Adaptation to stroke using a model of successful aging

The process of adaptation to the physical and psychosocial consequences after stroke is a major challenge for many individuals affected. The aim of this study was to examine if stroke patients within 1 month of admission (n = 153) and followed up at 1 year (n = 107) engage in selection, optimization, and compensation (SOC) adaptive strategies and the relationship of these strategies with functional ability, health-related quality of life (HRQOL) and depression 1 year later. Adaptive strategies were measured using a 15-item SOC questionnaire. Internal and external resources were assessed including recovery locus of control, stroke severity, and socio-demographics. Outcome measures were the Stroke Specific Quality of Life Questionnaire (SS-QoL), the Nottingham Extended Activities of Daily Living Scale and the Depression Subscale of the Hospital Anxiety and Depression Scale. Findings indicated that stroke patients engaged in the use of SOC strategies but the use of these strategies were not predictive of HRQOL, functional ability or depression 1 year after stroke. The use of SOC strategies were not age specific and were consistent over time, with the exception of the compensation subscale. Results indicate that SOC strategies may potentially be used in response to loss regulation after stroke and that an individual's initial HRQOL functional ability, levels of depression and socio-economic status that are important factors in determining outcome 1 year after stroke. A stroke-specific measure of SOC may be warranted in order to detect significant differences in determining outcomes for a stroke population.     

Depression,Positive and Negative Affect,Optimism and Health-Related Quality of Life in Recently Diagnosed Multiple Sclerosis Patients: The Role of Identity,Sense of Coherence,and Self-efficacy

The study aimed to describe the levels of depression, positive and negative affect, optimism and health-related quality of life (HRQOL) in a group of recently diagnosed multiple sclerosis (MS) patients (up to 3 years since the diagnosis), taking into account gender, age, and disease duration differences, and to investigate the possible role of identity, sense of coherence (SOC), and self-efficacy in MS (SEMS) on patients’ depression, positive and negative affect, optimism, and HRQOL. The cross-sectional study involved 90 MS patients (61% women; age: M = 37, SD = 12) with an Expanded Disability Status Scale score between 1 and 4 (mild to moderate disability). Patients completed measures of depression (CESD-10), positive and negative affect (PANAS), optimism (LOT-R), HRQOL (SF-12), identity motives, SOC, and SEMS. Depression scores were near the cut-off level for clinically significant depressive symptoms, and negative affect was higher and HRQOL was lower than those in the general population. Women and younger patients reported better adjustment as time passes since the diagnosis. Results of multiple regressions indicated that higher SOC was related to higher mental health, lower negative affect and lower depression. Higher SEMS was predictive of greater positive affect and lower negative affect, whereas higher identity satisfaction was predictive of higher positive affect and optimism and lower depression. The results suggest the usefulness of addressing identity redefinition, SOC and self-efficacy in psychological interventions aimed at promoting patients’ adjustment to MS.     

Long-term adherence to a physical activity intervention: The role of telephone-assisted vs. self-administered coping plans and strategy use

Objective: This study investigated the role of coping plans and the use of selection, optimisation and compensation (SOC) strategies within an experimental evaluation of a 26-week physical exercise intervention.

Methods: Older women (N?=?86, M _age?=?73.7 years) were randomly assigned to a telephone-assisted or a self-administered coping planning intervention after 6 weeks’ participation in an exercise programme. The number of different coping plans formulated, exercise-specific SOC strategy use and their interaction were used to predict objectively measured long-term adherence to the intervention.

Results: The number of coping plans formulated (β?=?0.28) and goal-pursuit strategies reported (sum score of optimisation and compensation strategies, β?=?0.39) predicted adherence to the exercise programme over 20 weeks. The predictive strength of coping plans increased with decreasing numbers of goal-pursuit strategies (β?=??0.21). Women supported via telephone reported significantly more coping plans than did women in the self-administered coping planning group, F(1,80)?=?9.47, p?=?0.003.

Conclusion: Coping plans have a buffering effect on adherence levels when use of SOC strategies is low. Older women's adherence to physical activities may be improved if they are given direct support in generating coping plans involving strategies of selection, optimisation and compensation.     

Cognitive and Behavioral Contributions to Depression Severity,Quality of Life,and Functioning Among People Living With HIV in South Africa

Cognitive-behavioral treatments for depression typically address both behavioral (e.g., activation) and cognitive (e.g., rumination) components, and consequently improve quality of life (QOL) and function in high-resource settings. However, little is known about the cross-cultural applicability and relative contribution of these components to depression symptom severity, QOL, and functional impairment in South Africa and other resource-limited global settings with high HIV prevalence rates.Persons with HIV (N = 274) from a peri-urban community outside Cape Town, South Africa, were administered multiple measures of depression (Hamilton Depression Scale, Centre for Epidemiological Studies Depression Scale, South African Depression Scale), cognitive and behavioral components related to depression (Ruminative Response Scale, Behavioral Activation for Depression Scale), and measures of QOL and functioning (Sheehan Disability Scale, Quality of Life Enjoyment and Satisfaction Scale—Short Form). Multiple linear regression models were fit to assess the relative contribution of behavioral and cognitive components to depression severity, QOL, and functional impairment in this population.Models accounting for age and sex revealed that lower levels of behavioral activation (BA) were significantly associated with all measures of depression, as well as with QOL and functional impairment (all ps < .01). Rumination was associated with all measures of depression (all ps < .01), but not with QOL or functional impairment.The consistent and unique association of BA with depression, QOL, and functional impairment bolsters its importance as a treatment target for this population.     

Selection,optimization, and compensation strategies: Interactive effects on daily work engagement

The theory of selective optimization with compensation (SOC) proposes that the “orchestrated” use of three distinct action regulation strategies (selection, optimization, and compensation) leads to positive employee outcomes. Previous research examined overall scores and additive models (i.e., main effects) of SOC strategies instead of interaction models in which SOC strategies mutually enhance each other's effects. Thus, a central assumption of SOC theory remains untested. In addition, most research on SOC strategies has been cross-sectional, assuming that employees' use of SOC strategies is stable over time. We conducted a quantitative diary study across nine work days (N = 77; 514 daily entries) to investigate interactive effects of daily SOC strategies on daily work engagement. Results showed that optimization and compensation, but not selection, had positive main effects on work engagement. Moreover, a significant three-way interaction effect indicated that the relationship between selection and work engagement was positive only when both optimization and compensation were high, whereas the relationship was negative when optimization was low and compensation was high. We discuss implications for future research and practice regarding the use of SOC strategies at work.     

The use of selection,optimization, and compensation (SOC) in goal pursuit in the daily lives of middle-aged adults

The current study investigated the use of selection, optimization, and compensation (SOC) in association with momentary goal conflict and facilitation in middle adulthood. In contrast to previous studies on SOC that focused on the habitual use of the SOC-strategies, the current study investigated the momentary SOC-use in the everyday lives of adults who face the developmental challenge of combining the demands of multiple life domains (e.g., work, family, leisure). In a sample of N = 89 employed middle-age adults, momentary SOC-use as well as momentary goal conflict and facilitation were assessed in a measurement burst design encompassing 20 days (M = 126 measurement points per person). Time-lagged analyses showed that momentary goal conflict was positively related to subsequent optimization and compensation, and momentary goal facilitation lead to lower subsequent loss-based selection and compensation. In contrast, SOC predicted neither subsequent goal conflict nor facilitation. Thus, the use of SOC-strategies seems to be a response to – rather than an antecedent of - currently experienced goal relations (conflict, facilitation), underscoring the importance of these strategies for managing multiple goals.     

Planning bridges the intention–behaviour gap: Age makes a difference and strategy use explains why

Objective: This study examines age-differential association patterns between intentions, planning and physical activity in young and middle-aged individuals. The effectiveness of planning to bridge the intention–behaviour gap is assumed to increase with advancing age. We explore the use of behaviour change strategies that include selection, optimisation and compensation (SOC) as underlying mechanisms for age differences. Methods: In N = 265 employees of a national railway company (aged 19–64 years), intentions, planning, SOC strategy use and physical activity were assessed at baseline (Time 1) and again 1 month later (Time 2). Hypotheses were tested in two different path models. Results: Age moderates the extent to which planning mediates the intention–behaviour relation due to an increasing strength of the planning–behaviour link. As a possible psychological mechanism for these age differences, we identified SOC strategy use as a mediator of the age by planning interaction effect on physical activity. Conclusion: These findings suggest differential mechanisms in behaviour regulation in young and middle-aged individuals.     

The compensation and capitalization models: A test of two approaches to individualizing the treatment of depression

Despite long-standing calls for the individualization of treatments for depression, modest progress has been made in this effort. The primary objective of this study was to test two competing approaches to personalizing cognitive-behavioral treatment of depression (viz., capitalization and compensation). Thirty-four adults meeting criteria for Major Depressive Disorder (59% female, 85% Caucasian) were randomized to 16-weeks of cognitive-behavioral treatment in which strategies used were selected based on either the capitalization approach (treatment matched to relative strengths) or the compensation approach (treatment matched to relative deficits). Outcome was assessed with a composite measure of both self-report (i.e., Beck Depression Inventory) and observer-rated (i.e., Hamilton Rating Scale for Depression) depressive symptoms. Hierarchical linear modeling revealed a significant treatment approach by time interaction indicating a faster rate of symptom change for the capitalization approach compared to the compensation approach (d = .69, p = .03). Personalizing treatment to patients' relative strengths led to better outcome than treatment personalized to patients' relative deficits. If replicated, these findings would suggest a significant change in thinking about how therapists might best adapt cognitive-behavioral interventions for depression for particular patients.     

压力事件对初中生抑郁的影响:网络使用动机与网络使用强度的作用

为探讨压力事件对初中生抑郁的影响以及网络使用动机和网络使用强度在其中的作用,采用生活事件量表,网络使用动机量表,网络使用强度量表和流调中心用抑郁量表对武汉市内两所中学的913名初中生进行调查。结果发现：（1）压力事件与网络使用动机、网络使用强度和抑郁均呈显著正相关; （2）压力事件正向预测网络使用动机与网络使用强度,网络使用动机正向预测网络使用强度,网络使用强度正向预测抑郁; （3）网络使用动机中,社会补偿动机正向预测抑郁,而好友联系动机与休闲娱乐动机负向预测抑郁; （4）压力事件通过网络使用动机和网络使用强度的链式中介作用影响抑郁。研究结果强调压力事件不仅可以直接影响初中生抑郁,还可以通过网络使用动机和网络使用强度间接影响初中生抑郁。     

Measurement of depression: Comparison between self-reports and clinical assessments of depressed outpatients

Agreement among several depression scales was investigated as regard the relative influences of administration mode (self-rating or clinical rating) and scale content. The Beck Depression Inventory (BDI), the Self-Rating Depression Scale (SDS), the Hamilton Rating Scale for Depression (HRSD), and three corresponding scales with identical structure and content but the alternative administration mode were administered to 47 outpatients with diagnoses of DSM-III major depression disorders. Correlations between the total scores and the degrees of association between corresponding items of different scales were calculated. The results suggest that differences in content contribute more to inter-scale discrepancy than differences in administration mode. The implications for the evaluation of outpatients with major depression are discussed.     

Relationships between the Beck Depression Inventory and the Hamilton Psychiatric Rating Scale for Depression in depressed outpatients

The Beck Depression Inventory (BDI) and the Hamilton Psychiatric Rating Scale for Depression (HRSD) were used with 300 outpatients diagnosed with DSM-III major depression disorders. A principal-components analysis was performed on the intercorrelations among the 21 BDI and 24 HRSD symptoms. Three orthogonal components were found and interpreted as reflecting differences in self-report and clinical rating methods for measuring the severity of depression. The importance of using both self-reports and clinical ratings for evaluating depression in psychiatric outpatients was discussed.     

An investigation of the effects of comorbid Axis II pathology on outcome of inpatient treatment for unipolar depression

DSM-based research on comorbidity has suggested thatdepression andpersonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depression. The present study was designed to explore the effect of comorbid Axis II pathology for a sample of 45 inpatients who received treatment for major depression. Both categorical and dimensional ratings of personality disorder were used in the statistical analysis. Positive categorical diagnosis of Cluster C (anxious-avoidant) disorder, as well as higher dimensional rating of Cluster A (odd-eccentric) pathology, was predictive of a poor response to treatment (p<.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depression Rating Scale. These results were construed as indicative of a significant Axis II comorbidity effect in the context of an inpatient, multimodal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.     

The Yale-Brown Obsessive-Compulsive Scale: Confirmatory Factor Analytic Findings

The psychometric properties of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have recently been heavily examined. Specifically, a number of researchers have been interested in determining the factor structure of this scale to find whether it best forms a one, two, or three factor model. The present study continued this examination by considering different scaling models using confirmatory factor analysis with a sample of individuals diagnosed with Obsessive-Compulsive Disorder (OCD). One hundred and forty-six individuals diagnosed with OCD participated and were administered the Y-BOCS and scales measuring depression (Hamilton Depression Rating Scale) and anxiety (Hamilton Anxiety Rating Scale). It was found that the Y-BOCS forms two different two-factor models. One model consisted of an obsessions and compulsions factor; the other composed of disturbance and symptom severity factors. It was likewise found that depression and anxiety were related to both factors in one model (disturbance and symptom severity). The finding that depression was related to obsessions and anxiety to compulsions was found, as in a previous factor analysis of the Y-BOCS. These findings suggest that OCD may be best characterized as a multidimensional syndrome that may not be adequately examined by a single unitary factor as described in the Y-BOCS.     

Religiosity and its association with subjective well-being and depression among Kuwaiti and Palestinian Muslim children and adolescents

The present study sought to investigate the association of religiosity and the self-ratings of happiness, satisfaction with life, mental health, physical health, and depression among Kuwaiti (N?=?1937) and Palestinian (N?=?1009) Muslim children and adolescents (M _age?=?14.1, SD?=?1.4). They responded to five self-rating scales and the Multidimensional Child and Adolescent Depression Scale. It was found that Palestinian males were significantly less religious than all other groups, while Kuwaiti males and females had significantly higher mean scores on happiness and satisfaction than Palestinians. Kuwaiti males had significantly higher mental health and less depression than all other groups. Among all the four groups, the correlations between religiosity and well-being rating scales were positively significant, but negatively significant with depression. The principal components analysis yielded a single salient factor for all groups and labelled “Religiosity and well-being vs. depression.” It was concluded that clinicians treating depression will probably make use of its negative association with religiosity mainly among Muslim clients.     

The depression proneness rating scale: Reliability, validity, and factor structure

This study describes the development of the Depression Proneness Rating Scale (DPRS), a brief, self-administered measure of the tendency to experience frequent, long-lasting, and severe depressions, and three investigations into the scale’s reliability, validity, and factor structure. Study 1, using 100 university students, found a stability coefficient of .82 for the DPRS over a test-retest interval of nine weeks. Further, Time 1 (T1) DPRS scores predicted Time 2 (T2) symptoms of depression, even after adjusting for Time 1 symptoms (R² Change=.03). Study 2, using 440 university students, found the DPRS to be a better predictor of past depressive episodes (r=.41 to .47) than was the Beck Depression Inventory (r=.32). Study 3, using 1101 university students, found that all 13 items of the DPRS loaded .40 or greater on a single factor for both males and females. Overall, results provide substantial evidence for the DPRS as a valid, unidimensional, and practical measure of depression proneness.     

The depression proneness rating scale: Reliability,validity, and factor structure

This study describes the development of the Depression Proneness Rating Scale (DPRS), a brief, self-administered measure of the tendency to experience frequent, long-lasting, and severe depressions, and three investigations into the scale’s reliability, validity, and factor structure. Study 1, using 100 university students, found a stability coefficient of .82 for the DPRS over a test-retest interval of nine weeks. Further, Time 1 (T1) DPRS scores predicted Time 2 (T2) symptoms of depression, even after adjusting for Time 1 symptoms (R² Change=.03). Study 2, using 440 university students, found the DPRS to be a better predictor of past depressive episodes (r=.41 to .47) than was the Beck Depression Inventory (r=.32). Study 3, using 1101 university students, found that all 13 items of the DPRS loaded .40 or greater on a single factor for both males and females. Overall, results provide substantial evidence for the DPRS as a valid, unidimensional, and practical measure of depression proneness.     

Illness representations,coping and psychological adjustment to Parkinson's disease

The present study reports an application of the common sense model (CSM) of illness representations to the prediction of psychological distress in people with Parkinson's disease (PD). The study sought to (i) examine cross-sectional and prospective associations between illness representations, coping and psychological distress, and (ii) test the hypothesis that coping would mediate any relationships between illness representations and psychological distress. Patients with PD (n = 58) completed the Illness Perception Questionnaire-Revised, the Medical Coping Modes Questionnaire and the Hospital Anxiety and Depression Scale. Patients (n = 57) were followed-up at 6 months. Illness representations explained large amounts of variance in time 1 anxiety (R ² = 0.42) and depression (R ² = 0.44) as well as additional variance in time 2 anxiety (ΔR ² = 0.12) and depression (ΔR ² = 0.09) after controlling for baseline scores. In addition, avoidance mediated the effect of emotional representations on time 1 anxiety, and acceptance-resignation mediated the effects of both consequences and emotional representations on time 1 depression. The present study therefore provides partial support for the mediational model outlined in the CSM, as significant mediation effects were found only in the cross-sectional analyses.     

Predictors of suicidal thoughts: Mood instability versus neuroticism

The personality trait neuroticism predicts depression and suicidal thoughts. Neuroticism is also linked to mood instability (MI)¹ that is common in patients with depression. This study investigated (a) whether MI predicts suicidal thoughts in depressed patients and (b) the relationship of MI to neuroticism. All 129 patients with Major Depression (MINI interview) were assessed on MI (Affective Lability Scale), neuroticism (Short Eysenck Neuroticism Scale), depression (Beck Depression Inventory), and suicidal thoughts (Beck Scale for Suicidal Ideation). Participants also completed the Perceived Stress Scale, Mood Disorder Questionnaire and five clinical questions on MI. Factor analysis of the Eysenck Neuroticism Scale revealed unstable moods as one of three main factors. Only depression severity and MI predicted suicidal thoughts once other variables including neuroticism were controlled. Mediation analyses showed that MI mediated the relationship between neuroticism and suicidal thoughts. These results suggest that MI as measured by the Affective Lability Scale typifies the type of depression that predicts suicidal thoughts and that MI may be more directly associated with suicidal thoughts than neuroticism. This demonstrates the clinical value of assessing MI rather than neuroticism in the treatment of patients with depression with suicidal thoughts.     

Socioeconomic and sociocultural determinants of psychological distress and quality of life among patients with psoriasis in a selected multi-ethnic Malaysian population

Patients with psoriasis may have increased risk of psychological comorbidities. This cross-sectional study aimed at determining associations between sociocultural and socioeconomic factors with the Depression Anxiety Stress Scale (DASS) scores and the Dermatology Life Quality Index (DLQI) scores. Adult patients with psoriasis were recruited from a Dermatology outpatient clinic via convenience sampling. Interviews were conducted regarding socio-demographic factors and willing subjects were requested to complete the DASS and DLQI questionnaires. The Pearson χ² test, Fisher’s exact test and multivariate logistic regression were used for statistical analysis to determine independent predictors of depression, anxiety, stress and severe impairment of quality of life. Unadjusted analysis revealed that depression was associated with Indian ethnicity (p = .041) and severe impairment of quality of life was associated with Indian ethnicity (p = .032), higher education (p = .013), higher income (p = .042), and employment status (p = .014). Multivariate analysis revealed that Indian ethnicity was a predictor of depression (p = .024). For stress, tertiary level of education (p = .020) was an independent risk factor while a higher monthly income was a protective factor (p = .042). The ethnic Indians and Malays were significantly more likely than the ethnic Chinese to suffer reduced quality of life (p = .001 and p = .006 respectively) and subjects with tertiary education were more likely to have severe impairment of quality of life (p = .002). Our study was unique in determining sociocultural influences on psychological complications of psoriasis in a South East Asian population. This has provided invaluable insight into factors predictive of adverse effects of psoriasis on psychological distress and quality of life in our patient population. Future studies should devise interventions to specifically target at risk groups in the development of strategies to reduce morbidity associated with psoriasis.