Companionship as a Mediator of the Relationship Between Marital Status and Psychosocial Outcomes: Findings in Individuals With Spinal Cord Injury.

OBJECTIVE

To test a mediational model where companionship mediates the relationship between marital status and psychosocial outcomes among participants with spinal cord injuries (SCI), controlling for demographic, injury, and socioeconomic characteristics.

DESIGN

Cross-sectional self-report study.

SETTING

Medical University in the Southeastern United States.

PARTICIPANTS

Participants (n=1810) were identified from one of 2 sources, including a specialty hospital and a state-based surveillance system in the Southeastern United States. Participants were at least 18 years old at enrollment with traumatic SCI. Participants were, on average, 55.9 years old at the time of the study and had an average of 22.2 years post-SCI onset.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Participants completed a self-report assessment that included the PROMIS Companionship scale, marital status (married, not married), Patient Health Questionnaire-9 to measure depressive symptom severity, Generalized Anxiety Disorder-7 to measure anxiety symptoms, and 3 life satisfaction outcomes: sex life satisfaction, home life satisfaction, and overall quality of life.

RESULTS

Companionship partially mediated the relationship between marital status, depression, and anxiety, and completely mediated the relationships between marital status and life satisfaction outcomes. Higher levels of companionship were associated with reduced depression scores and anxiety levels and increased satisfaction with sex life, home life, and overall quality of life.

CONCLUSIONS

Perceived companionship mediates the relationship between marriage and various psychosocial outcomes. Intervention strategies that improve relationship quality may be critical for maintaining mental health and social well-being following SCI.