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Zeyen P, Sannemann L, Hu X, Kambeitz J, Rietz C, Wagner M, Woopen C, Zank S, Jessen F, Dafsari FS. Prediction of depressive symptoms at high age (80+) by psychological, biological and functional factors. J Affect Disord 2024; 359:342-349. [PMID: 38754595 DOI: 10.1016/j.jad.2024.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 04/18/2024] [Accepted: 05/12/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Late-life depression (LLD) is highly prevalent, especially in people aged 80 years and older. We aimed to investigate predictors and their influence on depressive symptoms in LLD. METHODS We analysed data from the NRW80+ study, a population-based cross-sectional study of individuals aged 80 years and older. Data from n = 926 cognitively unimpaired participants were included. We reduced 95 variables to 21 predictors of depressive symptoms by using a two-step cluster analysis (TSCA), which were assigned to one of four factors (function, values and lifestyle, autonomy and contentment, biological-somatic) according to a principal component analysis. A second TSCA with complete data sets (n = 879) was used to define clusters of participants. Using weighted mean composite scores (CS) for each factor group, binary logistic regression analyses were performed to predict depressive symptoms for each cluster and the total population. RESULTS The second TSCA yielded two clusters (cluster 1 (n = 688), cluster 2 (n = 191)). The proportion of participants with depressive symptoms was significantly higher in cluster 2 compared to cluster 1 (39 % vs. 15 %; OR = 3.6; 95 % CI 2.5-5.1; p < .001). Participants in cluster 2 were significantly older (mean age 88 vs. 85 years; p < .001), with a higher proportion of women (56 % vs. 46 %; OR = 1.5; 95 % CI 1.1-2.0; p = .016), had a higher BMI (p = .017), lower financial resources (OR = 2.3; 95 % CI 1.6-3.5; p < .001), lower educational level (OR = 1.8; 95 % CI 1.2-2.5; p = .002), higher proportion of single, separated or widowed participants (OR = 1.9; 95 % CI 1.3-2.6; p < .001) and a smaller mean social network (p = .044) compared to cluster 1. Binary logistic regression analyses showed that the weighted mean CS including the autonomy and contentment predictors explained the largest proportion of variance (22.8 %) for depressive symptoms in the total population (Nagelkerke's R2 = 0.228, p < .001) and in both clusters (cluster 1: Nagelkerke's R2 = 0.171, p < .001; cluster 2: Nagelkerke's R2 = 0.213, p < .001), respectively. LIMITATIONS The main limitations are the restriction to cognitively unimpaired individuals and the use of a self-rated questionnaire to assess depressive symptoms. CONCLUSIONS Psychological factors such as autonomy and contentment are critical for the occurrence of depressive symptoms at higher age, independent of the functional and somatic status and may serve as specific targets for psychotherapy.
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Affiliation(s)
- Philip Zeyen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.
| | - Lena Sannemann
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Xiaochen Hu
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Christian Rietz
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Institute for Educational Science, Heidelberg University of Education, Heidelberg, Germany
| | - Michael Wagner
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Institute of Sociology and Social Psychology, University of Cologne, Cologne, Germany
| | - Christiane Woopen
- Heinrich-Hertz-Chair, Center for Life Ethics, University of Bonn, Bonn, Germany
| | - Susanne Zank
- CERES - Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, University of Cologne, Cologne, Germany; Department of Special Education and Rehabilitation Science, Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany; German Center for Neurodegenerative Disease (DZNE), Bonn, Cologne, Germany; Cellular Stress Response in Aging-Associated Diseases (CECAD) Cluster of Excellence, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Forugh S Dafsari
- Department of Psychiatry and Psychotherapy, University of Cologne, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
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Hayashida K, Nishi Y, Matsukawa T, Nagase Y, Morioka S. I am not the cause of this pain: An experimental study of the cognitive processes underlying causal attribution in the unpredictable situation whether negative outcomes. Conscious Cogn 2024; 117:103622. [PMID: 38101215 DOI: 10.1016/j.concog.2023.103622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES Pain causal attribution is the attribution of pain causes to self or others, which may depend on one's choice of actions. The study aimed to examine how the cognitive processes of pain causal attribution as one aspect of the sense of agency change in healthy individuals based on free or forced choice, using a temporal binding (TB) experimental task. METHODS Participants pressed keys (action) in a combined TB task, with one key having a high probability of delivering pain (with tone). In fact, only the bias between the free-choice and the forced choice conditions was manipulated. Participants estimated the time between their action and tone, with shorter intervals indicating internal attribution. RESULTS Interval estimation was significantly longer in the forced-choice condition than in the free-choice condition when a pain stimulus was delivered. CONCLUSIONS Explicit complaints of pain being caused by others may be represented in implicit cognitive processes.
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Affiliation(s)
- Kazuki Hayashida
- Department of Rehabilitation, Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, Wakayama, Japan; Neurorehabilitation Research Center, Kio University, Nara, Japan.
| | - Yuki Nishi
- Neurorehabilitation Research Center, Kio University, Nara, Japan; Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
| | - Taku Matsukawa
- Department of Rehabilitation, Murata Hospital, Osaka, Japan
| | - Yuya Nagase
- Department of Rehabilitation, Shinwakai Yachiyo Hospital, Aichi, Japan
| | - Shu Morioka
- Neurorehabilitation Research Center, Kio University, Nara, Japan; Department of Neurorehabilitation, Graduate School of Health Sciences, Kio University, Nara, Japan
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Cations M, Wilton-Harding B, Laver KE, Brodaty H, Low LF, Collins N, Lie D, McKellar D, Macfarlane S, Draper B. Psychiatric service delivery for older people in hospital and residential aged care: An updated systematic review. Aust N Z J Psychiatry 2022; 57:811-833. [PMID: 36317325 DOI: 10.1177/00048674221134510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To review studies reporting on the effectiveness of psychiatry service delivery for older people and people with dementia in hospital and residential aged care. METHODS A systematic search of four databases was conducted to obtain peer-reviewed literature reporting original research published since June 2004 evaluating a psychiatry service for older people (aged 60 years and over) or people with dementia in inpatient or residential aged care settings. RESULTS From the 38 included studies, there was consistent low-to-moderate quality evidence supporting the effectiveness of inpatient older persons' mental health wards (n = 14) on neuropsychiatric symptoms, mood, anxiety and quality of life. Inpatient consultation/liaison old age psychiatry services (n = 9) were not associated with improved depression, quality of life or mortality in high-quality randomised studies. However, low-quality evidence demonstrated improved patient satisfaction with care and reduced carer stress. The highest quality studies demonstrated no effect of psychiatric in-reach services to residential aged care (n = 9) on neuropsychiatric symptoms but a significant reduction in depressive symptoms among people with dementia. There was low-quality evidence that long-stay intermediate care wards (n = 6) were associated with reduced risk for dangerous behavioural incidents and reduced costs compared to residential aged care facilities. There was no effect of these units on neuropsychiatric symptoms or carer stress. CONCLUSIONS AND IMPLICATIONS The scarcity of high-quality studies examining the effectiveness of old age psychiatry services leaves providers and policy-makers to rely on low-quality evidence when designing services. Future research should consider carefully which outcomes to include, given that staff skill and confidence, length of stay, recommendation uptake, patient- and family-reported experiences, and negative outcomes (i.e. injuries, property damage) are as important as clinical outcomes.
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Affiliation(s)
- Monica Cations
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Bethany Wilton-Harding
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Kate E Laver
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry & Mental Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia.,Discipline of Psychiatry & Mental Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Lee-Fay Low
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Noel Collins
- Great Southern Mental Health Service, Albany, WA, Australia.,West Australian Country Health Service, Albany, WA, Australia.,The Rural Clinical School of Western Australia, The University of Western Australia, Albany, WA, Australia
| | - David Lie
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia.,The University of Queensland, Brisbane, QLD, Australia
| | - Duncan McKellar
- Northern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia.,Office of the Chief Psychiatrist, SA Health, Adelaide, SA, Australia
| | - Steve Macfarlane
- Department of Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Brian Draper
- Discipline of Psychiatry & Mental Health, Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
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Pedroso-Chaparro MDS, Márquez-González M, Vara-García C, Cabrera I, Romero-Moreno R, Barrera-Caballero S, Losada A. Guilt for perceiving oneself as a burden in healthy older adults. Associated factors. Aging Ment Health 2021; 25:2330-2336. [PMID: 32964745 DOI: 10.1080/13607863.2020.1822291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
METHODS Participants were 317 community-dwelling people over 60 years without cognitive or functional limitations. A path model that explores the role of self-perceived burden in the relationship between negative self-perception of aging, perceived control, depressive symptoms and guilt associated with self-perception as a burden was analyzed. RESULTS The model presented excellent fit to the data, explaining 41% of the depressive symptomatology and 45% of guilt for perceiving oneself as a burden. Negative self-perceptions of aging, lower sense of control, and a perception of being a burden were significantly associated with depressive symptoms and guilt for perceiving oneself as a burden. DISCUSSION This study documents potential correlates of psychological distress in older adults with no explicit physical or cognitive problems, suggesting paths through which feelings of guilt for perceiving oneself as a burden may be reported by this population.
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Affiliation(s)
| | - María Márquez-González
- Department de Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Isabel Cabrera
- Department de Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | - Andrés Losada
- Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Spain
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Krampe H, Danbolt LJ, Haver A, Stålsett G, Schnell T. Locus of control moderates the association of COVID-19 stress and general mental distress: results of a Norwegian and a German-speaking cross-sectional survey. BMC Psychiatry 2021; 21:437. [PMID: 34488667 PMCID: PMC8419811 DOI: 10.1186/s12888-021-03418-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/03/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND An internal locus of control (LoC I) refers to the belief that the outcome of events in one's life is contingent upon one's actions, whereas an external locus of control (LoC E) describes the belief that chance and powerful others control one's life. This study investigated whether LoC I and LoC E moderated the relationship between COVID-19 stress and general mental distress in the general population during the early months of the COVID-19 pandemic. METHODS This cross-sectional survey study analysed data from a Norwegian (n = 1225) and a German-speaking sample (n = 1527). We measured LoC with the Locus of Control-4 Scale (IE-4), COVID-19 stress with a scale developed for this purpose, and mental distress with the Patient Health Questionnaire 4 (PHQ-4). Moderation analyses were conducted using the PROCESS macro for SPSS. RESULTS The association between COVID-19 stress and general mental distress was strong (r = .61 and r = .55 for the Norwegian and the German-speaking sample, respectively). In both samples, LoC showed substantial moderation effects. LoC I served as a buffer (p < .001), and LoC E exacerbated (p < .001) the relation between COVID-19 stress and general mental distress. CONCLUSIONS The data suggest that the COVID-19 pandemic is easier to bear for people who, despite pandemic-related strains, feel that they generally have influence over their own lives. An external locus of control, conversely, is associated with symptoms of depression and anxiety. The prevention of mental distress may be supported by enabling a sense of control through citizen participation in policy decisions and transparent explanation in their implementation.
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Affiliation(s)
- Henning Krampe
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lars Johan Danbolt
- Practical Theology, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Centre for Psychology of Religion, Innlandet Hospital Trust, Ottestad, Norway
| | - Annie Haver
- Faculty of Social Sciences, Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway
- Faculty of Social Sciences, School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Gry Stålsett
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway
- Modum Bad Psychiatric Center, Vikersund, Norway
| | - Tatjana Schnell
- Social Sciences, MF Norwegian School of Theology, Religion and Society, Oslo, Norway.
- Existential Psychology Lab, Institute of Psychology, University of Innsbruck, Innsbruck, Austria.
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Psychological Resources and Driving Status: A Study of Current and Former Drivers 55 Years of Age and Older. Can J Aging 2021; 40:396-404. [PMID: 34053474 DOI: 10.1017/s0714980820000434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Psychological resources can help individuals adjust to changes associated with aging. In this study, we examined the effect of demographic, health, and psychological resource variables in explaining driving status among adults 55 years and older. A convenience sample of 222 adults between the ages of 55 and 91 years (mean = 72.20 years) completed questionnaires that included measures of driving status, self-rated health, and psychological resources (e.g., life control, life purpose, and locus of control). Multiple logistic regression models that controlled for confounders were constructed with driver status (i.e., current driver or former driver) as the outcome. Former drivers were older, reported being in poorer health, and reported more depression symptoms. After controlling for age and health, current drivers reported higher levels of life control and life purpose and a more internal locus of control. Results highlight the importance of considering psychological resources when examining driving cessation.
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Thumala D, Gajardo B, Gómez C, Arnold-Cathalifaud M, Araya A, Jofré P, Ravera V. Coping processes that foster accommodation to loss in old age. Aging Ment Health 2020; 24:300-307. [PMID: 30596452 DOI: 10.1080/13607863.2018.1531378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: Flexible adjustment or accommodation to loss is healthy; however, little is known about how it can be achieved in old age. We sought to identify and characterize effective coping processes for achieving accommodation at this stage of life. Our aim was to foster the activation of the psychological resources of those who must deal with significant losses to which they will inevitably need to adapt.Method: Qualitative study with a sample of men (n = 16) and women (n = 19) aged 60 years and up. Information was collected through observation and content analysis applied to 35 in-depth interviews, using Atlas-Ti (v7).Results: Eighteen coping processes implemented in response to loss were identified and characterized. Although no single process led to full adjustment by itself, the difference between the participants who accommodated and those who lacked accommodation was reflected in the predominance of certain processes. This approach enabled us to identify 13 effective processes, such as the search for meaning and the use of humor, which were generally used by participants who had achieved accommodation. The processes regarded as ineffective, such as avoidance and procrastination, were used more often by those who displayed insufficient accommodation.Conclusion: It was confirmed that accommodation to losses in old age not only results from "the passage of time"; rather, it can be fostered by people's active efforts. Knowledge of these practices can help practitioners orient mental health interventions for older adults who have difficulty coping in healthy ways and preserving their subjective well-being.
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Affiliation(s)
- Daniela Thumala
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile.,Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Bárbara Gajardo
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Camila Gómez
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | | | - Alfonso Araya
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Pamela Jofré
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | - Valeria Ravera
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
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Anderson E, Cochrane A, Golding J, Nowicki S. Locus of control as a modifiable risk factor for cognitive function in midlife. Aging (Albany NY) 2018; 10:1542-1555. [PMID: 30001219 PMCID: PMC6075438 DOI: 10.18632/aging.101490] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
Few modifiable risk factors for cognitive decline have been identified. Despite an external locus of control (LoC) being adversely associated with many psychological and physical health outcomes, few studies have examined whether it is related to cognitive function in adulthood. In 1178 women from the Avon Longitudinal Study of Parents and Children, we examined whether LoC, and change in LoC over time, is associated with cognitive function in midlife. LoC was prospectively measured at mean ages 30 and 48 years using the validated Nowicki-Strickland scale. Cognitive function was examined at mean age 51 years. At both time points, greater externality was associated with lower cognitive function. For example, the group of women classified as being external at mean age 48 years had, on average, a 0.18 lower cognitive function score (95% CI: (0.11 to 0.25) than the group classified as being internal (p<0.001). Participants who changed from external to internal over time, on average, had better cognitive function than those who remained external or changed to become external. In summary, an external LoC may be detrimental to cognitive function. Thus, interventions to increase internality may help to minimise the adverse consequences on cognitive health later in life.
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Affiliation(s)
- Emma Anderson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
| | - Alice Cochrane
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
| | - Jean Golding
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Stephen Nowicki
- Department of Psychology, PAIS Building, Emory University, Atlanta, GA 30322, USA
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