Marital Status, Marital Transitions, Well-Being and Spinal Cord Injury: An Examination of the Effects of Sex and Time

Arch Phys Med Rehabil, 2011 · DOI: 10.1016/j.apmr.2010.07.239 · Published: March 1, 2011

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This study examines how marriage and marital changes affect the well-being of individuals with spinal cord injuries (SCI). It investigates whether marriage provides benefits (marital resource model) or if marital dissolution leads to poorer well-being (marital crisis model). The study looks at how gender, marital status (single, married, divorced/separated, widowed), and marital transitions (becoming married, divorced, or widowed) influence life satisfaction, depressive symptoms, and self-perceived health. The findings suggest that marital loss, particularly through separation/divorce or widowhood, has the most significant negative impact on well-being. Becoming married only showed an advantage for lower depression over time.

Study Duration

One year through 15 years post-injury

Participants

4,864 men and 1,277 women who sustained traumatic SCI

Evidence Level

Prospective cohort from the SCI Model Systems National Database

Key Findings

1
Marital loss through separation/divorce or widowhood had the most consistent negative impact on well-being outcomes.
2
Being or becoming married only had an advantage for lower depression symptomatology over time.
3
Widowed women experienced greater depressive symptoms than widowed men, and a decline in self-perceived health across time, while self-perceived health remained relatively stable for widowers.

Research Summary

The study examined the applicability of the marital resource or marital crisis models to the SCI population by studying the effects of gender, marital status and marital transitions on well-being. Results supported the marital crisis model, indicating that marital loss through separation/divorce or widowhood had the most consistent and negative impact across well-being outcomes. The study found that women and men can experience the effects of marital dissolution differently, and that not all marital losses result in compromised well-being, nor does marriage necessarily enhance it.

Practical Implications

Clinical intervention

Healthcare providers should be aware of the potential negative impact of marital dissolution on the well-being of individuals with SCI, particularly for women who become widowed.

Support services

Targeted support services may be beneficial for individuals with SCI experiencing marital loss, to help them cope with the emotional and social challenges associated with these transitions.

Further research

Future research should explore the complex dynamics of marital status and transitions in the SCI population, including the role of social engagement, relationship quality, and other factors that may influence well-being.

Study Limitations

1
The estimates of predictors were small.
2
Participants are not fully representative of the population of persons with SCI.
3
Many factors that impact well being and interact with marital status and marital transitions are not included in these data.

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