title: Vitality and mental health in disability: Associations with social relationships in persons with spinal cord injury and their partners.
abstract: Various social relationship constructs have been proposed to affect mental health. However, these constructs have rarely been studied in a comprehensive way in persons with chronic disabilities and their partners, inhibiting researchers from evaluating their relative importance.
  
  
  
  To investigate 1) the variation in the quantity and quality of social relationships in persons with spinal cord injury (SCI) and their partners; 2) dyadic coherence within social relationship constructs; 3) the interrelationships between social relationship constructs; and 4) the associations of social relationship constructs with vitality and mental health.
  
  
  
  Cross-sectional survey data from 133 couples of persons with SCI and their partners was used. Quantitative (social networks) and qualitative aspects (social support, relationship quality, loneliness, and reciprocity in partnerships) of social relationships were assessed. Correlations were performed to analyse dyadic coherence and interrelationships of social relationship constructs and multivariable regressions were applied to examine associations with vitality and mental health.
  
  
  
  Loneliness, larger social networks and higher relationship quality were more prevalent in SCI. All social relationship constructs, apart from loneliness, were more similar within couples than between couples and the interrelationships between different constructs were small. Qualitative aspects of relationships were more important than the quantitative aspects in their associations to vitality and mental health. These associations were most consistent for loneliness, reciprocity and relationship quality in both groups.
  
  
  
  In the long-term management of community functioning in persons with SCI and their partners, the fostering of high quality intimate relationships should take priority.
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland. Electronic address: hannah.tough@paraplegie.ch.
authors.forename: Hannah
authors.initials: H
authors.lastname: Tough
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Fekete
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Martin W G
authors.initials: MWG
authors.lastname: Brinkhof
authors.affiliation: Senior Professorship 'Work Stress Research', Faculty of Medicine, University of Düsseldorf, Life-Science-Center, Düsseldorf, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Siegrist
mesh_terms: D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008132:Loneliness; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D012111:Residence Characteristics; D012944:Social Support; D013119:Spinal Cord Injuries
keywords: Loneliness; Mental health; Social relationships; Spinal cord injury; Vitality