Psychosocial resource models as frameworks for explaining functional status: Tests in an injured population

Traditionally, research on traumatic injury has explored the role of specific psychological resources, social resources, and coping behaviors, in improving health outcomes. Few studies, however, have done so using theoretical frameworks that specify connections among these influences and explain how such connections may alter each construct's effect on health. Because such frameworks are rarely employed, many studies also fail to consider additional factors such as social stressors which may combine with injure-related concerns to diminish resources, alter coping responses, and further decrease functioning. To address these omissions, this study used deterioration, buffering, and mediating psychosocial resource models to devise frameworks relating psychological and social resources, coping behaviors, and social stressors to functional status. All models were evaluated and revised using structural equation modeling techniques and survey data from a random sample of 249 patients discharged from the trauma center of the University of Alabama at Birmingham Hospital. These data did not support the validity of the deterioration or mediating models but indicate that (a) psychological resources, social resources, and emotion-focused coping behaviors directly impact functional status; (b) social stressors indirectly affect functioning via their direct effects on psychological and social resources; (c) emotion-focused coping behaviors mediate the effects of psychological resources; and (d) psychological resources exhibit stress-buffering effects. Relationships revealed in the analyses reaffirm the need to employ more comprehensive efforts to predict and improve functioning after injury. Such efforts must account for current and preexisting stressors when relating resources to functioning and must fortify psychological resources if progressive coping responses are to be inspired.