How demoralization is related to trait resilience factors: a network analysis in a representative sample of the general population.

Ramm, M; Schnabel, K; Jedamzik, J; Jürgens, L; Gerke, J; Rassenhofer, M; Brähler, E; Heuft, G; Conrad, R.

Abstract

Background: Demoralization refers to a mental state of poor coping characterized by a loss of purpose and meaning, feelings of hopelessness and worthlessness, and suicidal ideation. The revised demoralization scale (DS-II) is among the most frequently used self-report measures. Recently, the psychometric properties and normative values of the DS-II-Ms (Münster version of the DS-II) were published, alongside a validation study linking it to depression and anxiety in the general population. This study investigates the relationship between DS-II-Ms scores and resilience, as well as well-validated trait resilience factors, specifically locus of control and general self-efficacy, using a network psychometrics approach. Methods: DS-II-Ms, Patient Health Questionnaire 2 (PHQ-2), Generalized Anxiety Disorder Scale 2 (GAD-2), Internal-External Locus of Control Short Scale-4 (IE4), General Self-Efficacy Short Scale-3 (GSE-3) and Brief Resilience Scale (BRS) were applied to a representative sample (N = 2401) of the German general population. A gaussian graphical model was estimated using a non-regularized algorithm to depict the unique connections between the measures. Results: DS-II-Ms was moderately associated with lower internal (and higher external) locus of control while being conditionally independent from BRS and GSE-3. Conversely, depression symptoms lack of interest/low mood were connected to resilience and general self-efficacy but conditionally independent from locus of control. Conclusions: Although the cross-sectional study design limits directional interpretation, our findings indicate that trait resilience measures have unique associations with demoralization and depression/anxiety symptoms, supporting the discriminant validity of the demoralization construct. Depressed and demoralized individuals might benefit from different therapeutical approaches, targeting specific resilience factors.