Clinical correlates of resilience factors in geriatric depression

Abstract

Resilience was significantly associated with a range of mental health constructs in a sample of older adults with depression. Future clinical trials and dismantling studies may help determine whether interventions targeting grit, active coping, accommodative coping, and spirituality can increase resilience and help prevent and treat depression in older adults.

Resilience predicts remission in antidepressant treatment of geriatric depression

“…Furthermore, the authors found that a 1-unit (25% increase) on an item indicating use of cognitive restructuring (ie, "I try to see the humorous side of things when I am faced with problems") was associated with a 125% increase in the odds of PTSD improvement. As this item loaded most strongly on the accommodative coping self-efficacy factor in our recent EFA, 32 this is consistent with our finding that accommodative coping self-efficacy was uniquely predictive of treatment response in our sample.…”

“…Responses are summed with possible total scores ranging from 0 to 100; higher scores indicate greater resilience. Resilience factors identified in the abovementioned EFA (with example items) are (1) grit (eg, “I have a strong sense of purpose”), (2) active coping self‐efficacy (eg, “I am in control of my life”), (3) accommodative coping self‐efficacy (eg, “I am able to adapt to change”), and (4) spirituality (eg, “I believe things happen for a reason”). A reliability analysis (with each item included only in the factor on which it loaded most strongly) using data from the larger EFA sample (N = 337) yielded the following Cronbach α estimates: total CD‐RISC: 0.92, factor 1: 0.89, factor 2: 0.91, factor 3: 0.90, factor 4: 0.71.…”

“…32 Each factor was significantly associated with lower severity of depressive symptoms and apathy. 32 Other studies have similarly found that spirituality, 35,36 greater meaning/purpose, 37-39 greater coping self-efficacy, 40 and self-reported use of active 41 and accommodative coping strategies 42 are associated with lower severity of geriatric depression. Because accommodative coping is thought to increase over the life span, 43,44 this aspect of resilience may be particularly relevant to geriatric depression.…”

“…Self‐report tools for assessing resilience—ie, the ability to adapt and thrive in the face of adversity—may help identify those older adults who are less likely to respond to first‐line antidepressant treatment. Preliminary evidence for this hypothesis comes from an exploratory factor analysis (EFA) of the Connor‐Davidson Resilience Scale (CD‐RISC), which a systematic review identified as having the best psychometric properties out of the 17 resilience scales identified . Exploratory factor analysis of data collected from 337 older adults with MDD yielded 4 factors: (1) “grit,” reflecting perseverance and passion for long‐term goals; (2) “active coping self‐efficacy,” reflecting self‐efficacy for coping with stress via problem‐focused strategies; (3) “accommodative coping self‐efficacy,” reflecting self‐efficacy for adapting to sources of stress; and (4) “spirituality,” reflecting endorsement of spiritual beliefs .…”

“…Exploratory factor analysis of data collected from 337 older adults with MDD yielded 4 factors: (1) “grit,” reflecting perseverance and passion for long‐term goals; (2) “active coping self‐efficacy,” reflecting self‐efficacy for coping with stress via problem‐focused strategies; (3) “accommodative coping self‐efficacy,” reflecting self‐efficacy for adapting to sources of stress; and (4) “spirituality,” reflecting endorsement of spiritual beliefs . Each factor was significantly associated with lower severity of depressive symptoms and apathy . Other studies have similarly found that spirituality, greater meaning/purpose, greater coping self‐efficacy, and self‐reported use of active and accommodative coping strategies are associated with lower severity of geriatric depression.…”