Academic Scientific JournalsDepressive symptom clusters among the elderly: a longitudinal study of course and its correlates
Keywords:
coping, depression, elderly, cluster analysis, longitudinal studyAbstract
Background
The longitudinal course of depressive symptoms among the elderly was examined over a one-month follow-up period. The aim of the study was to identify clusters of change as well as their correlates, including demographic variables and coping strategies (brooding, reflection, co-rumination, and positive reappraisal).
Participants and procedure
Two hundred and seventy-seven seniors (age 77.39 ±9.20 years, 67.50% women) were assessed twice within one month with the 11-item version of the Centre for Epidemiological Studies Depression Scale. Demographic and clinical characteristics were measured at baseline together with coping strategies. Selected items from Ruminative Response Styles (brooding, reflection), the Co-Rumination Questionnaire (co-rumination), and mini-COPE (positive reframing) were used.
Results
On the basis of a two-step cluster analysis, four clusters of depression course were recognized: low stable (n = 53), medium stable (n = 101), high increasing (n = 69), and very high stable (n = 54). Multinomial logistic regression analyses showed that higher number of diseases, higher brooding and lower positive reappraisal were associated with increased likelihood of belonging to the higher symptom groups. No significant gender effect was noted.
Conclusions
A non-clinical sample of older people appeared to be heterogeneous regarding symptoms of depression and its course. However, only 19.00% of participants reported a low level of depression. Strategies of coping with health concerns may play a significant role here, as brooding and positive reappraisal significantly differentiate between clusters of low stable and high stable symptoms, even after control for a proxy of objective health status.
Downloads
References
Abelaira, H., Réus, G., Petronilho, F., Barichello, T., & Quevedo, J. (2014). Neuroimmunomodulation in depression: A review of inflammatory cytokines involved in this process. Neurochemical Research [serial online]. Accessed July 23, 2014. DOI: 0.1007/s11064-014-1372-5
Alicke, M. D., Braun, J. C., Glor, J. E., Klotz, M. L., Magee, J., Sederhoim, H., & Siegel, R. (1992). Complaining behavior in social interaction. Personality and Social Psychology Bulletin, 18, 286-295. DOI: 10.1177/0146167292183004
Arbuckle, J. L. (1995-2010). IBM SPSS AMOS 19. User’s guide. Chicago, FL: Amos Development Corporation. Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology, 57, 236-247. DOI: 10.1037/a0029256
Börsch-Supan, A., Brugiavini, A., Jürges, H., Kapteyn, A., Mackenbach, J., Siegrist, J., & Weber G. (2008). First Results from the Survey of Health, Ageing and Retirement in Europe (2004-2007). Starting the Longitudinal Dimension. Mannheim: Mannheim Research Institute for the Economics of Aging.
Brans, K., Koval, P., Verduyn, P., Lim, Y., & Kuppens, P. (2013). The regulation of negative and positive affect in daily life. Emotion, 13, 926-939. DOI: 10.1037/a0032400
Burwell, R., & Shirk, S. (2007). Subtypes of rumination in adolescence: associations between brooding, reflection, depressive symptoms, and coping. Journal of Clinical Child and Adolescent Psychology, 36, 56-65. DOI: 10.1080/15374410709336568
Byers, A. L., & Yaffe, K. (2011). Depression and risk of developing dementia. Nature Reviews Neurology, 7, 323-331. DOI: 10.1038/nrneurol.2011.60
Carver, C. S. (1997). You want to measure coping but your protocol’s too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92-100.
Central Statistical Office (GUS, 2009). Prognoza ludności na lata 2008-2035 [Population projection for Poland 2008-2035]. Warszawa: Zakład Wydawnictw Statystycznych.
Central Statistical Office (GUS, 2013). Trwanie życia w 2012 roku [Life expectancy of Poland 2012]. Warszawa: Zakład Wydawnictw Statystycznych.
Ciesla, J. A., & Roberts, J. E. (2002). Self-directed thought and response to treatment for depression: A preliminary investigation. Journal of Cognitive Psychotherapy, 16, 435-453. DOI: 10.1891/jcop.16.4.435.52528
Czapiński, J. (2013). Quality of life in Poland – winners and losers. Social Diagnosis 2013. Objective and subjective Quality of life in Poland [Special issue]. Contemporary Economics, 7, 376-399. DOI: 10.5709/ce.1897-9254.119
Djernes, J. K. (2006). Prevalence and predictors of depression in populations of elderly: A review. Acta Psychiatrica Scandinavica, 113, 372-387.
Dojka, E., Górkiewicz, M., & Pająk, A. (2003). Wartość pomiarowa skali CES-D do oceny depresji w populacji polskiej [Psychometric value of CES-D scale for the assessment of depression in Polish population]. Psychiatria Polska, 37, 281-292.
EUROSTAT (2010). Demography Report. Retrieved July 20, 2014 from http://epp.eurostat.ec.europa.eu/portal/page/portal/population/documents/Tab/report.pdf
Folkman, S., & Moskowitz, J. (2000). Positive affect and the other side of coping. American Psychologist, 55, 647-654.
Garnefski, N., & Kraaij, V. (2006). Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual Differences, 40, 1659-1669. DOI: 10.1016/j.paid.2005.12.009
Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549-576. DOI: 10.1146/annurev.psych.58.110405.085530
Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271-299. DOI: 1089-2680/98/$3.00
Gooding, P. A., Taylor, P. J., & Tarrier, N. (2012). Perceived extent and effectiveness of reflection and brooding in relation to depressed mood. Cognitive Therapy and Research, 36, 282-289. DOI: 10.1007/s10608-011-9367-x
Hank, K. (2011). How “successful” do older Europeans age? Findings from SHARE. Journal of Gerontology: Social Sciences, 66B, 230-236. DOI: 10.1093/geronb/gbq089
Helgeson, V. S., Helgeson, V. S., Reynolds, K. A., & Tomich, P. L. (2006). A meta-analytic review of benefit finding and growth. Journal of Consulting and Clinical Psychology, 74, 797-816. DOI: 10.1037/0022-006X.74.5.797
HelpAge International (2013). Global AgeWatch Index 2013: Insight report. Retrieved July 20, 2014, from http://www.helpage.org/global-agewatch/#
Juczyński, Z. (2009). Narzędzia pomiaru w promocji i psychologii zdrowia [Measurement tools in the health promotion and psychology]. Warszawa: Pracownia Testów Psychologicznych PTP.
Kirchberger, I., Meisinger, C., Heier, M., Zimmermann, A., Thorand, B., Autenrieth, C., Peters, A., Ladwig, K. H., & Döring, A. (2012). Paterns of multimorbidity in the aged population. Results from the KORA-Age study. PLoS One, 7, e30556. DOI: 10.1371/journal.pone.0030556
Kraaij, V. V., Pruymboom, E. E., & Garnefski, N. N. (2002). Cognitive coping and depressive symptoms in the elderly: A longitudinal study. Aging & Mental Health, 6, 275-281. DOI: 10.1080/13607860220142387
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing.
Lyubomirsky, S., & Nolen-Hoeksema, S. (1993). Self-perpetuating properties of dysphoric rumination. Journal of Personality and Social Psychology, 65, 339-349. DOI: 10.1037/0022-3514.65.2.339
Lyubomirsky, S., & Tkach, C. (2003). The consequences of dysphoric rumination. In: C. Papageorgiou, & A. Wells (eds.), Rumination: Nature, theory, and treatment of negative thinking in depression (pp. 21-41). Chichester, England: John Wiley & Sons.
Maes, M., Berk, M., Goehler, L., Song, C., Anderson, G., Gałecki, P., & Leonard, B. (2012). Depression and sickness behavior are Janus-faced responses to shared inflammatory pathways. BMC Medicine, 10, 66 [serial online]. Accessed July 23, 2014. DOI: 10.1186/1741-7015-10-66
Marroquin, B., Fontes, M., Scilletta, A., & Miranda, R. (2010). Ruminative subtypes and coping responses: Pathways to depressive symptoms. Cognition and Emotion, 24, 1446-1455. DOI: 10.1080/02699930903510212
Mooi, E., & Sarstedt, M. (2011). A Concise Guide to Market Research. The Process, Data, and Methods Using IBM SPSS Statistics. Berlin Heidelberg: Springer-Verlag.
Nolen-Hoeksema, S. (2001). Gender differences in depression. Current Directions in Psychology Science, 10, 173-176.
Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3, 400-424. DOI: 10.1111/j.1745-6924.2008.00088.x Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. DOI: 10.1177/014662167700100306
Rechel, B., Grundy, E., Robine, J., Cylus, J., Mackenbach, J., Knai, C., & McKee, M. (2013). Ageing in the European Union. The Lancet, 381, 1312-1322. DOI: 10.1016/S0140-6736(12)62087-X
Rewston, C., Clarke, C., Moniz-Cook, E., & Waddington, R. (2007). Distinguishing worry from rumination in older people: a preliminary investigation. Aging and Mental Health, 11, 604-611. DOI: 10.1080/13607860701529619
Roberts, R. E., Kaplan, G. A., Shema, S. J., & Strawbridge, W. J. (1997). Does growing old increase the risk for depression? The American Journal of Psychiatry, 154, 1384-1390.
Rose, A. J. (2002). Co-rumination in the friendships of girls and boys. Child Development, 73, 1830-1843.
Rose, A. J., Carlson, W., & Waller, E. M. (2007). Prospective associations of co-rumination with friendship and emotional adjustment: Considering the socioemotional trade-offs of co-rumination. Developmental Psychology, 43, 1019-1031. DOI: 0.1037/0012-1649.43.4.1019
Schoofs, H., Hermans, D., & Raes, F. (2010). Brooding and reflection as subtypes of rumination: Evidence from confirmatory factor analysis in nonclinical samples using the Dutch Ruminative Response Scale. Journal of Psychopathology and Behavioral Assessment, 32, 609-617. DOI: 10.1007/s10862-010-9182-9
Steuden, S. (2011). Psychologia starzenia się i starości [Psychology of Ageing and Old Age]. Warszawa: Wydawnictwo Naukowe PWN.
Thomsen, D., Mehlsen, M., Viidik, A., Sommerlund, B., & Zachariae, R. (2005). Age and gender differences in negative affect – Is there a role for emotion regulation? Personality and Individual Differences, 38, 1935-1946. DOI: 10.1016/j.paid.2004.12.001
Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27, 247-259. DOI: 10.1023/A:1023910315561
Troy, A. S., Shallcross, A. J., & Mauss, I. B. (2013). A person-by-situation approach to emotion regulation: Cognitive reappraisal can either help or hurt, depending on the context. Psychological Science, 24, 2505-2514. DOI: 10.1177/0956797613496434
Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163-206. DOI: 10.1037/0033-2909.134.2.163
Whitmer, A., & Gotlib, I. H. (2011). Brooding and reflection reconsidered: A factor analytic examination of rumination in currently depressed, formerly depressed, and never depressed individuals. Cognitive Therapy And Research, 35, 99-107. DOI: 10.1007/s10608-011-9361-3
Wojciszke, B., Baryła, W., Szymków-Sudziarska, A., Parzuchowski, M., & Kowalczyk, K. (2009). Saying is experiencing: Affective consequences of complaining and affirmation. Polish Psychological Bulletin, 40, 74-84. DOI: 10.2478/s10059-009-0008-0
World Health Organization (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization.
World Health Organization (2011). Global Health and Aging. Geneva: World Health Organization. Retrieved July 20, 2014 from http://www.who.int/ageing/publications/global_health/en/
Ziarko, M., Kaczmarek, Ł. D., & Haładzińki, P. (2013). Polish version of Centre for Epidemiological Studies Depression Scale (CES-D): results of a preliminary study on the psychometric properties of the scale. Current Issues in Personality Psychology, 1, 51-61. DOI: 10.5114/cipp.2013.40637
