All ETDs from UAB

Advisory Committee Chair

Fred J Biasini

Advisory Committee Members

Sylvie Mrug

Beverly A Mulvihill

Sharina D Person

Jan L Wallander

Document Type

Dissertation

Date of Award

2007

Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences

Abstract

Adolescents with mobility limitations may be at increased risk of certain adverse outcomes because of unique or exacerbated pre-existing challenges. The current study examined the relationships among mobility limitations, depressive symptomatology, and suicidal behaviors. Moreover, it was examined if pain and perceived social support mod-erated the relationships between severity of mobility limitations and the three outcome variables, and whether depressive symptomatology mediated the relationships between mobility limitations and suicidal behaviors. Secondary analyses of the AddHealth data set were performed. The sample was 49.18% female, 16.02% African-American, 65.46% Caucasian, 12.20% Hispanic, and 6.33% coded as Other. The mean age was 15.96 (SE = 0.11). In all, 4.35% reported mobility limitations; 22.49% had scores indicative of de-pressive symptomatology, 12.91% indicated suicidal ideation, and 3.62% had attempted suicide in the past year. Adolescents with mobility limitations were significantly more likely to be in the depressive symptomatology (OR = 1.64, 95% CI = 1.15-2.35), suicidal ideation (OR = 1.91, 95% CI = 1.35-2.72), and suicide attempt (OR = 2.53, 95% CI = 1.45-4.40) groups compared to adolescents without mobility limitations after controlling for age, gender, race, family income, and community residence. Severity of mobility limitations was not significantly associated with any of the three outcome variables. Pain was significantly associated with depressive symptomatology with an R2 change = 0.11, B = 1.29 (95% CI = 1.16-1.41), Wald F (1, 131) = 402.83, p < .0001. Adding perceived ii social support in the next step resulted in an R2 = 0.27 (Wald F (16, 131) = 783.04, p < .0001). Perceived social support was significantly associated with depressive symptoma-tology with an R2 change = 0.10, B = -0.70 (95% CI = -0.78 to -0.61), Wald F (1, 131) = 276.86, p < .0001. However, pain and perceived social support did not significantly mod-erate the relationships between severity of mobility limitations and depressive symptoma-tology and suicidal behaviors. Depressive symptomatology partially mediated the rela-tionships between mobility limitations and suicidal ideation and suicide attempt (12-14% respectively). Based on these results, experiencing mobility limitations in adolescence should be considered a potential risk factor for depressive symptomatology and suicidal behaviors.

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