Effects of Adult Romantic Attachment and Social Support on Resilience and Depression in Individuals with Spinal Cord Injuries

Abstract

Background:Spinal cord injury (SCI) can cause psychological consequences that negatively affect quality of life. It is increasingly recognized that factors such as resilience and social support may produce a buffering effect and are associated with improved health outcomes. However, the influence of adult attachment style on an individual's ability to utilize social support after SCI has not been examined. Objective: The purpose of this study was to examine relationships between adult romantic attachment, perceived social support, depression, and resilience in individuals with SCI. In addition, we evaluated potential mediating effects of social support and adult attachment on resilience and depression. Methods: Participants included 106 adults with SCI undergoing inpatient rehabilitation. Individuals completed measures of adult attachment (avoidance and anxiety), social support, resilience, and depression. Path analysis was performed to assess for presence of mediation effects. Results: When accounting for the smaller sample size, support was found for the model (comparative fit index = .927; chi square = 7.86, P = .01; β = -0.25, standard error [SE ] = -2.93, P < .05). The mediating effect of social support on the association between attachment avoidance and resilience was the only hypothesized mediating effect found to be significant (β = -0.25, SE = -2.93, P < .05). Conclusion: Results suggest that individuals with SCI with higher levels of attachment avoidance have lower perceived social support, which relates to lower perceived resilience. Assessing attachment patterns during inpatient rehabilitation may allow therapists to intervene to provide greater support.

Psychosocial factors affecting resilience in Nepalese individuals with earthquake-related spinal cord injury: a cross-sectional study

“…The total score can range from 0 to 27, where higher scores represent a higher depressive mood. The PHQ-9 has been standardized with sound psychometric properties [ 16 , 22 ] and Cronbach’s alpha was 0.87 in this study.…”

“…Previous studies revealed that self-efficacy, social support [ 13 , 19 ], and spirituality [ 11 , 20 , 21 ] enhanced resilience in persons with SCI, whereas depression/depressive mood [ 6 , 11 , 16 , 19 ], stress, anxiety, and internal locus of control [ 6 ] impeded resilience of those individuals. Previous findings regarding the influence of demographic and injury-related factors on resilience are still inconclusive [ 6 , 13 , 16 , 22 ]. Most of the aforementioned factors were also found to affect resilience in individuals surviving earthquakes or other disasters [ 17 , 18 , 23 ].…”

Who is the surgically resilient individual with traumatic spinal cord injury?

“…Some contributing variables included family relationships, social support, and resilience (16)(17)(18)(19)(20). Active coping strategies have been found to have a strong impact on individual variance in positive recovery outcomes in patients (20,21).…”

Determinants of resilience among people who sustained spinal cord injury from the 2015 earthquake in Nepal

“…4 Higher resilience is consistently associated with strong self-efficacy, greater perceived social support and stable mood. 4, 5,9 Resilience can vary among individuals based on the presence of different factors. 10,11 Personal demographic and injury-related factors were found to be associated with resilience among individuals with SCI 12,13 and survivors of earthquake.…”

“…12,13 Nevertheless, some studies reported a non-significant association between resilience and demographic and injury-related factors. 4,5,9,12,16 Hence, there are inconclusive findings on the demographic and injury-related variables contributing to resilience. Resilience is dynamic in nature; therefore, a cross-sectional study might not represent a holistic picture.…”