Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes
Abstract Purpose This study characterized depression trajectories during the COVID pandemic and investigated how appraisal and changes in appraisal over time related to these depression trajectories. Methods This longitudinal study of the psychosocial impact of the COVID-19 pandemic included 771 peo...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-07-01
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| Series: | Journal of Patient-Reported Outcomes |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41687-023-00600-z |
| _version_ | 1797778811309260800 |
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| author | Carolyn E. Schwartz Katrina Borowiec Bruce D. Rapkin |
| author_facet | Carolyn E. Schwartz Katrina Borowiec Bruce D. Rapkin |
| author_sort | Carolyn E. Schwartz |
| collection | DOAJ |
| description | Abstract Purpose This study characterized depression trajectories during the COVID pandemic and investigated how appraisal and changes in appraisal over time related to these depression trajectories. Methods This 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. Results Sequence 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. Conclusion The 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. |
| first_indexed | 2024-03-12T23:22:55Z |
| format | Article |
| id | doaj.art-0f2cec7f35cb4efab6166481c1972151 |
| institution | Directory Open Access Journal |
| issn | 2509-8020 |
| language | English |
| last_indexed | 2024-03-12T23:22:55Z |
| publishDate | 2023-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj.art-0f2cec7f35cb4efab6166481c19721512023-07-16T11:18:33ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202023-07-017111510.1186/s41687-023-00600-zDepression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processesCarolyn E. Schwartz0Katrina Borowiec1Bruce D. Rapkin2DeltaQuest Foundation, Inc.DeltaQuest Foundation, Inc.Department of Epidemiology and Population Health, Albert Einstein College of MedicineAbstract Purpose This study characterized depression trajectories during the COVID pandemic and investigated how appraisal and changes in appraisal over time related to these depression trajectories. Methods This 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. Results Sequence 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. Conclusion The 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.https://doi.org/10.1186/s41687-023-00600-zAppraisalDepressionChronic illnessGeneral populationResponse shiftCOVID |
| spellingShingle | Carolyn E. Schwartz Katrina Borowiec Bruce D. Rapkin Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes Journal of Patient-Reported Outcomes Appraisal Depression Chronic illness General population Response shift COVID |
| title | Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes |
| title_full | Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes |
| title_fullStr | Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes |
| title_full_unstemmed | Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes |
| title_short | Depression trajectories during the COVID-19 pandemic: a secondary analysis of the impact of cognitive-appraisal processes |
| title_sort | depression trajectories during the covid 19 pandemic a secondary analysis of the impact of cognitive appraisal processes |
| topic | Appraisal Depression Chronic illness General population Response shift COVID |
| url | https://doi.org/10.1186/s41687-023-00600-z |
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