PURPOSE: The main objective of this study was to determine the relationship between quality of life, social functioning, depressive symptoms, self-efficacy, physical function, and socioeconomic status (SES) in community-dwelling older adults.METHODS: A cross-sectional design was used to examine the relationships. A sample of 193 community-dwelling older adults completed the measurements. Structural equation modeling with full information maximum likelihood in LISREL was used to evaluate the relationships between the latent variables (SES, social functioning, depressive symptoms, self-efficacy, physical function, and quality of life).RESULTS: The path analysis exhibited significant effects of SES on physical function, social functioning, depressive symptoms, and self-efficacy (γ = 0.42-0.73), and significant effects in regard to social functioning, depressive symptoms, and self-efficacy on quality of life (γ = 0.27-0.61). There was no direct effect of SES on the quality of life. The model fit indices demonstrated a reasonable fit (χ (2) = 98.3, df = 48, p < 0.001), matching the relative Chi-square criterion and the RMSEA criterion. The model explained 55.5 % of the variance of quality of life.CONCLUSIONS: The path analysis indicated an indirect effect of SES on the quality of life by social functioning, depressive symptoms, and self-efficacy in community-dwelling older adults. Physical function did not have a direct effect on the quality of life. To improve the quality of life in older adults, additional focus is required on the socioeconomic psychosocial differences in the community-dwelling older population.
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The aim of this study was to assess the feasibility, acceptability and preliminary effectiveness of Mindfulness-Based Compassionate Living (MBCL) as a follow-up intervention to Mindfulness Based Cognitive Therapy in adults with recurrent depression. We conducted an uncontrolled study in 17 patients with recurrent depression, in two successive groups. The first group contained novices to compassion training (N = 14); in the second group, ten of these participated again, in addition to three new participants (N = 13). The overall group contained 15 females and 2 males, aged between 37 and 71. The MBCL program was qualitatively evaluated using post-intervention focus group interviews in both groups. In addition, self-report questionnaires assessing depressive symptoms, worry and both self-compassion and mindfulness skills were administered before and after MBCL. No patients dropped out of the intervention. Average attendance was 7.52 (SD 0.73) out of eight sessions. Helpful elements were theory on the emotion regulation systems, practicing self-compassion explicitly and embodiment of a compassionate attitude by the teachers. Unhelpful elements were the lack of a clear structure, lack of time to practice compassion for self and the occurrence of the so-called back draft effect. We adapted the program in accordance with the feedback of the participants. Preliminary results showed a reduction in depressive symptoms in the second group, but not in the first group, and an increase in self-compassion in both groups. Worry and overall mindfulness did not change. MBCL appears to be feasible and acceptable for patients suffering from recurrent depressive symptoms who previously participated in MBCT. Selection bias may have been a factor as only experienced and motivated participants were used; this, however, suited our intention to co-create MBCL in close collaboration with knowledgeable users. Examination of the effectiveness of MBCL in a sufficiently powered randomised controlled trial is needed.
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It is by no means uncommon that academic scholars, journalists and even poets use the epi-thet ‘age of’ to signal how a certain feature is particularly characteristic of the times in which we live. In this chapter, we argue that it makes sense to address our current epoch as an ‘age of emotions’. Broadly speaking this entails that emotions, in many shapes and forms, have been widely recognized as decisive factors in social, cultural, economic and political realms in ways that were not the case before. For example, emotions are proven to play a key role in otherwise rational aspects of life such as political orientation and elections, as Arlie R. Hochschild so forcefully has demonstrated in her account of how people’s deep emotions are decisive when constructing their political identity and casting their vote (Hochschild 2016). In a more specific sense, emotions have historically been singled out as particularly informative about the psychic constitution of the times in which we live. W. H. Auden in 1947 famously declared that this epoch was an ‘age of anxiety’ (Auden 1948). Written in the aftermath of World War II, this pessimistic statement is not surprising: Anxiety was a normal human response to extraordinary circumstances. Recently, journalist of The Guardian, Oli-ver Burkeman, has pondered whether we currently live in an ‘age of rage’, in which people are – simply put – angrier than before, and in which social media is supporting and encourag-ing the ventilation of people’s rage and fury in a hitherto unseen manner. In relation to this chapter, the statement made by Allan V. Horwitz and Jerome C. Wakefield, based on an in-creasing prevalence of the phenomenon in question, that contemporary society should be understood as an ‘age of depression’, is noteworthy (Horwitz and Wakefield 2005). This characteristic begs the questions of how depression has become such an influential and prev-alent disorder in our times and how – even if – we should understand the phenomenon as an indicatory emotion of our epoch? Both as a sign of our times and as an emotion, depression is a particularly interesting phenomenon to study. This is not least due to its long and prolific history. As literary scholar Clark Lawlor has stated, it seems as if depression has been around forever and that depres-sion has been ‘fashionable throughout its history’ (Lawlor 2012:2). For centuries, Lawlor explains, depression has been a socio-cultural weighty condition that a significant amount of people has been emotionally affected by. Similarly, however, he also implies that the under-standing of depression – as a fashionable type of suffering – has changed proportionate to various socio-historical transformations. That is, depression is by no means a static descrip-tion of a specific type of human suffering. Depression changes and ‘relates’ to the societal circumstances it is situated in. If we focus on contemporary late modern society, two things hold true. First of all, there seems to be no doubt about the fact that the dominating under-standing of depression, by and large, is equivalent with the medically informed definition of Major Depression Disorder found in the DSM (Diagnostic and Statistical Manual of Mental Disorders). In here, depression is perceived as a biomedical disease that people suffer from. Secondly, we are witnessing a societal proliferation of the diagnosis of depression unseen in history. WHO has expressed that a veritable depression alarm is ringing loudly worldwide, and that more than 264 million people of all ages now suffer from depression (www.who.int). The combination of these facts is interesting. It informs us about a situation in which a biomedical understanding of depression has inserted itself in the societal discourse about what depression is, and that this understanding has internalized itself in the lives of many people. How are we to fathom this? In this chapter, we shall address this by following four main steps. First, we shall explore how depression has come to be understood as a biomedical disorder that is treated as a specific diagnosable disease, and then show how this understand-ing has been criticized. Second, we elucidate how – and against the backdrop of what – con-temporary depression can be understood as an emotion. Third, we will attempt to nuance the understanding of depression as emotion by arguing that when one zooms in on the phenome-non – that is on the experience of depression – one comes to understand depression as ele-mentary disconnection. Fourth, and based on this deepened understanding, we shall show how the alleged ‘depression epidemic’ can be sensibly linked to a certain subject-position in contemporary culture. Lastly, we will discuss some important implications of this nuanced understanding of depression. This is an Accepted Manuscript of a book chapter published by Routledge/CRC Press in "Emotions in Culture and Everyday Life Conceptual, Theoretical and Empirical Explorations". on 27.05.2024, available online: https://www.routledge.com/Emotions-in-Culture-and-Everyday-Life-Conceptual-Theoretical-and-Empirical-Explorations/Jacobsen/p/book/9781032077314?srsltid=AfmBOop3BqR29YtXXk7FrP4zXPX2BNdx5XizlZGoNZo4fDYC9HJ9OwQE
