2013. Vol.4, No.12, 1059-1063
Published Online December 2013 in SciRes (
Open Access 1059
Coping, Personality Traits and Social Support in
Severe Burn Survivors
Priscilla M. P. Frota, Daniela S. Zanini
Pontifical Catholic University of Goiás, Goiânia, Brazil
Received September 20th, 2013; revised October 18th, 2013; accepted November 27th, 2013
Copyright © 2013 Priscilla M. P. Frota, Daniela S. Zanini. This is an open access article distributed under the
Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any
medium, provided the original work is properly cited. In accordance of the Creative Commons Attribution Li-
cense all Copyrights © 2013 are reserved for SCIRP and the owner of the intellectual property Priscilla M. P.
Frota, Daniela S. Zanini. All Copyright © 2013 are guarded by law and by SCIRP as a guardian.
Objective: The present study aimed at investigating the correlations among coping, personality traits, and
social support for burn survivors. Method: Participants were 48 patients from a reference burn hospital
who attended group meetings at a non-governmental organization associated to that institution that offers
support to burn survivors. Data were collected from February to May, 2010. The participants answered a
socio-demographic questionnaire and three instruments: Coping Strategy Indicator (CSI), Personality
Markers, and Social Support Questionnaire (MOS Scale). Results: The data obtained showed a signifi-
cant correlation among the personality traits neuroticism and socialization and social support, as well as
between socialization and coping; however, differently than expected, no significant correlation was es-
tablished between social support and coping. Conclusion: Personality traits are related to the perception
of support from others; however the perception of support does not influence the way burn survivors cope
with their problems. These data were discussed in order to broaden the knowledge and stimulate new
studies on the area, so that, based on this information, more efficient treatment plans and interventions can
be designed to fulfill both the physical and emotional needs of these survivors with more competency and
Keywords: Coping; Personality Traits; Social Support
Get burned, apart from being a sudden and traumatic event
for those who suffer it and for those surrounding them (Patter-
son et al., 1993), also involves a long treatment process. The
impact caused by it is not only restricted to physical sequelae
but also affects the survivor’s emotional life, and might lead to
pre-existent psychopathologies or to those resulting from the
burn (Fauerbach et al., 1997).
Patterson et al. (1993) indicate that people with premorbid
psychopathological disorders, such as depression, personality
disorders, alcohol and drug abuse, are more likely to have burn
injuries. They also have a tendency to have longer and more
difficult recovery suggesting that there is a correlation between
personality and burns accidents. The authors also identify a
considerable number of survivors with emotional instability
previous to the burn experience and highlight that the medical
model usually developed in the researches has proved insuf-
ficient to evaluate the psychological impact that afflicts burn
Regarding physical sequelae, Fauerbach et al. (2002) indicate
that the radical changes in the survivors’ physical appearance
reflect strongly on the integration of cognitions and behaviors.
All this brings losses to the cognitive and social abilities needed
to adapt to the new condition. Even considering the physical
and emotional impact of the burn, discrepancies among sur-
vivors have been observed regarding their abilities to adapt to
the new condition. Fauerbach et al., All these circumstances
increase the need for this type of patient to be cared for by an in-
ter-disciplinary team, which not always happens (Gilboa, 2001).
As the burn event has a strong and traumatic impact on one’s
life, it can be considered as a stressful event (or a stressor) and
the way the individual will cope with it will depend on his cop-
ing abilities and resources (Lazarus & Folkman, 1984). Ac-
cording to Folkman and Lazarus (1980), coping involves the
individual perception of the stressful event and the cognitive
and behaveioral strategies chosen by him to manage it. So when
the effecttiveness of the strategies is evaluated, it is necessary
to consider the specificity of person environment relationship,
such as nature, coping resource and result (Victorson, Farmer,
Burnett, Ouellette, & Barocas, 2005).
One particular situation considered stressful can originate
several possibilities of coping, which led Moos (1993) to estab-
lish a categorization based on focus and method. Therefore
concerning the first aspect, the coping strategies can be de-
scribed as approach coping (or problem focused coping), when
it describes efforts to solve the problem directly, or avoidance
coping (or emotional focused coping), when it is described as
efforts to solve the emotion caused by the stressful event. The
second aspect can be cognitive or behavioral, i.e., it can use
several cognitive efforts (e.g. cognitive re-evaluation) or be-
havioral efforts (e.g. problem solving).
Regarding the recovery of severe burn survivors, the exten-
sion of the burn is often not the most important predictor of his
re-adaptation, but his personality. Thus, when it comes to deal-
ing with the stress caused by the burn injury using coping abili-
ties (Gilboa, Bisk, Montag, & Tsur, 1999), it can be observed
that the cognitive evaluation and the emotional response to the
trauma apparently derive from one’s personality. Smith, Smith,
Rainey and DelGiorno (2006) postulated that personality and
coping prior to the burn should guide the treatment planning.
Grant and Langan-Fox (2007) suggest that the presence of a
high level of neuroticism predisposes individuals to create
stressful situations, and establishes a correlation between this
trait in life in general and specifically at work.
Andrews, Browne, Drummond and Wood (2010) argued that
the healthcare team assisting severe burn survivors can have
more productive interventions from the understanding of the
impact of patients’ personality on their dysfunctional reactions
and behaviors. They can acquire tools to assist patients in fac-
ing difficulties, with emotional support and functional coping
strategies. Apart from the great influence of personality, also
the role of social networks and the social support are important
for coping with burn.
Receiving social support as well as being part of a social ne-
twork can bring benefits to health, both by buffering the stress-
ful event and by reinforcing feelings of self-esteem. Both con-
ditions are associated with the reduction of negative effects
from exposition to physical or emotional trauma (Lawrence &
Fauerbach, 2003), with the increase of quality of life of both,
patients and caregivers (Yu, Hu, Efird, McCoy, 2013), and with
coping with difficulties of acute burn injuries (Farrell, Bennett,
& Gamelli, 2010).
However, the support does not depend only on the provider,
but also on the receiver, who needs to be capable of eliciting
the response from the environment or of perceiving it. So, once
more, the importance of taking into consideration personality
traits and its relation to personality is reinforced (Gilboa et al.,
1999). In fact, Onyishi and Okongwu (2013) demonstrate that
life satisfaction can be predicted by personality and social sup-
port even in adverse environment or work such as with Nige-
rian prisons officers.
The social context, in conformity with Moos (2003), has pa-
radoxically a curing and a destructive potential and, in this
sense, social support has the role of protecting and preventing
dysfunctional reactions in crisis situations.
Moos (2002, 2003) hypothesized that, the environment and
the quality of the relationships established in it influence the
individual’s commitment to this environment. His findings
indicate that the moderate emphasis on establishing relation-
ships in this net strengthens and benefits the person, while ex-
aggeration can bring serious problems, so as to cause a de-
pendence on it. The author continued to state that the individual
does not need, necessarily to seek support in family and friends
to obtain these benefits, but only the knowledge that he can
count on them can suffice.
Badger and Royse (2010) evaluated the perceived social
support from other burn survivors of 30 burn survivors in their
psychosocial rehabilitation. The authors stressed the positive
effect on health of the perception of belonging and been affili-
ate to a group in which people had a common experience. This
effect is not only situational but can have effects throughout life.
That’s what Meyer et al. (2004) postulate. For them a routine
follow-up throughout life is important, especially for the female
population. That is because women tend to face more difficult-
ties connected to physical appearance, leading them to react to
the burn sequelae with anger and attempts of isolation. The
purpose of the follow-up evaluations would be to measure, in
the long term, the level of adaptation to the new reality and to
identify possible problems that need intervention and so the
group experience could help.
Farrel, Bennet and Gamelli (2010) researched the correlation
between burn survivors’ discharge disposition and social sup-
port, and verified that the social support plays a decisive role
when determining discharge disposition. The authors demon-
strated that those individuals who did not have adequate social
support, were usually transferred from a hospital to another
inpatient setting, thus extending the length of their hospitalize-
tion and, consequently, postponing their return home to face
their daily lives. In fact, Russel et al. (2008) conducted a paper
with the purpose of identifying the level of agreement between
the statements regarding personal problems given by burn sur-
vivors and by an informant with whom they have a close per-
sonal relationship. In their results, they detected that the per-
ception of problems stated by the informants was much higher
than the ones stated by the survivors themselves. They con-
cluded that this suggests that survivors used an adaptive coping
mechanism in order to avoid an anticipated rejection in their
interpersonal relationships.
Taking into account that cultural factors play an important
role and that they, possibly, exert influence in the way the as-
pects studied are manifested. This paper aimed at researching
how personality, coping and social support appear and interact
specifically in a sample of severe burn survivors in the Brazil-
ian population. The results can help to develop appropriate
interventions to the Brazilian sociocultural context and contrib-
ute to a better reinsertion of these survivors.
Participants were 48 burn survivors from a Brazilian refer-
ence burn hospital, being 33 females and 15 males, aged be-
tween 12 to 73 years (M = 29.13, SD = 14.16) and 42.2% with
incomplete primary school.
In order to accomplish this study the following instruments
were used:
1) A sociodemographic questionnaire with information re-
garding age, gender and level of schooling.
2) The Coping Strategy Indicator (CSI) developed by
Amirkhan (1990), is a self-report scale, in which, initially, the
participants are instructed to select a stressing event in their
lives and describe it briefly. Later, the participants read a list of
33 specific coping behaviors and were asked to indicate the
extension with which these were used by them to deal with the
event described (never, sometimes or always). By means of
simple addition of the questions, the three scales of coping are
grouped: problem-solving (e.g., thought about what needed to
be done to solve the problem); search for social support (talk to
a friend); and avoidance (doing something in order to avoid
facing the problem). The alpha values obtained in the present
study for this scale were: α = 0.63, α = 0.79 and α = 0.70 for
problem-solving, social support and avoidance, respectively.
Open Access
3) An inventory named Marcadores de Personalidade (Per-
sonality Markers), developed by Hutz et al. (1998), was used.
This instrument is composed by 96 adjectives and individuals
should recognize the degree of intensity in which a given adjec-
tive (such as “hard-working”, “pessimistic”, “honest”, “respon-
sible”, “kind”, among others) described their personality, mark-
ing their agreement in a scale of 7 points. These adjectives can
be grouped in five scales in the means of the Big Five. The
alphas for the scale in this study were: 0.83, 0.85, 0.60, 0.62
and 0.80 for socialization, extroversion, consciousness, neuroti-
cism and openness, respectively.
4) To evaluate the perception of social support, the Social
Support Questionnaire (MOS Scale), originally developed for
the Medical Outcomes Study (MOS) (Sherbourne & Stewart,
1991), and adapted to Portuguese by Griep, Chor, Faerstein and
Lopes (2003), was used. The questionnaire is composed of 19
questions, which must be answered according to the Likert
scale ranging from 1 (never) to 5 (always). These questions,
such as “If you need so, how often do you count on some-
one…to help you if you are bedridden?” are grouped into four
subscales in the Brazilian version , according to factorial analy-
sis: a) material support; b) affective support; c) emotional/in-
formational support; d) positive social interaction support. The
alpha coefficients of these subscales range from 0.95 to 0.76.
The alpha values of these four subscales obtained in this study
were: 0.88, 0.87, 0.90 and 0.83 for material support, affective
support, emotional/informational support and positive social
interaction support, respectively.
After evaluation and approval of the project of this research
by the Ethics Committee, which regulates the application of the
Resolution CSN Nr 196 of the National Health Council, refer-
ring to research with human beings (Brazil, 1996), contact was
made with the management of a reference burn hospital from
the Center-West Region, requesting authorization to execute
this study. Once the authorization was obtained, the burn sur-
vivors were contacted, and after signing the Free and Clarified
Consent Term, the data collection started. The anonymity and
the possibility of consent withdrawal at any moment of the
process were ensured to all participants. The interviews were
performed on the same days and time of the group meetings
that the participants attend, starting straight after the end of the
meetings. The application took place in groups of six survivors
in a ventilated and well-lit room, lasting from 30 to 50 minutes.
Aiming at evaluating the existence of significant differences
in the average scores of the personality markers, social support
and coping strategies according to gender, an average compari-
son study was performed using t Student test (Table 1). The
results indicate no differences between gender and the person-
ality markers social support or coping strategies.
To evaluate the correlation among personality markers, so-
cial support and coping strategies, a Pearson bivariate correla-
tion (Table 2) was used. The data reveal that the higher the
score in socialization, the higher the account of total social
support (r = 0.37, p = 0.03) and the lower the use of avoidance
coping (r = 0.41, p = 0.02). Apart from that, the higher the
score in neuroticism, the lower the account of total social sup-
port was (r = 0.45, p = 0.01).
Table 1.
Average, standard-deviation, t value and significance level (p) in the
average comparison study for the variables personality marker, total so-
cial support in the MOS scale and approach and avoidance coping
strategies, according to gender.
Gender T p
Variable Male
M (DP)
M (DP)
Personalit y marker
Socialization 90.09 (11.45) 93.93 (13.01) 0.920.37
Extroversion 41.08 (13.59) 45.72 (13.62) 0.990.33
Accomplishment 81.17 (6.69) 78.04 (8.97) 1.16 0.25
Neuroticism 38.67 (6.43) 38.03 (10.25) 0.24 0.81
Openness 52.45 (16.18) 55.00 (12.93) 0.440.65
Total social su pport
MOS Scale 73.50 (18.94) 82.90 (11.07) 1.610.13
Coping strategy
Problem-solving 26.27 (3.20) 27.30 (3.22) 0.910.37
Search for social support26.15 (3.36) 25.90 (4.84) 0.20 0.84
Avoidance 22.45 (5.48) 22.55 (3.53) 0.050.95
Table 2.
Pearson correlation among personality markers, social support and cop-
ing strategies.
Coping strate gy
Variable Social
support Problem-
Search for
social supportAvoidance
Socialization 0.37* 0.21 0.16 0.41*
Extroversion 0.23 0.32 0.19 0.15
Consciousness 0.23 0.33 0.11 0.13
Neuroticism 0.45** 0.24 0.15 0.25
Openness 0.16 0.19 0.10 0.01
Total social
support – 0.23 0.23 0.15
*Significant correlation at 0.05% (two-tailed test). **Significant correlation at
0.01% (two-tailed test).
The present study aimed at investigating the correlations
among coping, personality traits, and social support for burn
survivors. The results diverge from those obtained in the stud-
ies of Kazak, Reber and Snitzer (1998), Glynn, Christenlfeld
and Gerin (1999) and Zanini, Verolla-Moura and Queiroz
(2009), which indicated that social support is perceived in dif-
ferent ways by different groups of people, for instance between
men and women or between married and single people. It is
thought that this divergence occurred for two distinct reasons:
the fact that the sample studied may not have been large enough
for the differences to appear in relation to gender; or, as sug-
gested by studies such as by Patterson et al. (1993), the variable
that would most exert influence in the definition of the burn
survivor’s profile would not be gender, but personality charac-
teristics, which could be expressed by means of traits, percep-
tions and behavioral manifestations.
However, despite the fact that in this specific sample gender
Open Access 1061
did not have a recognized significance in the results found, this
is not always a neutral variable regarding burns. For that reason,
it is important to accentuate that some studies with qualitative
methodology, such as by Meyer et al. (2004), demonstrated that
the impact of the burn differs significantly between men and
women, for example, evidencing that women tend to present a
higher difficulty to deal with changes in physical appearance as
a result of a burn event, which eventually makes them present
more externalizing behavior problems than the male population.
Also, the results show that the socialization trait correlated
with a higher perception of social support and also with a small-
ler use of coping strategies of avoidance, establishing, therefore,
a significant correlation among the personality trait, the occur-
rence of social support and the choice of coping strategies.
There was also an inverse correlation between the neuroticism
trait and social support. The results are in accordance with
those from several studies that also found that the personality is
an important factor of influence on the selection and use of ap-
proach coping strategies (Endler & Parker, 1990; Kaiseler, Pol-
man & Nicholls, 2012). Similar findings were stated by Gilboa
et al. (1999), who postulated that the cognitive evaluation and
the response to the trauma are influenced by personality. It also
exerts substantial impact on coping and the subsequent post-
trauma adjustment of the individual. In other words, the find-
ings of this study indicate that, despite the Brazilian cultural
particularities, there is a similarity of results between this spe-
cific sample of the Brazilian population and those found in the
foreign literature.
Regarding the correlation between personality traits and so-
cial support, one can hypothesize that the occurrence of social
support would not depend solely on its emitter, as the receiver
would also have the power to elicit the response from the envi-
ronment and mobilize internal resources, which would, once
again, connect this capacity to personality traits (Gilboa et al.,
1999). Moreover, Cramer, Henderson and Scott (1997) evi-
denced that the existing difference between the social support
perceived and the social support received is due to the fact that
the first is recognized by the receiver as available in his envi-
ronment in case it is needed, while the second is the one that
effectively occurs in a concrete situation. Therefore, once more,
the perception of support is influenced by the personality of
whom it is received by, as, countless times, even being avail-
able, the support is not perceived as such by the potential re-
ceiver, due to his personality characteristics.
On the other hand, it is important to emphasize that signify-
cant correlations between social support and coping were not
found in this study, what contradicts most of the literature here
referenced, especially regarding that social support is a coping
resource. Considering the specificities of the sample, this find-
ing strengthens the hypothesis that cultural differences exert a
considerable influence on coping strategies, as well as in the
perception of social support. It also can be hypothesized that
this occurrence could be explained by the fact that, even bene-
fitting from the social support, the impact of the burn and its
consequences in the survivors’ lives are so devastating that they
would not manage to perceive the support as something that
would make it easier to cope with the situation, i.e., as a coping
resource, due to the magnitude of the trauma experienced.
However, it is important to emphasize that previous studies in
Brazil, developed with university students not afflicted by burn
injury did not detect a significant correlation between social
support and coping either (Queiroz, 2009) what can indicate
some cultural variance on the relation between social support
and coping. To clarify this hypothesis future studies are needed.
There has been a significant increase in the number of burn
survivors with the intense progress of medicine in the last 30
years. Faced with this new reality the treatment, which previ-
ously was restricted to saving the patient’s life, and which was
not always successful, had its spectrum widened to new object-
tives, needs and interests. The professionals dedicated to this
type of care started to deal with new issues, which, if on one
hand are not considered urgent in relation to survival, on the
other hand are essential when considering the course of the
treatment and the quality of life of these patients.
The aims of this paper result precisely from this new look
upon burn survivors following the evolution of treatments and
the optimization of the results obtained, and which are, there-
fore, deeply connected to the culture and the context they are
inserted. In that sense, researches such as this one have an im-
portant role, as the sooner the burn survivors’ particularities are
detected and diagnosed, the higher the chances of the interven-
tions to be appropriate and successful. Despite all the pro-
gresses obtained in the area, it must be highlighted that there is
a gap when treating the emotional aspects of the severe burn
survivors. It is appropriate to remember that burn survivors
experience a long recovery process and that hospital discharge
is just the beginning of a new stage, among the many that will
This paper had the purpose to contribute towards filling this
gap, viewing these patients in a perspective that goes beyond a
strictly medical point, aiming at comprising also the important
psychological aspects of burn survivors. The results of this re-
search confirmed the correlation among personality, social sup-
port and coping. Showing that for Brazilian severe burn survi-
vors having high scores of socialization is positively related
with perceiving more social support and negatively related to
avoidance coping. On the other hand, having high scores on
neuroticism is negatively associated with social support.
However, in this study, as in Richter, Lauritz, Preez, Cas-
simjee and Ghazinour (2013), only some personality traits are
related with coping strategies demonstrating that although per-
sonality influences some coping strategies there still some
amount of variability that cannot be explained by personality
traits and so they must be understood in the light of the envi-
ronment and stressful event influence.
The fact that the sample is small may have interfered in the
analysis and in the data generalization, as it consists of partici-
pants from a specific NGO in one city, which may not faithfully
depict the diversity of the Brazilian reality in relation to burn
survivors. It is important to note, however, that some of the
group members came from other cities and even from other
states for the monthly meetings. Therefore, it cannot be stated
that the participants of this sample were restricted exclusively
to the population of the county where the NGO is located. Nev-
ertheless, future studies with a longitudinal nature and with
larger samples can verify the reliability of the results currently
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