Measuring psychological outcomes following rehabilitation

Recent literature leaves little doubt that people with disabilities experience depressive and adjustment disorders at a greater rate that those in the general population. Differences between rates detected in different studies, however, prompt researchers to explore the definition of depression as applied to people with a disability, and to challenge the long-held notions that everyone with a disability undergoes depression at one time or another as part of the process of adjustment to disability. The present study measures the two related, but theoretically distinct, constructs of depression and adjustment to disability in a sample of spinal cord injured adults interviewed at one, four and twelve months post-rehabilitation. On the basis of these data, a two-dimensional measurement model is empirically developed for psychological outcomes, with the two dimensions representing adjustment and depression. The measurement model is supported by data at all three time intervals and by a number of different analyses. These findings underline the importance of distinguishing between depression and adjustment both in clinical applications and in research.