The Buffering Effect of Resilience on Depression Among Individuals With Spinal Cord Injury: A Structural Equation Model

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. Design: Quantitative descriptive research design using structural equation modeling (SEM). Participants: Two-hundred and fifty-five individuals with SCI recruited from the Canadian Paraplegic Association (CPA). Outcome Measures: Outcome was measured by the Center for Epidemiologic Studies-Depression Scale. Results: The resilience model fit the data relatively well: χ ² (200, N = 255) = 451.57, p < .001; χ ²/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.