The Personal Importance of Being Independent: Associations with Changes in Disability and Depressive Symptoms

Rehabil Psychol, 2014 · DOI: 10.1037/a0034438 · Published: February 1, 2014

Spinal Cord Injury Mental Health Disability

Simple Explanation

This study explores how important independence is to people with spinal cord injuries (SCI) and how it affects their mental health as their physical abilities change. It looks at how changes in their ability to do daily tasks relate to feelings of depression. The research also investigates whether valuing independence highly makes people more prone to depression, especially when their physical limitations increase. The study found that for those who highly value independence, increases in disability led to more depressive symptoms, while improvements in ability led to fewer symptoms. Those who didn't value independence as much were less affected by these changes.

Study Duration

12-month follow-up

Participants

173 SCI survivors

Evidence Level

Not specified

Key Findings

1
Increased disability was related to increased depressive symptoms, particularly in the control group.
2
Higher independence centrality was associated with more depressive symptoms at baseline.
3
SCI survivors with high independence centrality experienced more depressive symptoms when disability increased but fewer when it decreased; those low in independence centrality were less affected.

Research Summary

The study investigated the relationship between changes in disability, independence centrality, and depressive symptoms in SCI survivors. It found that increased disability was associated with increased depressive symptoms, and higher independence centrality was linked to greater depressive symptoms at the start of the study. The study also revealed that independence centrality moderates the impact of changes in disability on depressive symptoms, with those highly valuing independence being more sensitive to changes in their functional status.

Practical Implications

Clinical Interventions

Caregivers should help maximize the autonomy of individuals with SCI while balancing primary control-striving with secondary control strategies.

Psychological Support

Interventions should consider individual differences in the desire for functional independence when assisting persons with SCI and their families.

Life Course Development

Successful aging and coping with disability require shifting from primary to secondary control strategies when goals are no longer attainable.

Study Limitations

1
The study's 12-month follow-up may be too short to capture substantial changes in disability.
2
The changes in disability found in the study may not be clinically meaningful.
3
The intervention designed to improve caregiver well-being may have confounded the results.

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