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丧亲或分手:抑郁网络的差异。

Bereavement or breakup: Differences in networks of depression.

机构信息

Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands; Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands; Institute for Advanced Study, University of Amsterdam, Amsterdam, the Netherlands.

Department of Clinical Psychology, Utrecht University, Utrecht, the Netherlands; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands.

出版信息

J Affect Disord. 2020 Apr 15;267:1-8. doi: 10.1016/j.jad.2020.01.157. Epub 2020 Jan 30.

Abstract

BACKGROUND

Prior network analyses demonstrated that the death of a loved one potentially precedes specific depression symptoms, primarily loneliness, which in turn links to other depressive symptoms. In this study, we extend prior research by comparing depression symptom network structures following two types of marital disruption: bereavement versus separation.

METHODS

We fitted two Gaussian Graphical Models to cross-sectional data from a Swiss survey of older persons (145 bereaved, 217 separated, and 362 married controls), and compared symptom levels across bereaved and separated individuals.

RESULTS

Separated compared to widowed individuals were more likely to perceive an unfriendly environment and oneself as a failure. Both types of marital disruption were strongly linked to loneliness, from where different relations emerged to other depressive symptoms. Amongst others, loneliness had a stronger connection to perceiving oneself as a failure in separated compared to widowed individuals. Conversely, loneliness had a stronger connection to getting going in widowed individuals.

LIMITATIONS

Analyses are based on cross-sectional between-subjects data, and conclusions regarding dynamic processes on the within-subjects level remain putative. Further, some of the estimated parameters in the network exhibited overlapping confidence intervals and their order needs to be interpreted with care. Replications should thus aim for studies with multiple time points and larger samples.

CONCLUSIONS

The findings of this study add to a growing body of literature indicating that depressive symptom patterns depend on contextual factors. If replicated on the within-subjects level, such findings have implications for setting up patient-tailored treatment approaches in dependence of contextual factors.

摘要

背景

先前的网络分析表明,亲人的离世可能会导致特定的抑郁症状,尤其是孤独感,而孤独感又与其他抑郁症状有关。在这项研究中,我们通过比较两种婚姻破裂类型(丧偶和离异)后的抑郁症状网络结构,扩展了先前的研究。

方法

我们使用瑞士老年人调查的横截面数据拟合了两个高斯图形模型(145 名丧偶者、217 名离异者和 362 名已婚对照组),并比较了丧偶者和离异者的症状水平。

结果

与丧偶者相比,离异者更有可能感到环境不友好和自己失败。两种类型的婚姻破裂都与孤独感密切相关,从那里出现了与其他抑郁症状的不同关系。例如,在离异者中,孤独感与自我失败感的联系比在丧偶者中更强。相反,在丧偶者中,孤独感与振作起来的联系更强。

局限性

分析基于横断面的被试间数据,关于个体内动态过程的结论仍然是假设性的。此外,网络中一些估计的参数具有重叠的置信区间,其顺序需要谨慎解释。因此,复制研究应旨在进行具有多个时间点和更大样本量的研究。

结论

这项研究的结果增加了越来越多的文献表明,抑郁症状模式取决于环境因素。如果在个体内水平上得到复制,这些发现将对根据环境因素为患者量身定制治疗方法产生影响。

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