Companionship as a mediator of the relationship between marital status and psychosocial outcomes: Findings in individuals with spinal cord injury.

Abstract

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. Cross-sectional self-report study. Medical University in the Southeastern United States (US). Participants (n = 1810) were identified from one of two sources including a specialty hospital and a state-based surveillance system in the Southeastern US. Participants were a minimum of 18 years old at enrollment with traumatic SCI. Participants were on average 55.9 years old at the time of the study and an average of 22.2 years post SCI onset. Not applicable. Participants completed a self-report assessment that included the PROMIS Companionship scale, marital status (married, not married), PHQ-9 to measure depressive symptom severity, GAD-7 to measure anxiety symptoms, and three life satisfaction outcomes: sex life satisfaction, home life satisfaction, and overall quality of life (QOL). 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 QOL. 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.