title: The buffering effect of resilience on depression among individuals with spinal cord injury: a structural equation model.
abstract: OBJECTIVE
  To translate the theoretical constructs from a model of resilience into a structural equation model and evaluate relationships among the model's theoretical constructs associated with resilience and the occurrence of depressive symptoms.
  
  
  METHODS
  Quantitative descriptive research design using structural equation modeling (SEM).
  
  
  METHODS
  Two-hundred and fifty-five individuals with SCI recruited from the Canadian Paraplegic Association (CPA).
  
  
  METHODS
  Outcome was measured by the Center for Epidemiologic Studies-Depression Scale.
  
  
  RESULTS
  The resilience model fit the data relatively well: χ² (200, N = 255) = 451.57, p < .001; χ²/df = 2.26; CFI = .92, RMSEA = 0.070 (90% CI: 0.062-0.079), explaining 77% of the variance in depressive symptomatology. Severity of SCI-related stressors significantly influenced perceived stress (β = .60) and perceived stress, in turn, affected depressive symptoms (β = .66), characteristics of resilience (β = -.43), and social support (β = -.26). The resilience characteristics had an inverse relationship with depressive symptoms (β = -.29). No direct relationship was found between severity of SCI-related stressors and depressive symptoms.
  
  
  CONCLUSIONS
  Findings provide support for the resilience model and suggests characteristics of resilience "buffer" the perceptions of stress on depressive symptoms. The resilience model may be useful to guide clinical interventions designed to improve the mental health of individuals with SCI.
authors.affiliation: Department of Rehabilitation, Social Work and Addictions, University of North Texas, Denton, TX 76203, USA. Denise.Catalano@unt.edu
authors.forename: Denise
authors.initials: D
authors.lastname: Catalano
authors.forename: Fong
authors.initials: F
authors.lastname: Chan
authors.forename: Lisa
authors.initials: L
authors.lastname: Wilson
authors.forename: Chung-Yi
authors.initials: CY
authors.lastname: Chiu
authors.forename: Veronica R
authors.initials: VR
authors.lastname: Muller
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000517:prevention & control*; D003866:Depressive Disorder / Q000453:epidemiology / Q000517:prevention & control*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D055500:Resilience, Psychological; D012944:Social Support; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*