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

Area of Science:

• Neuroscience
• Psychiatry
• Rehabilitation Medicine

Background:

• Post-stroke depression (PSD) affects one-third of stroke survivors, with complex contributing factors.
• The relationship between general self-efficacy (GSE) and PSD requires further clarification regarding directionality and impact.

Purpose of the Study:

• To investigate the dynamic interplay between general self-efficacy (GSE) and depression in the first two years following ischemic stroke.
• To control for stable inter-individual differences using continuous time structural equation modeling.

Main Methods:

• Longitudinal study of 294 patients (mean age 63.78) assessed six weeks post-stroke and at four follow-ups over two years.
• Utilized the General Self-Efficacy Scale (GSE Scale) and Geriatric Depression Scale (GDS).
• Employed continuous time (CT) structural equation modeling (SEM) to analyze within-person cross-lagged effects.

Main Results:

• A significant within-person effect of decreasing GSE on increasing GDS scores (a21 = -.29) was observed.
• The effect of GDS on GSE was smaller (a12 = -.17).
• Maximal cross-lagged effects were evident at six months post-stroke, coinciding with social re-integration phases.

Conclusions:

• Declining general self-efficacy is a significant predictor of increasing depressiveness after stroke.
• Interventions aimed at enhancing perceived control and general self-efficacy may be crucial for preventing and managing post-stroke depression.
• Targeting GSE enhancement around the six-month mark post-stroke could be particularly beneficial for patients facing social re-integration.