Positive attributes in elderly people with different degrees of depression: a study based on network analysis

Abstract Introduction Depression in aging may lead to loss of autonomy and worsening of comorbidities. Understanding how positive attributes contribute to healthier and happier aging has been one ofthe purposes of Positive Psychology. However, the literature still lacks studies that evaluate how depression in the elderly is related to constructs considered positive. Objective The present study aimed comparing scores of constructs of spiritual well-being, social support, selfesteem, life satisfaction, affection, optimism, and hope in the elderly with minimal, mild, moderate, and severe depression and healthy controls in order to investigate possible indirect and mediated relationships between positive constructs and depression. Methods A cross-sectional study was conducted with elderly, 62 of whom were diagnosed with different severity of Major Depression (DSM-V) (minimum, mild, moderate, and severe according to the Beck Depression Inventory - BDI) and 66 healthy controls matched by age, sex and schooling. The instruments used were adapted and validated versions of the Spirituality Self-Rating Scale, the Rosenberg Self-Esteem Scale, the Medical Outcomes Social Scale of Support, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, the Revised Life Orientation Test, and the Adult Dispositional Hope Scale. After comparing the means of scores between groups, an analysis of normalized partial association networks was performed to investigate the direct and mediated relationships between depression and other evaluated constructs. Results Scores of spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affects, and hope differed significantly between the control group and the degrees of depression (p < 0.001). The analysis of normalized partial association networks has shown that the relations of depression with the constructs of life satisfaction, self-esteem, and social support are mediated, while the constructs of dispositional hope, positive affect, spiritual well-being, and optimism are indirectly related to depression. The social class was also positively related to depression. Conclusion Depression in different degrees is associated with a reduction in the scores of instruments that evaluate positive attributes. The constructs directly associated with depression are spiritual well-being, optimism, positive affect, and dispositional hope. The others had mediated relationship. These results may contribute to the planning of future interventions for the prevention of depression among the elderly.

Estudos para construção e propriedades psicométricas da escala contextual de depressão em idosos / Studies for construction and psychometric properties of the contextual scale of depression in elderly

Esta pesquisa teve como objetivo construir uma escala contextual de depressão em idosos baseando-se na importância das intervenções primárias em saúde. Concebeu-se uma versão inicial do instrumento com vinte e sete itens para depressão geriátrica, que foram preenchidos pelo público idoso. A amostra foi constituída por 95 idosos, com idade entre 60 e 83 anos, sendo 22 homens e 73 mulheres. O instrumento construído foi aplicado junto à Escala de Depressão Geriátrica de Yesavage e a Overall Life Satisfaction. Após análises de Curva ROC, quinze itens foram considerados satisfatórios a partir da correlação com o construto de depressão geriátrica e validade discriminante, aferida entre a população com e sem sintomas depressivos. Esses itens passaram pela análise fatorial exploratória, encontrando-se uma solução com quatro fatores e 54% de variância explicada. O instrumento final apresentou Alpha de Cronbach no valor de 0,77. Devido a algumas limitações técnicas, sugere-se a continuação do estudo.

This research aimed to build a contextual scale of depression in the elderly, accordingly with the importance of primary interventions in health care. A version of the instrument was developed with twenty seven risk factors for geriatric depression that were met by the elderly population. The study sample consisted of 95 elderly subjects, 22 men and 73 women, from 60 to 83 years old. The developed instrument was applied amongst the Yesavage’s Geriatric Depression Scale and Overall Life Satisfaction. After statistical analysis, fifteen items were considered satisfactory accordingly with the correlation with the construct of geriatric depression and discriminant validity, measured amongst the population with and without depressive symptoms. These items went through an exploratory factorial analysis, and a solutionwas found within four factors and 54% explained variance. The final instrument presented Cronbach’s Alpha in the value of 0,77. Due to some technical limitations, the development of the study is suggested.