Skip to main content
SpringerLink
Log in

Factors Affecting Disability-Related Depression in Patients with Lost Limbs: A Mediational Model

  • Original Paper
  • Published:
Journal of Religion and Health Aims and scope Submit manuscript

Abstract

The objective of the present study was to determine the mediating role of self-efficacy between religiosity, social support, and depression in patients with lost limbs. We sampled 67 male and 33 female disabled patients who had lost limbs in accidents or amputations from four public hospitals in Lahore, Pakistan, and used Religiosity Index (Farooq and Imam, in The effect of religiosity on locus of control. Department of Psychology, Govt College University, Lahore, 1997), General Self-efficacy Scales (Tabassum et al., in Urdu adaptation of the general self-efficacy scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm, 2003), Berlin Social Support Scale (Schwarzer and Schulz, in Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm, 2000), and Siddiqui–Shah Depression Scale (Siddiqui and Shah, in Pychol Dev Soc 9(2):245–262, 1997), and used a correlation matrix and mediational analyses along with other inferential statistics to develop a model that suggested self-efficacy mediated between religiosity, social support, and depression with negative correlations that partially mediated this relationship. The findings suggest that low level of religiosity, social support, and self-efficacy may play a role in the onset and continuation of depression or its symptoms. We found no significant differences in gender, education, and cause of disability in patients with lost limbs. Results have implications for clinical psychologists, counselors, and health psychologists to develop a treatment plan for such patients with depression focusing on the factors implicated above.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Allgower, A., Wardle, J., & Steptoe, A. (2001). Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychology, 20, 223–227. doi:10.1037/0278-6133.20.3.223.

    Article  CAS  PubMed  Google Scholar 

  • Arnstein, P., Caudill, M., Mandle, C. L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80(3), 483–491.

    Article  CAS  PubMed  Google Scholar 

  • Auerbach, R. P., Bigda-Peyton, J. S., Eberhart, N. K., Webb, C. A., & Ringo-Ho, M. (2010). conceptualizing the prospective relationship between social support, stress, and depressive symptoms among adolescents. Journal of Abnormal Child Psychology. doi:10.1007/s10802-010-9479-x.

    PubMed  PubMed Central  Google Scholar 

  • Bandura, A., Pastorelli, C., Barbaranelli, C., & Caprara, G. V. (1999). Self-efficacy pathways to childhood depression. Journal of Personality and Social Psychology, 76(2), 258–269.

    Article  CAS  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  CAS  PubMed  Google Scholar 

  • Bogard, K. L. (2005). Affluent adolescents, depression, and drug use: The role of adults in their lives. Adolescence, 40, 281–306.

    PubMed  Google Scholar 

  • Bonelli, R., Dew, R. E., Koenig, H. G., Rosmarin, D. H., & Vasegh, S. (2012). Religious and spiritual factors in depression: Review and integration of the research. Depression Research and Treatment, 179, 1–8. doi:10.1155/2012/962860.

    Article  Google Scholar 

  • Brummett, B. H., Barefoot, J. C., Vitaliano, P. P., & Siegler, I. C. (2003). Associations among social support, income, and symptoms of depression in an educated sample: The UNC alumni heart study. International Journal of Behavioral Medicine, 10(3), 239–250.

    Article  PubMed  Google Scholar 

  • Byrne, P. F. (2012). I believe; I can : the relationship between religiosity, general self-efficacy and locus of control. Article retrieved from http://esource.dbs.ie/handle/10788/462

  • Comunian, A. L. (1989). Some characteristics of relations among depression, anxiety, and selfefficacy. Perceptual and Motor Skills, 69, 755–764.

    Article  CAS  PubMed  Google Scholar 

  • Coultas, D. B., Edwards, D. W., Barnett, B., & Wludyka, P. (2007). Predictors of depressive symptoms in patients with COPD and health impact. Journal of Chronic Obstructive Pulmonary Disease, 4(1), 23–28.

    Article  PubMed  Google Scholar 

  • Crocker, A. D., & Hakim-Larson, J. (1997). Predictors of pre-adolescent depression and suicidal ideation. Canadian Journal of Behavioural Science, 29, 76–82.

    Article  Google Scholar 

  • Davis, B. J. (1990). Physical self efficacy, perceived physical status, and depression symptomatology in older adults. Journal of Psychology, 124(2), 207–215.

    Article  Google Scholar 

  • Gull, F., & Dawood, S. (2012). Religiosity, social support, coping strategies and subjective well being among people living in old homes. (Unpublished Mphil thesis). Lahore: Center for Clinical Psychology, University of the Punjab.

  • Deno, M., Tashiro, M., Miyashita, M., Asakage, T., Takahashi, K., & Saito, K. (2012). The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psychooncology, 21(2), 144–152.

    Article  PubMed  Google Scholar 

  • DeVellis, B., & DeVellis, R. (2001). Self-efficacy and health. In A. Baum, T. Revenson, & J. Singh (Eds.), Handbook of Health Psychology (pp. 235–247). Hillsdale, NJ: Lawrence Earlbaum.

    Google Scholar 

  • Dieserud, G., Roysamb, E., Ekeberg, O., & Kraft, P. (2001). Toward an integrated model of suicidal attempt: a cognitive psychological approach. Suicide & Life Threating Behavavior, 31(2), 153–168.

    Article  CAS  Google Scholar 

  • Ehrenberg, M. F., Cox, D. N., & Koopman, R. F. (1991). The relationship between self-efficacy and depression in adolescents. Adolescence, 26, 361–374.

    CAS  PubMed  Google Scholar 

  • Ellonen, N., Kääriäinen, J., & Autio, V. (2008). Adolescent depression and school support: a multilevel analysis of a Finnish sample. Journal of Community Psychology, 36, 552–567.

    Article  Google Scholar 

  • Farooq, N., & Imam, S. (1997). The effect of religiosity on locus of control. (Unpublished Masters thesis). Lahore: Department of Psychology, Govt College University.

  • Field, T., Diego, M., & Sanders, C. (2001). Adolescent depression and risk factors. Adolescence, 36, 491–498.

    CAS  PubMed  Google Scholar 

  • Flett, G. L., Panico, T., & Hewitt, P. L. (2011). Perfectionism, Type A behavior, and selfefficacy in depression and health symptoms among adolescents. Current Psychology, 30, 105–116.

    Article  Google Scholar 

  • Francis, L. J., Robbins, M., Lewis, C. A., Quigley, C. F., & Wheeler, C. (2004). Religiosity and general health among undergraduate students: A response to O’Connor (2003). Journal of Personality and Individual Difference, 37(3), 485–494.

    Article  Google Scholar 

  • Freedman, D. A. (1987). As others see us: A case study in path analysis. Journal of Educational Statistics, 12, 101–128.

    Google Scholar 

  • Freedman, D. A. (1997). From association to causation via regression. In V. R. McKim & S. P. Turner (Eds.), Causality in crisis? Statistical methods and the search for causal knowledge in the social sciences (pp. 113–161, 177–182). Notre Dame, IN: University of Notre Dame Press.

  • Gee, C., & Rhodes, J. (2007). A Social support and social strain measure for minority adolescent mothers: A Confirmatory factor analytic study. Child: Care. Health and Development, 34, 87–97.

    Google Scholar 

  • Goldman, D., & Lakdawalla, D. (2001). Understanding health disparities across education groups. WP: National Bureau of Economic Research. 8326.

    Book  Google Scholar 

  • Goldman, D., & Smith, J. (2002). Can patient self-management help explain the SES health? Proceedings, National Academy of Sciences, 99, 10929–10934.

    Article  CAS  Google Scholar 

  • Haber, M. G., Cohen, J. L., Lucas, T., & Baltes, B. B. (2007). The relationship between selfreported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39, 133–144. doi:10.1007/s10464-007-9100-9.

    Article  PubMed  Google Scholar 

  • Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127, 773–796.

    Article  CAS  PubMed  Google Scholar 

  • Hassan, S., & Malik, A. A. (2012). Psycho-social correlates of intimate partner violence. Pakistan Journal of Psychological Research, 27(2), 279–295.

    Google Scholar 

  • Hobfoll, S. E., Freedy, J., Lane, C., & Geller, P. (1990). Conservation of social resources: Social support resource theory. Journal of Social and Personal Relationships, 7, 465–478.

    Article  Google Scholar 

  • Jette, A. M. (2006). Toward a common language for function, disability, and health. Physical Therapy, 86(5), 726–734.

    PubMed  Google Scholar 

  • Karademas, E. C. (2006). Self-efficacy, social support and well-being: the mediating role of optimism. Personality and Individual Difference, 40(6), 1281–1290.

    Article  Google Scholar 

  • Kendler, K. S., Myers, M. S., & Prescott, C. A. (2005). Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs. The American Journal of Psychiatry, 162, 250–256.

    Article  PubMed  Google Scholar 

  • Kenkel, D. S. (1991). Health behaviour, health knowledge and schooling. Journal of Political Economy, 99, 287–305.

    Article  Google Scholar 

  • Koenig, H. G., George, L. K., & Peterson, B. L. (1998a). Religiosity and remission of depression in medically ill older patients. American Journal of Psychiatry, 155, 536–542.

    Article  CAS  PubMed  Google Scholar 

  • Koenig, H. G., Pargament, K. I., & Nielsen, J. (1998b). Religious coping and health status in medically ill hospitalized adults. The Journal of Nervous and Mental Disease, 186, 513–521.

    Article  CAS  PubMed  Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Google Scholar 

  • Lepore, S. L., Glaser, D. B., & Roberts, K. J. (2008). On the positive relation between received social support and negative affect: a test of the triage and self-esteem threat models in women with breast cancer. Psycho-Oncology, 17(12), 1210–1215.

    Article  PubMed  Google Scholar 

  • Levin, S. J., & Chatters, M. L. (1998). Religion health and psychological well-being in older adults. Journal of Aging and Health, 10, 504–531.

    Article  CAS  PubMed  Google Scholar 

  • Levine, E. G., & Targ, E. (2002). Spiritual correlates of functional well-being in women with breast cancer. Integrative Cancer Therapies, 1, 166–174.

    Article  PubMed  Google Scholar 

  • Luszczynska, A., & Schwarzer, R. (2005). The role of self-efficacy in health self-regulation. In W. Greve, K. Rothermund, & D. Wentura (Eds.), The adaptive self: Personal continuity and intentional self-development (pp. 137–152). Göttingen: Hogrefe/Huber.

    Google Scholar 

  • Lutjen, L. J., Silton, N. R., & Flannelly, K. J. (2012). Religion, forgiveness, hostility and health: A structural equation analysis. Journal of Religion and Health, 51(2), 468–478. doi:10.1007/s10943-011-9511-7.

    Article  PubMed  Google Scholar 

  • Makaremi, A. (2000). Self-efficacy and depression among Iranian college students. Psychological Reports, 86(2), 386–388.

    Article  CAS  PubMed  Google Scholar 

  • Maltay, J., & Day, L. (2000). Depressive symptoms and religious orientation: examining the relationship between religiosity and depression within context of other correlates of depression. Personality and Individual Differences, 28, 383–393.

    Article  Google Scholar 

  • McFarlane, A. H., Kamath, M. V., Fallen, E. L., Malcolm, V., Cherian, F., & Norman, F. (2001). The effect of sertraline on the recovery rate of cardiac autonomic function in depressed patients following an acute myocardial infarction. American Heart Journal, 142(4), 617–623.

    Article  CAS  PubMed  Google Scholar 

  • Meehl, P. E., & Waller, N. G. (2002). The Path analysis controversy: A New statistical approach to strong appraisal of verisimilitude. Psychological Methods, 7(3), 283–300.

    Article  PubMed  Google Scholar 

  • Meraviglia, M. G. (2004). The effects of spirituality on well-being of people with lung cancer. Oncology Nursing Forum, 31, 89–94.

    Article  PubMed  Google Scholar 

  • Miller, L., Wickramaratne, P., Gameroff, M. J., Sage, M., Tenke, C. E., & Weissman, M. M. (2012). Religiosity and major depression in adults at high risk: A ten-year prospective study. American Journal of Psychiatry, 169, 89–94.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moatamedi, A., Ezhehei, J., Azad Fallah, P., & Kiamanes, A. R. (2005). The relationship between religious tendency and successful aging. Daneshvar Raftar, 12(10), 43–56.

    Google Scholar 

  • Moreira-Almeida, A., Neto, F. L., & Koenig, H. G. (2006). Religiousness and mental health: A review. Revista Brasileira de Psiquiatria, 28(3), 242–250.

    Article  PubMed  Google Scholar 

  • Mosqueiro, B. P., da Rocha, N. S., & Fleck, M. P. A. (2015). Intrinsic religiosity, resilience, quality of life, and suicide risk in depressed inpatients. Journal of Affective Disorders, 179, 128–133.

    Article  PubMed  Google Scholar 

  • Nolen-Hoeksema, S. (2001). Abnormal Psychology. New York: McGraw Hill.

    Google Scholar 

  • Pajares, F. (2002). Gender and perceived self-efficacy in self-regulated learning. Theory into Practice, 41(2), 116–125.

    Article  Google Scholar 

  • Palesh, O. G., Shaffer, T., Larson, J., Edsall, S., Chen, X. H., & Koopman, C. (2006). Emotional self-efficacy, stressful life events, and satisfaction with social support in relation to mood disturbance among women living with breast cancer in rural communities. The Breast Journal, 12(2), 123–129.

    Article  PubMed  Google Scholar 

  • Pargament, K. I. (1997). The psychology of religion and coping: theory, research, practice. New York: The Guilford Press.

    Google Scholar 

  • Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A 2-year longitudinal study. Archives of Internal Medicine, 161(15), 1881–1885.

    Article  CAS  PubMed  Google Scholar 

  • Ray, R., Dasgupta, P., & Basu, S. (2003). Unknown women: Aged, widowed, tribals & urbans. Kolkata: Classique Books.

    Google Scholar 

  • Rizwan, M., & Syed, N. (2010). Urdu translation and psychometric properties of Social Provision Scale. The International Journal of Eductional Psychological Assessment, 4, 33–47.

    Google Scholar 

  • Sacco, W. P., Wells, K. J., Vaughan, C. A., Friedman, A., Perez, S., & Matthew, R. (2005). Depression in adults with type 2 diabetes: the role of adherence, body mass index, and selfefficacy. Health Psychology, 24(6), 630–634.

    Article  PubMed  Google Scholar 

  • Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy Scale. In J. Weinman, S. Wright, & M. Johnston. Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor, England: NFER-NELSON. Scale retrieved from http://www.midss.org/sites/default/files/faq_gse.pdf

  • Schwarzer, R., & Schulz, U. (2000). Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm

  • Segal, Z. V., & Ingram, R. E. (1994). Mood priming and construct activation in tests of cognitive vulnerability to unipolar depression. Clinical Psychology Review, 14, 663–695.

    Article  Google Scholar 

  • Shehni, Y. M., Movahhed, A., & Shokrkon, H. (2002). Relationships between religious attitudes, well-being, physical and mental health among students of Shahid Chamran university of Ahvaz. Journal of Psychological and Educational Science, 11(1–2), 19–34.

    Google Scholar 

  • Siddiqui, S., & Shah, S. A. A. (1997). Siddiqui-Shah Depression Scale (SSDS): Development and Validation. Pychology and Developing Societies, 9(2), 245–262.

    Article  Google Scholar 

  • Singh, R., Ripley, D., Pentland, B., Todd, I., Hunter, J., Hutton, L., & Philip, A. (2009). Depression and anxiety symptoms after lower limb amputation: the rise and fall. Clinical Rehabilitation, 23(3), 281–286. doi:10.1177/0269215508094710.

    Article  PubMed  Google Scholar 

  • Smith, C. (2003). Theorizing religious effects among American adolescents. Journal for the Scientific Study of Religion, 42, 17–30.

    Article  Google Scholar 

  • Smith, T. B., McCullough, M. E., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating Influence of stressful life events. Psychological Bulletin, 129(4), 614–636.

    Article  PubMed  Google Scholar 

  • Srinivasan, C. (2013). Religiosity and well-being of older adults in Chennai. India. Aging & Mental Health, 17(7), 880–887.

    Article  Google Scholar 

  • Stroppa, A., & Moreira-Almeida, A. (2013). Religiosity, mood symptoms, and quality of life in bipolar disorder. Bipolar Disorders, 15, 385–393.

    Article  PubMed  Google Scholar 

  • Tabassum, U., Rehman, G., Schwarzer, R., & Jerusalem, M. (2003). Urdu Adaptation of the General Self-Efficacy Scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm.

  • Thase, M. E., Jindal, R., & Howland, R. H. (2002). Biological aspect of depression. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 192–218). New York: Guilford Press.

    Google Scholar 

  • Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416–423.

    Article  CAS  PubMed  Google Scholar 

  • Thoresen, C. E., & Harris, H. S. (2002). Spirituality and health: What’s the evidence and what’s needed? Annals of Behavioral Medicine, 24(1), 3–13.

    Article  PubMed  Google Scholar 

  • Unwin, J., Kacperek, L., & Clarke, C. (2009). A prospective study of positive adjustment to lower limb amputation. Clinical Rehabilitation, 23(11), 1044–1050. doi:10.1177/0269215509339001.

    Article  PubMed  Google Scholar 

  • Windle, M. (1992). A longitudinal study of stress buffering for adolescent problem behaviors. Developmental Psychology, 28, 522–530.

    Article  Google Scholar 

  • World Health Organisation. (2001). The international classification of functioning, disability and health–icf. Geneve: WHO.

    Google Scholar 

  • Zung, W. W. K. (1965). A Self Rating Depression Scale. Archives of General Psychiatry, 12, 63–70.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, GC University Lahore, 192 B1 Johar Town, Lahore, Pakistan

    Syeda Shahida Batool & Samina Nawaz

Authors
  1. Syeda Shahida Batool
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Samina Nawaz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Syeda Shahida Batool.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Batool, S.S., Nawaz, S. Factors Affecting Disability-Related Depression in Patients with Lost Limbs: A Mediational Model. J Relig Health 55, 1381–1393 (2016). https://doi.org/10.1007/s10943-015-0098-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10943-015-0098-2

Keywords

Search

Navigation