Chiu C","year":"2022","unstructured":"Chiu C, Brooks J, Jones A, et al. Resilient coping types in people with spinal cord injury: Latent class analysis. Rehabil Couns Bull. 2022;65(3):213-222."},{"issue":"1","key":"b26","series-title":"BMC Psychiatry","first-page":"60","article-title":"Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study","volume":"18","author":"Bhattarai M","year":"2018","unstructured":"Bhattarai M, Maneewat K, Sae-Sia W. Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study. 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