Analyzing - Journal Bingg (Group 4)

Analyzing Journal Psychological Factors
Determine Depressive
Symptomatology After Stroke
Group 4:
Anggi Putri Dewi
Annisa sukma A
Fei nositasari
Hanif cahyo B
Lulu nabilah
Lutviyah
Yusuf kresnadi2019-12-12
Novita fili
Risnawati
Sahda nur erlinda
Yesi putriana
Yosi syafitri
Title Article: Psychological Factors Determine Depressive Symptomatology After Stroke
Author:
01
Maria L. van Mierlo, MSc,
Caroline M. van Heugten, PhD,
Marcel W. Post, PhD,
Paul L. de Kort, MD, PhD,
Johanna M. Visser-Meily, MD, PhD
Year: 2015
Country: America
Method :
Design: Cross-sectional study, with patients assessed at 2 months poststroke
The medical ethics committees of all participating hospitals approved

the Restore4Stroke Cohort study, and informed consent was obtained
02
from all included patients. The present study reports data from stroke
onset and 2 months poststroke. The first assessment (t1) regarded
demographic and strokerelated factors. After informed consent had
been given, the strokerelated factors, assessed by the neurologist on day
4, were extracted from the medical charts. Information on demographic
factors was obtained from the patient or family members. In the second
assessment, which took place 2 months poststroke (t2), patients were
asked to complete the self-report scales for depression and
psychological factors, and cognitive screening was conducted by trained
research assistants.
Result :
A total of 395 stroke patients were included in the
Restore4Stroke Cohort study. The data of 344 participants (87%)
were available for analysis.
Two months poststroke, 21.5% of the participants experienced
03 depressive symptoms. Of these patients, 71.6% had a score

between 8 and 11 (mild), 17.7% had a score between 12 and 14
(moderate), and 10.7% had a score of 15 (severe) on the HADS-D.
Bivariate analysis showed that the presence of PSDS was
associated with higher levels of neuroticism, pessimism,
helplessness, and passive coping, and lower levels of
extraversion, optimism, self-efficacy, acceptance, perceived
benefits, and proactive coping
Discussion :
Two months after stroke, 21.5% of the participants had depressive symptoms in
the clinical range, most of whom had mild symp-toms. All psychological factors
investigated were bivariately related to the presence of depressive symptoms 2
month spost-stroke. More helplessness and passive coping and less acceptance
and perceiving benefits were identified as independent predictors of the presence
04
of PSDS 2 months poststroke.
According to the CSM, patients create illness cognitions of their illness when they
are confronted with it. These cognitions lead to the use of different coping styles
in order to adapt to the illness. Furthermore, a person’s stable characteristics, such
as personality traits, are assumed to influence the process of creating the illness
cognition. In the present study we showed that personality traits, illness
cognitions, and coping styles are asso-ciated with PSDS. An interesting topic for
future research would be to investigate whether the relationships between these
factors follow the path assumed in the CSM-that is, whether the influ-ence of
personality traits on depressive symptoms is mediated by illness cognitions and
coping styles.
Discussion :
To optimize rehabilitation interventions for PSDS, we need to know which factors influence
PSDS and which factors can be modified by means of therapy. Traditionally, it was assumed
that personality traits, such as neuroticism, remain relatively stable throughout a person’s
lifespan. This assumption has been partly confirmed by studies showing that personality
traits were indeed relatively stable overtime, as reflected in test-retest cor-relations of
04
personality measures. However, there is also increasing evidence that personality traits
have the potential to change and develop during one’s life. A study assessing an
individualized stroke self-management intervention found positive results in terms of
changing self-efficacy after stroke. Studies, in patients with other chronic diseases, such as
inflammatory rheumatic diseases, have reported promising results concerning the
possibility of modifying illness cognitions by means of multidisciplinary rehabilitation
treatment and cognitive behavioral therapy. Research has also shown that patients with
traumatic brain injury can be taught to make use of more adaptive coping styles, such as
active problem-focused styles. A recent meta-analysis found moderate effectiveness of
psychological treatment of depression in individuals with acquired brain injury
Conclusion :
This study shows the relevance of psychological factors for the
presence of depressive symptoms 2 months poststroke. It is
important to take these psychological factors into account during
05 poststroke rehabilitation
Limitation
1. Patients with an ischemic lesion were overrepresented in our cohort: 93% of the patients had an i
schemic lesion, compared with 75% in the total stroke population in the Netherlands. Another rea
son could be that hemorrhagic lesions are generally more severe, which means that fewer patient
06 s are able to receive and understand information about the study and agree to participate within
1 week after the onset of stroke. However, we do not think this over- representation of patients w
ith ischemic stroke has led to problems regarding the generalizability of the results.
2. This was a cross-sectional study in which both depressive symptoms and the psychological factors
were assessed 2 months poststroke. Future research should focus on longitudinal designs assessin
g the psychological factors in the subacute phase and the experience of depressive symptoms in t
he chronic phase poststroke. This will provide more insight into potential causal relationships bet
ween psychological factors and depressive symptoms.
3. It is difficult to differentiate between psychological factors and depressed mood. For instance, dep
ressed mood may lead to a high score for pessimism. In our opinion, however, these factors are co
nceptually different from depressed mood, and the questionnaires used to measure psychological
factors and depressive symptoms use very different statements.
empirical research shows that the association between psychological factors and depressive sympto
ms is far from perfect, indicating that psychological factors and depression are at least partially distinc
t from each other. The literature shows that there are even psychological factors whose association w
ith depressive symptoms in stroke has not yet been established. Earlier research18 did not find optimi
sm to be associated with depressive symptoms, but in the present study it was.
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Analyzing Journal Psychological Factors

The medical ethics committees of all participating hospitals approved

03 depressive symptoms. Of these patients, 71.6% had a score

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