Identifying the effective factors on depression in patients with multiple sclerosis using structural equation modeling approach: The role of stress, self-esteem, and mindfulness

Shahab Baheshmat, Hadi Hashemi-Razini, Asiye Khaledi

DOI: 10.22122/cdj.v7i2.381

Abstract


BACKGROUND: The purpose of this study was to identify the effective factors that are related to depression in people with multiple sclerosis (MS).

METHODS: This study utilized a cross-sectional, descriptive, and correlational design. Statistical population of this research included all patients with MS in Mazandaran Province, Iran, in 2016. The sample consisted of
147 patients who were selected via the available sampling method. For data collection, the Depression, Anxiety, and Stress Scale-21 items (DASS-21), Rosenberg Self-Esteem Scale (RSES), and Freiburg Mindfulness Inventory-Short Form (FMI-SF) were administered for all patients. Then the data was analyzed via SPSS and AMOS software using confirmatory factor analysis (CFA) and structural equation modeling (SEM).

RESULTS: The results of the CFA to review the construct validity of the questionnaires indicated that the model was consistent with the data. SEM indicated that self-esteem served as a mediator between both stress and depression. Also, mindfulness had the role of mediator variable in the relationship between self-esteem and depression.

CONCLUSION: This study adds to the existing literature by providing SEM for depression in patients with MS. Theoretical and practical implications of presented results and model are also discussed.


Keywords


Depression; Life Stress; Self-Concept; Mindfulness; Multiple Sclerosis

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References


Fricska-Nagy Z, Fuvesi J, Rozsa C, Komoly S, Jakab G, Csepany T, et al. The effects of fatigue, depression and the level of disability on the health-related quality of life of glatiramer acetate-treated relapsing-remitting patients with multiple sclerosis in Hungary. Mult Scler Relat Disord 2016; 7: 26-32.

Fischer A, Schroder J, Vettorazzi E, Wolf OT, Pottgen J, Lau S, et al. An online programme to reduce depression in patients with multiple sclerosis: A randomised controlled trial. Lancet Psychiatry 2015; 2(3): 217-23.

Ifantopoulou N, Artemiadis K, Triantafyllou N, Chrousos G, Papanastasiou I, Darviri C. Self-esteem is associated with perceived stress in multiple sclerosis patients. Neurol Res 2015; 37(7): 588-92.

Maurer M, Comi G, Freedman MS, Kappos L, Olsson TP, Wolinsky JS, et al. Multiple sclerosis relapses are associated with increased fatigue and reduced health-related quality of life-A post hoc analysis of the TEMSO and TOWER studies. Mult Scler Relat Disord 2016; 7: 33-40.

Hoang H, Laursen B, Stenager EN, Stenager E. Psychiatric co-morbidity in multiple sclerosis: The risk of depression and anxiety before and after MS diagnosis. Mult Scler 2016; 22(3): 347-53.

Grech LB, Kiropoulos LA, Kirby KM, Butler E, Paine M, Hester R. The effect of executive function on stress, depression, anxiety, and quality of life in multiple sclerosis. J Clin Exp Neuropsychol 2015; 37(5): 549-62.

Dennison L, Moss-Morris R, Chalder T. A review of psychological correlates of adjustment in patients with multiple sclerosis. Clin Psychol Rev 2009; 29(2): 141-53.

Admon R, Holsen LM, Aizley H, Remington A, Whitfield-Gabrieli S, Goldstein JM, et al. Striatal hypersensitivity during stress in remitted individuals with recurrent depression. Biol Psychiatry 2015; 78(1): 67-76.

Pechtel P, Dutra SJ, Goetz EL, Pizzagalli DA. Blunted reward responsiveness in remitted depression. J Psychiatr Res 2013; 47(12): 1864-9.

Kivimaki M, Kalimo R. Self-esteem and the occupational stress process: Testing two alternative models in a sample of blue-collar workers. J Occup Health Psychol 1996; 1(2): 187-96.

Auerbach RP, Abela JR, Ringo Ho MH, McWhinnie CM, Czajkowska Z. A prospective examination of depressive symptomology: Understanding the relationship between negative events, self-esteem, and neuroticism. J Soc Clin Psychol 2010; 29(4): 438-61.

Beck AT. Depression: Clinical, experimental, and theoretical aspects. University of Pennsylvania Press; 1967.

Shahar G, Davidson L. Depressive symptoms erode self-esteem in severe mental illness: A three-wave, cross-lagged study. J Consult Clin Psychol 2003; 71(5): 890-900.

Carletto S, Borghi M, Francone D, Scavelli F, Bertino G, Cavallo M, et al. The efficacy of a mindfulness based intervention for depressive symptoms in patients with Multiple Sclerosis and their caregivers: Study protocol for a randomized controlled clinical trial. BMC Neurol 2016; 16: 7.

Bamber MD, Kraenzle Schneider J. Mindfulness-based meditation to decrease stress and anxiety in college students: A narrative synthesis of the research. Educational Research Review 2016; 18: 1-32.

Orth U, Robins RW, Widaman KF, Conger RD. Is low self-esteem a risk factor for depression? Findings from a longitudinal study of Mexican-origin youth. Dev Psychol 2014; 50(2): 622-33.

Bajaj B, Robins RW, Pande N. Mediating role of self-esteem on the relationship between mindfulness, anxiety, and depression. Pers Individ Dif 2016; 96: 127-31.

Miao R, Cao J, Zhang K, Chen B, Jiang Z, Wang L. Value-added path of service-oriented manufacturing based on structural equation model: The case of electric car rental for instance. Int J Prod Res 2014; 52(18): 5502-13.

Samani S, Joukar B. A study on the reliability and validity of the short form of the depression anxiety stress scale (DASS-21). Journal of Social Sciences and Humanities of Shiraz University 2007; 26(3): 65-77. [In Persian].

Rajabi G, Karjo Kasmai S. A study of confirmatory structure two-factor model of the Persian version rosenberg self-esteem scale. Journal of Psychological Models and Methods 2012; 2(6): 33-43.

Ghasemi Jobaneh R, Arab Zadeh M, Jalili Nikoo S, Mohammad Alipoor Z, Mohsenzadeh F. Survey the validity and reliability of the Persian version of short form of Freiburg mindfulness inventory. J Rafsanjan Univ Med Sci 2015; 14(2): 137-50. [In Persian].

Anens E, Emtner M, Zetterberg L, Hellstrom K. Physical activity in subjects with multiple sclerosis with focus on gender differences: A survey. BMC Neurol 2014; 14: 47.

Petrocchi N, Ottaviani C. Mindfulness facets distinctively predict depressive symptoms after two years: The mediating role of rumination. Pers Individ Dif 2016; 93: 92-6.

Barnhofer T, Duggan DS, Griffith JW. Dispositional mindfulness moderates the relation between neuroticism and depressive symptoms. Pers Individ Dif 2011; 51(8): 958-62.

Desrosiers A, Klemanski DH, Nolen-Hoeksema S. Mapping mindfulness facets onto dimensions of anxiety and depression. Behav Ther 2013; 44(3): 373-84.


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