Identifying depression severity risk factors in persons with traumatic spinal cord injury

Ryan T. Williams*, Catherine S Wilson, Allen W. Heinemann, Linda E. Lazowski, Jesse R. Fann, Charles H. Bombardier

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Purpose/Objective: Examine the relationship between demographic characteristics, health-, and injuryrelated characteristics, and substance misuse across multiple levels of depression severity. Research Method/Design: 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. Results: 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Conclusions/Implications: Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics.

Original languageEnglish (US)
Pages (from-to)50-56
Number of pages7
JournalRehabilitation Psychology
Issue number1
StatePublished - Feb 2014


  • Major depressive disorder
  • PHQ-9
  • Screening
  • Spinal cord injury, rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Identifying depression severity risk factors in persons with traumatic spinal cord injury'. Together they form a unique fingerprint.

Cite this