Volz Matthias, Voelkle Manuel C, Werheid Katja
Department of Psychology, Humboldt Universität zu Berlin , Berlin , Germany.
Max Planck Institute for Human Development, Center for Lifespan Psychology , Berlin , Germany.
Neuropsychol Rehabil. 2019 Oct;29(9):1426-1438. doi: 10.1080/09602011.2017.1418392. Epub 2018 Jan 4.
Post-stroke depression (PSD) is the most common psychiatric condition after stroke, affecting one third of survivors. Despite identification of meaningful predictors, knowledge about the interplay between these factors remains fragmentary. General self-efficacy (GSE) is closely linked to PSD, yet direction and magnitude of this relationship remains unclear. The authors assessed the relationship between GSE and depression during the first two years post-stroke while controlling for stable inter-individual differences using (CT) structural equation modelling (SEM). Patients of two German rehabilitation centres (= 294, mean age = 63.78 years, SD = 10.83) were assessed six weeks after ischemic stroke and at four follow-ups covering two years. GSE Scale and Geriatric Depression Scale (GDS) were used to assess GSE and depression. CT-analysis revealed significantly higher -person cross-effects of GSE on GDS ( = -.29) than vice versa (= -.17). Maximal cross-lagged effects emerged six months post-stroke. Our results show that decreasing GSE led to increasing depressiveness, and only to a smaller extent vice versa. This suggests that fostering GSE by strengthening perceived control after stroke can counter PSD emersion and exacerbation. Six months post-stroke, when patients face social re-integration, programmes focusing on GSE could potentially help to prevent later PSD.
中风后抑郁（PSD）是中风后最常见的精神疾病，影响三分之一的幸存者。尽管已经确定了有意义的预测因素，但关于这些因素之间相互作用的知识仍然支离破碎。一般自我效能感（GSE）与PSD密切相关，但这种关系的方向和程度仍不清楚。作者使用结构方程模型（SEM）在中风后的头两年评估了GSE与抑郁之间的关系，同时控制个体间的稳定差异。对德国两个康复中心的患者（n = 294，平均年龄 = 63.78岁，标准差 = 10.83）在缺血性中风六周后以及两年内的四次随访中进行了评估。使用GSE量表和老年抑郁量表（GDS）来评估GSE和抑郁。交叉滞后分析显示，GSE对GDS的个体间交叉效应（β = -0.29）显著高于反之（β = -0.17）。最大交叉滞后效应出现在中风后六个月。我们的结果表明，GSE的降低导致抑郁程度增加，反之则程度较小。这表明通过加强中风后感知到的控制来提高GSE可以对抗PSD的出现和加重。中风后六个月，当患者面临社会重新融入时，关注GSE的项目可能有助于预防后期的PSD。
