Loss of resources and demoralization in the chronically ill, Dischinger et al., 2019

Dolphin · Aug 13, 2019

I have no idea what this might be like. I just thought it was interesting to see "loss of resources" mentioned in a paper. There is also a "loss of resources inventory" mentioned. I think people with ME/CFS can have huge losses of resources.

https://www.sciencedirect.com/science/article/pii/S0163834319302026

General Hospital Psychiatry
Available online 10 August 2019
In Press, Journal Pre-proof
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Loss of resources and demoralization in the chronically ill
Author links open overlay panel
M.I.Dischingera
L.Langea
S.Vehlingb
https://doi.org/10.1016/j.genhosppsych.2019.08.002 Get rights and content

Abstract
Objective
The study examined whether the association between the severity of physical symptoms and demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms.

Method
This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire – Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression.

Results
Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high demoralization. Loss of resources fully mediated the effect of symptom severity on demoralization, explaining 56% of the variance of demoralization and inhibiting the initially significant effect of symptom severity on demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (−0.27, 0.32)].

Conclusion
Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of demoralization in individuals with chronic symptoms.
Click to expand...

Keywords
Demoralization
COR theory
Loss of resources
Chronic symptoms

Trish · Aug 13, 2019

I wish they would write in plain English.
What sort of resources are they talking about - money, employment, home, or emotional resources?

feeb · Aug 13, 2019

Wikipedia has a page on COR theory (mentioned in the keywords) here: https://en.wikipedia.org/wiki/Conservation_of_resources_theory

This is the only attempt at a definition:

Hobfoll posited that psychological stress occurred in three instances; when there was a threat of a loss of resources, an actual net loss of resources, and a lack of gained resources following the spending of resources. From this perspective, resources are defined as things that one values, specifically objects, states, and conditions. [2] COR states that loss of these types of resources will drive individuals into certain levels of stress.
Click to expand...

Shrug.

NelliePledge · Aug 13, 2019

I really hate this pseudo intellectual way of writing that some academics use.

rvallee · Aug 13, 2019

Oddly enough, losing 90%+ of income is bad for having access to resources. More so when compensating resources are denied. Even more so when overt discrimination leads to ostracization, cutting off yet another compensating resource. It would be interesting to compare with otherwise healthy people being made to permanently lose 90%+ of their income. I suspect using those questionnaires it would be hard to distinguish as there would be much overlap.

Medicine still seems to be on square one as far as understanding the social and economic consequences of illness. As if people still believed in the disability fairy, you know, the purveyor of those sweet, sweet secondary benefits. Bit embarrassing.

Simbindi · Aug 14, 2019

rvallee said: ↑

As if people still believed in the disability fairy, you know, the purveyor of those sweet, sweet secondary benefits
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I love your way with words!

rvallee · Aug 14, 2019

Simbindi said: ↑

I love your way with words!
Click to expand...

I really hope to turn that into a satirical comic or video one day. I think it would hurt in places people are not aware they can hurt. So many bizarre ideas about what happens when you get sick, and most of those seem to be believed by the very same people who make it not happen. Just weird. Something like a crossover between Dora the explorer, Catch-22 and H.P. Lovecraft.

Andy · Sep 28, 2019

Merged thread

Psychs in shock "having a misunderstood chronic illness is shit" discovery!

Objective
The study examined whether the association between the severity of physical symptoms and demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms.

Method
This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire – Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression.

Results
Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high demoralization. Loss of resources fully mediated the effect of symptom severity on demoralization, explaining 56% of the variance of demoralization and inhibiting the initially significant effect of symptom severity on demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (−0.27, 0.32)].

Conclusion
Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of demoralization in individuals with chronic symptoms.
Click to expand...

Paywall, https://www.sciencedirect.com/science/article/pii/S0163834319302026
Scihub, https://sci-hub.se/10.1016/j.genhosppsych.2019.08.002

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