Social skills: a resource for more social support, lower depression levels, higher quality of life, and participation in individuals with spinal cord injury?

OBJECTIVE To examine the relevance of social skills and their different dimensions (ie, expressivity, sensitivity, control) in relation to social support, depression, participation, and quality of life (QOL) in individuals with spinal cord injury (SCI). DESIGN Cross-sectional data collection within the Swiss Spinal Cord Injury Cohort. SETTING Community-based. PARTICIPANTS Individuals with SCI (N=503). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Depression, participation, and QOL were measured using the Hospital Anxiety and Depression Scale, the Utrecht Scale for Evaluation of Rehabilitation-Participation, and 5 selected items of the World Health Organization Quality of Life Scale. The Social Skills Inventory and the Social Support Questionnaire were used to assess social skills (expressivity, sensitivity, control) and social support, respectively. RESULTS Structural equation modeling was conducted. In model 1 (χ(2)=27.81; df=19; P=.087; root mean square error of approximation=.033; 90% confidence interval=.000-.052), social skills as a latent variable was related to social support (β=.31; R(2)=.10), depression (β=-.31; total R(2)=.42), and QOL (β=.46; R(2)=.25). Social support partially mediated the effect of social skills on QOL (indirect effect: β=.04; P=.02) but not on depression or participation. In model 2 (χ(2)=27.96; df=19; P=.084; root mean square error of approximation=.031; 90% confidence interval=.000-.053), the social skills dimension expressivity showed a path coefficient of β=.20 to social support and β=.18 to QOL. Sensitivity showed a negative path coefficient to QOL (β=-.15) and control a path coefficient of β=-.15 to depression and β=.24 to QOL. CONCLUSIONS Social skills are a resource related to more social support, lower depression scores, and higher QOL.