Depression and subjective well-being among 97 American Indians with spinalcord injury: A descriptive study

Objective: To measure both clinical and nonclinical aspects of depression a nd subjective welt-being (SWB) among a sample of American Indians with spin al cord injury (SCI) and to identify factors associated with depression and SWB. Study Designs Interviews were conducted by telephone with all partici pants except those who did not have telephones (who returned materials by m ail). Setting: A large rehabilitation hospital in the western-Rocky Mountai n region of the United States. Participants: Ninety-seven American Indians with SCI completed a health-related interview that included measures of dep ression and SWB. All participants were adults with traumatic SCI of at leas t 1 year in duration, most of whom lived on reservations. Main Outcome Meas ures: Measures of biographic and injury status, depression, SWB, activities , and health-related behaviors. Results: The American Indian sample reporte d elevated levels of depression and diminished SWB in 5 of 8 areas relative to previous studies on non-American Indians with SCI. Hierarchical multipl e regression accounted for 59% of the variance in depression scores and bet ween 10% and 52% of the variance in SWB scales. Health status, activity pat terns, social support, years of education, and frequency of alcohol use wer e among the primary predictors of the study outcomes. Conclusions: The resu lts suggest that American Indians with SCI experience diminished SWB relati ve to other SCI populations and that interventions are needed to reduce alc ohol misuse, to help build support networks, and to increase participation in social activities.