Early Maladaptive Cognitive Schema as a Predictor of Post-Stroke Depression

Post-stroke depression is a leading cause of disability and the identification of risk factors is critical for rehabilitation and prevention initiatives. Early Maladaptive Cognitive Schema (EMS) have been implicated with depression with no known medical cause but not previously explored in post-stroke depression. The overall purpose of the study was to explore the role of EMS in post stroke depression. The Young Schema Questionnaire-Short Form (YSQ-SF) is used to assess EMS, and one objective was the validation of the YSQ-SF in a post-stroke sample. The validated questionnaire was subsequently used to identify EMS as covariates for post-stroke acute and chronic phase depression, as well as the identification of acute phase EMS as predictors of chronic phase depression. Additional variables of health locus of control, social support and level of disability, among others, were also explored as covariates and predictors of post-stroke depression. Further objectives included the assessment of EMS and psychosocial variable stability from the acute to the chronic phase post-stroke as well as gender differences in EMS. This was a longitudinal study in which 69 post-stroke participants were recruited on average 25.10 days (SD=29.61) post-stroke, and 21 participants remained to follow-up in the chronic phase, on average 15.81 months (SD=5.04) post-stroke. The theoretical structure of the YSQ-SF was successfully replicated in this post-stroke sample with 68 of the original 75 items having loadings greater than 0.40 and internal consistencies ranging between 0.62 and 0.89. Significant acute phase covariates with acute phase depression were the Failure to Achieve and the Vulnerability to Harm EMS, while significant predictors of depression in the chronic phase were acute phase depression scores and time since stroke. Schema stability was supported in the current study with the only EMS demonstrating change being Enmeshment and Subjugation, and of the psychosocial variables significant change in the Barthel Index demonstrated patient recovery over time. Significant gender differences were found in the Self-Sacrifice EMS in which females scored significantly higher than males. These findings show promising trends in the involvement of EMS in post-stroke psychopathology which warrants further investigation in this clinical group.

Name dc:type.qualificationname

PhD

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

De Montfort University

Year dc:date.issued

2016

Author dc:creator

• Stalias, Maria Efstathia

Licence

• https://dora.dmu.ac.uk/bitstreams/994992b2-9114-4c5d-966e-8367ca072b7a/download