General Self-Efficacy as a Driving Factor of Post-Stroke Depression: A Longitudinal Study
Abstract
Post-stroke depression (PSD) is the most common psychiatric condition after stroke, affecting one third of survivors. Despite identification of meaningful predictors, knowledge about the interplay between these factors remains fragmentary. General self-efficacy (GSE) is closely linked to PSD, yet direction and magnitude of this relationship remains unclear. The authors assessed the relationship between GSE and depression during the first two years post-stroke while controlling for stable inter-individual differences using continuous time (CT) structural equation modelling (SEM). Patients of two German rehabilitation centres (N = 294, mean age = 63.78 years, SD = 10.83) were assessed six weeks after ischemic stroke and at four follow-ups covering two years. GSE Scale and Geriatric Depression Scale (GDS) were used to assess GSE and depression. CT-analysis revealed significantly higher within-person cross-effects of GSE on GDS (a21 = −.29) than vice versa (a12 = −.17). Maximal cross-lagged effects emerged six months post-stroke. Our results show that decreasing GSE led to increasing depressiveness, and only to a smaller extent vice versa. This suggests that fostering GSE by strengthening perceived control after stroke can counter PSD emersion and exacerbation. Six months post-stroke, when patients face social re-integration, programmes focusing on GSE could potentially help to prevent later PSD.
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The level of self-efficacy may influence recovery results, depression occurrence, professional performance, quality of life, PA, daily activities, and mobility after stroke.
“The level of self-efficacy may influence the results of recovery [18], the occurrence of depression [19,20,21], improvement of professional performance [22], quality of life, PA, daily activities [23] and mobility [20] after a stroke.”
From Physical Activity, Psychological and Functional Outcomes in Non-Ambulatory Stroke Patients during Rehabilitation—A Pilot Study (2022) · cites this paper as [19]
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Jourdan, C., Ruet, A., Bayen, É., Vallat‐Azouvi, C., Pradat-Diehl, P., & Azouvi, P. (2026) · Annals of Physical and Rehabilitation Medicine · doi:10.1016/j.rehab.2026.102175
Effort-based decision-making:A value-based dissection and arousal-focused synthesis
Clairis, N., & Tobler, P. N. (2026) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2026.107062
- Authors
- Volz, M., Voelkle, M. C., & Werheid, K.
- Affiliations
- Humboldt-Universität zu Berlin (DE)
- Corresponding author
- Volz, Matthias
- Venue
- Neuropsychological Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2018-01-04
- Volume
- 29
- Issue
- 9
- Pages
- 1426-1438
- ISSN
- 0960-2011 (ISSN-L)
- 1464-0694
- OpenAlex
- W2782098470
- Cited by
- 65
- References
- 47
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 10 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 11 · 2019: 1 · 2018: 2
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychological Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- PUB – Publications at Bielefeld University (Bielefeld University) (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Funders
- Humboldt University
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- post-stroke depression, general self-efficacy, ischemic stroke, perceived control, within-person effects, cross-lagged effects, stroke rehabilitation, social reintegration, depression prevention
- MeSH terms
- Aged, Brain Ischemia, Depressive Disorder, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Self Efficacy, Stroke
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