title: 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychology, University of North Texas, Denton, Texas.
authors.forename: Zane
authors.initials: Z
authors.lastname: Dodd
authors.affiliation: Physical Medicine and Rehabilitation, Baylor Institute for Rehabilitation, Dallas, Texas.
authors.forename: Simon
authors.initials: S
authors.lastname: Driver
authors.affiliation: Division of Trauma, Acute Care and Critical Care Surgery, Baylor University Medical Center, Dallas, Texas.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Warren
authors.affiliation: Department of Psychology, University of North Texas, Denton, Texas.
authors.forename: Shelley
authors.initials: S
authors.lastname: Riggs
authors.affiliation: Center for Social Research, University of Notre Dame, Notre Dame, Indiana.
authors.forename: Mike
authors.initials: M
authors.lastname: Clark
mesh_terms: D000328:Adult; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D008149:Love; D008297:Male; D055500:Resilience, Psychological; D012944:Social Support; D013119:Spinal Cord Injuries / Q000523:psychology* / Q000534:rehabilitation
keywords: adult attachment; depression; inpatient rehabilitation; resilience; social support; spinal cord injury