General self-efficacy as a driving factor of post-stroke depression: A longitudinal study

ABSTRACT

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 continuous time (CT) structural equation modelling (SEM). Patients of two German rehabilitation centres (N = 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 within-person cross-effects of GSE on GDS (a₂₁ = −.29) than vice versa (a₁₂= −.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.

KEYWORDS:

• Stroke
• Rehabilitation
• Depression
• General self-efficacy
• Continuous time
• Structural equation modelling

Acknowledgements

Many thanks to Dr. Charles Driver for his advice on the statistical analysis. Simon Ladwig, Johanna Moebus, Christa Letsch, Anna Lewin-Richter, Inga Pontow and Yasmina Giebeler assisted with data collection and project management.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Matthias Volz http://orcid.org/0000-0002-0946-1116

Additional information

Funding

The first author was supported by the Humboldt University structured graduate programme “Self-Regulation Dynamics Across Adulthood and Old Age”. The funding source had no role in the planning, implementation or writing of this research or manuscript.