Department of Psychology, Palo Alto University, Palo Alto, CA, USA.
Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Psychol Health Med. 2024 Apr;29(4):732-742. doi: 10.1080/13548506.2023.2211805. Epub 2023 May 11.
Decisions of individuals with depression are often risk-averse. Risk-aversion may also extend to decisions regarding treatment, which may cause individuals to forgo or delay treatment. It is also well established that depression is associated with lower satisfaction with life. However, whether life satisfaction is associated with risk aversion for individuals with depression is not yet known. Three groups of participants (Depressed: = 61; Chronic pain: = 61; Comorbid depression and pain: = 58) completed a clinical interview and several self-report questionnaires, including the Satisfaction with Life Scale (SWLS). Participants also completed two utility elicitation tasks: time trade-off (TTO), which measures utilities of health states without implied risks, and standard gamble (SG), which measures utilities of health states in the presence of risk (presented in this study as a hypothetical clinical trial described as having both potential harms and benefits). Risk aversion is defined as the difference in the utility ratings generated via SG and via TTO. For both TTO and SG, individuals evaluated their own depression or pain. When perfect health was used as a hypothetical benefit in TTO and SG tasks, satisfaction with life was not associated with risk preferences, for either depressed participants or participants with chronic pain (all s ). However, for participants with depression, when the hypothetical benefit was a more ecologically valid 'mild' depression in TTO and SG tasks, lower satisfaction with life was associated with greater risk aversion ( < .005; < .03). For depressed individuals, therefore, lower satisfaction with life may be associated with risk aversion regarding treatments when benefits are seen as minor, which may result in treatment avoidance and, consequently, further worsening of both symptoms and life satisfaction.
抑郁症患者的决策往往倾向于规避风险。这种风险规避可能也会延伸到治疗决策上，从而导致患者选择放弃或延迟治疗。此外，抑郁症与生活满意度降低之间的关系也已经得到了充分证实。然而，目前尚不清楚生活满意度是否与抑郁症患者的风险规避倾向有关。三组参与者（抑郁症组：=61；慢性疼痛组：=61；共病抑郁症和疼痛组：=58）完成了临床访谈和几项自我报告问卷，包括生活满意度量表（SWLS）。参与者还完成了两项效用 elicitation 任务：时间权衡（TTO），用于衡量没有隐含风险的健康状态的效用；标准博弈（SG），用于衡量存在风险的健康状态的效用（在本研究中，作为一个描述为具有潜在危害和益处的假设临床试验呈现）。风险规避被定义为通过 SG 和 TTO 生成的效用评分之间的差异。对于 TTO 和 SG，个体评估自己的抑郁或疼痛。当完美健康被用作 TTO 和 SG 任务中的假设益处时，生活满意度与风险偏好无关，无论是对抑郁参与者还是慢性疼痛参与者（所有 s）。然而，对于患有抑郁症的参与者来说，当假设的益处是 TTO 和 SG 任务中的更具生态效度的“轻度”抑郁症时，较低的生活满意度与更大的风险规避相关（<0.005；<0.03）。因此，对于抑郁个体而言，当利益被视为较小的时候，他们可能会对治疗产生风险规避，从而导致治疗回避，进而导致症状和生活满意度进一步恶化。
