The relationship between demoralization and depressive symptoms among patients from the general hospital: network and exploratory graph analysis

Murri, Martino Belvederi; Caruso, Rosangela; Ounalli, Heifa; Zerbinati, Luigi; Berretti, E.; Costa, Silvia Souza da; Recla, Elisabetta; Folesani, Federica; Kissane, David W.; Nanni, Maria Giulia; Grassi, Luigi

doi:10.1016/j.jad.2020.06.074

Cited by 33 publications

(20 citation statements)

References 74 publications

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“…A lower correlation between DS-II and the PHQ-9 score was found for the patients receiving palliative care (r = 0.41) in the study introducing the DS-II (Robinson et al, 2016b), however, in that calculation, the PHQ-9 was only used in two categories. Despite the positive association between depression and demoralization, both constructs can be distinguished by its core symptoms (depression: loss of pleasure and interest vs. demoralization: a loss of meaning, Robinson et al, 2015) and a dimensional characterization of depressed/demoralized patients indicates possible implications for treatment (Belvederi Murri et al, 2020a). Recent research identified a proportion of patients [17% (Wu et al, 2021) up to 28% (Tang et al, 2020)] with high levels of demoralization but low depression scores to whom special attention must be paid in clinical care.…”

Section: Discussionmentioning

confidence: 99%

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer

et al. 2021

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Objective: To test the psychometric properties, internal consistency, dimensional structure, and convergent validity of the German version of the Demoralization Scale-II (DS-II), and to examine the association between demoralization, sociodemographic, disease- and treatment-related variables in patients with cancer.Methods: We recruited adult patients with cancer at a Psychosocial Counseling Center and at oncological wards. Participants completed the 16-item DS-II, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-2 (GAD-2), Distress Thermometer (DT), and Body Image Scale (BIS). We analyzed internal consistency of the DS-II using Cronbach‘s Alpha (α). We tested the dimensional structure of the DS-II with Confirmatory Factor Analyses (CFA). Convergent validity was expressed through correlation coefficients with established measures of psychological distress. The associations between demoralization, sociodemographic, disease- and treatment-related variables were examined with ANOVAs.Results: Out of 942 eligible patients, 620 participated. The average DS-II total score was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20, and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency ranged from high to excellent with α = 0.93 for the DS-II total scale, α = 0.90 for the Meaning and Purpose subscale, and α = 0.87 for the Distress and Coping Ability subscale. The one-factor and the two-factor model yielded similar model fits, with CFI and TLI ranging between 0.910 and 0.933, SRMR < 0.05. The DS-II correlated significantly with depression (PHQ-9: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress (DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29, SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).Conclusion: The DS-II has very good psychometric properties and can be recommended as a reliable tool for assessing demoralization in patients with cancer. The results support the implementation of a screening for demoralization in specific risk groups due to significantly increased demoralization scores.

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Section: Discussionmentioning

confidence: 99%

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer

et al. 2021

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“…For example, Choi et al (2017) used network analysis to examine depression, post-traumatic stress disorder, and sexual risk. Belvederi et al (2020) analysed the relationship between demoralisation and depressive symptoms among patients from a general hospital. Fischer Note.…”

Section: Study 2 Estimating the Situational Strength Network Through An Exploratory Graph Analysismentioning

confidence: 99%

Measuring the Influence of Environment on Behaviour: A Multimethod Multisample Validation of the Situational Strength at Work (SSW) Scale in Spanish-Speaking Samples

García-Arroyo

Segovia

2021

Revista De Psicología Del Trabajo Y De Las Organizaciones

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Environment and personality interact determining the manner a subject behaves, but research on how to conceptualise and measure the environment is still scarce. This article addresses this issue presenting strong evidence on the reliability and validity of the Situational Strength at Work (SSW) Scale (Meyer et al., 2014) in Spanish-speaking work contexts. Through three studies, we found sound evidence for the four-factor structure of the situational strength's construct, comprising clarity, consistency, constraints, and consequences, with adequate reliability for each factor. Results of studies also found that the instrument is invariant according to sex, country (Spain, Ecuador, Mexico), and occupation (salespeople, teachers, office workers). Convergent and discriminant validity were successfully tested, and exploratory graphical network analysis depicted satisfactory results. Theoretical and practical implications are pointed out, and it is concluded that the SSW scale is a suitable instrument for investigating situational strength at work cross-nationally in Spanish-speaking contexts.

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“…Recently, demoralization, a psychological syndrome distinct from depression [ 7 ], has been diagnosed in a high percentage of medically ill patients [ 8 ], particularly with a high prevalence of up to 86% in KTRs [ 9 ]. That is a condition described as a state of existential distress, characterized by loss of meaning and purpose in life, hopelessness and helplessness and feelings of “being trapped” because of persistently being unable to cope with a particular stressful situation [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Level of Post Traumatic Growth in Kidney Transplant Recipients via Network Analysis

Battaglia

Zerbinati

Murri

et al. 2021

JCM

Self Cite

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Although kidney transplant can lead to psychiatric disorders, psychosocial syndromes and demoralization, a positive post-traumatic growth (PTG) can occur in kidney transplant recipients (KTRs). However, the PTG-Inventory (PTGI), a reliable tool to measure PTG is scarcely used to explore the effect of this stressful event in KTRs. Thus, the purpose of our study was to assess the level of PTG and its correlation with demoralization, physical and emotional symptoms or problems via network analysis in KTRs. Additionally, we aimed at exploring the association of PTG with psychiatric diagnoses, Diagnostic Criteria for Psychosomatic Research (DCPR) conditions, and medical variables. A total of 134 KTRs were tested using MINI International Neuropsychiatric Interview 6.0 (MINI 6.0), DCPR interview, PTGI, Edmonton Symptom Assessment System (ESAS), Canadian Problem Checklist (CPC) and Demoralization scale (DS-IT). PTGI was used to investigate the positive psychological experience of patients after KT. It consists of 21 items divided in five factors. Routine biochemistry, immunosuppressive agents, socio-demographic and clinical data were collected. A symptom network analysis was conducted among PTGI, ESAS and DS-IT. Mean score of PTGI total of sample was 52.81 ± 19.81 with higher scores in women (58.53 ± 21.57) than in men (50.04 ± 18.39) (p < 0.05). PTGI-Relating to Others (16.50 ± 7.99) sub-score was markedly higher than other PTGI factor sub-scores. KTRs with DCPR-alexithymia or International Classification of Diseases, tenth revision (ICD-10) anxiety disorders diagnosis had lower PTGI total score and higher PTGI-Personal Strength sub-score, respectively (p < 0.05). The network analysis identified two communities: PTGI and ESAS with DS-IT. DS-IT Disheartenment, DS-IT Hopelessness and PTGI Relating to Others were the most central items in the network. After 1000 bootstrap procedures, the Exploratory graph analysis revealed the presence of a median of two communities in the network in 97.5% of the bootstrap iterations. A more extensive use of PTGI should be encouraged to identify and enhance the positive psychological changes after KT.

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The relationship between demoralization and depressive symptoms among patients from the general hospital: network and exploratory graph analysis

Cited by 33 publications

References 74 publications

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer

Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer

Measuring the Influence of Environment on Behaviour: A Multimethod Multisample Validation of the Situational Strength at Work (SSW) Scale in Spanish-Speaking Samples

Exploring the Level of Post Traumatic Growth in Kidney Transplant Recipients via Network Analysis

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