Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes

Journal of Patient-Reported Outcomes

Research

Katrina Borowiec¹  Carolyn E. Schwartz²  Bruce D. Rapkin³ 

[1] DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA;Department of Measurement, Evaluation, Statistics, and Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA;DeltaQuest Foundation, Inc., 31 Mitchell Road, 01742, Concord, MA, USA;Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA;Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA;

关键词: Appraisal;    Depression;    Chronic illness;    General population;    Response shift;    COVID;   

DOI  :  10.1186/s41687-023-00600-z

 received in 2022-12-09, accepted in 2023-06-04,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeThis study characterized depression trajectories during the COVID pandemic and investigated how appraisal and changes in appraisal over time related to these depression trajectories.MethodsThis longitudinal study of the psychosocial impact of the COVID-19 pandemic included 771 people with data at three timepoints over 15.5 months. The depression index was validated using item-response-theory methods and receiver-operating-characteristic curve analysis. The Quality of Life (QOL) Appraisal Profilev2 Short-Form assessed cognitive-appraisal processes. Sequence analysis characterized depression-trajectory groups, and random effects models examined appraisal main effects, appraisal-by-group, and appraisal-by-group-by-time interactions.ResultsSequence analysis generated six trajectory groups: Stably Well (n = 241), Stably Depressed (n = 299), Worsening (n = 79), Improving (n = 83), Fluctuating Pattern 1 (No–Yes–No; n = 41), and Fluctuating Pattern 2 (Yes–No–Yes; n = 28). While all groups engaged in negative appraisal processes when they were depressed, the Stably Depressed group consistently focused on negative aspects of their life. Response-shift effects were revealed such that there were differences in the appraisal-depression relationship over time for standards of comparison and recent changes for the Stably Depressed, and in health goals for those Getting Better.ConclusionThe present work is, to our knowledge, the first study of response-shift effects in depression. During these first 15.5 pandemic months, group differences highlighted the connection between negative appraisals and depression, and response-shift effects in these relationships over time. Egregious life circumstances may play a lesser role for the Stably Depressed but a greater role for people who have transient periods of depression as well as for those with improving trajectories (i.e., endogenous vs. reactive depression). How one thinks about QOL is intrinsically linked to mental health, with clear clinical implications.

【 授权许可】

CC BY   
© The Author(s) 2023

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