Correlates of Resilience in Adults with Spina Bifida Amy Showen,

Correlates of Resilience in Adults with Spina Bifida Amy Showen, MD MSc Isabel Allen, PhD Hillary Copp, MD MS Lindsay Hampson, MD MAS University of California, San Francisco The Societies for Pediatric Urology Annual Meeting 2020

SPINA BIFIDA Over 75% of individuals with spina bifida live into adulthood Lifelong physical and psychosocial challenges – Hydrocephalus, bladder dysfunction, mobility – Depression, anxiety, social isolation – Quality of life

RESILIENCE The process of positive adaptation in the face of adversity Associated with improved outcomes – Quality of life – Psychological well-being (depression, anxiety) – Health-related behaviors (adherence) Modifiable – Cognitive behavioral therapy, mindfulness

OBJECTIVES (1) Measure resilience in adults with spina bifida (2) Identify associated demographic and clinical factors

METHODS Anonymous survey via Facebook advertising Inclusion criteria: age 18 years, diagnosis of spina bifida, complete data – N 195 Independent variables: age, gender, race, household education, insurance, urologic surgeries, VP shunt, physical function Dependent variable: resilience – Connor Davidson Resilience Scale Analysis: multiple linear regression – Backward elimination approach

RESULTS: RESILIENCE Resilience in our study population is moderately poor, relative to a US general population sample (p 0.001)

RESULTS: RESILIENCE Multiple sclerosis - Koelmel et al., 2017 Muscular dystrophy - Terrill et al., 2016 Acquired spinal cord injury - Kilic et al., 2013 US general population - Campbell-Sills et al., 2009 20 25 Mean Resilience Score (CD-RISC 10), with 95% Confidence Interval 30 35

RESULTS: RESILIENCE Multiple sclerosis - Koelmel et al., 2017 Muscular dystrophy - Terrill et al., 2016 Acquired spinal cord injury - Kilic et al., 2013 US general population - Campbell-Sills et al., 2009 20 25 Mean Resilience Score (CD-RISC 10), with 95% Confidence Interval 30 35

RESULTS: RESILIENCE Multiple sclerosis - Koelmel et al., 2017 Muscular dystrophy - Terrill et al., 2016 Acquired spinal cord injury - Kilic et al., 2013 US general population - Campbell-Sills et al., 2009 20 25 Mean Resilience Score (CD-RISC 10), with 95% Confidence Interval 30 35

RESULTS: RESILIENCE Multiple sclerosis - Koelmel et al., 2017 Muscular dystrophy - Terrill et al., 2016 Acquired spinal cord injury - Kilic et al., 2013 US general population - Campbell-Sills et al., 2009 20 25 Mean Resilience Score (CD-RISC 10), with 95% Confidence Interval 30 35

RESULTS: CORRELATES OF RESILIENCE

RESULTS: CORRELATES OF RESILIENCE

CONCLUSIONS Resilience is moderately poor in adults with spina bifida Older age, higher household education, prior urologic surgeries, and greater physical function are associated with resilience As a modifiable construct with positive effects on quality of life, psychological well-being, and healthrelated behaviors, resilience is a promising target for intervention in this population

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