Diagnosis and measurement of subjective incompetence: the clinical hallmark of demoralization
Abstract
Background: This article presents the development and application of a method to diagnose and measure subjective incompetence, the clinical hallmark of demoralization. Methods: The subjects (n = 112) were patients with cancer at a consultation clinic of a cancer center. They completed a questionnaire on general background information, the Brief Cope Scale, and a newly developed scale to measure subjective incompetence. The development and psychometric properties of this scale were studied. Data analysis included both univariate and bivariate statistical tests and an examination of the intercorrelations between the subjective incompetence scores and the scores on the Brief Cope Scale. Results: The scale for subjective incompetence was found to have adequate reliability and validity. Conclusions: The proposed scale will allow us to determine if the distinction between depression and demoralization has practical implications and to what extent and to further clarify the role of demoralization in the etiology and pathogenesis of both physical illnesses and mental disorders. The combined use of this scale with the existing criteria and scales for demoralization will highlight the role of subjective incompetence in converting what might have been a normal response to stress into an abnormal state requiring intervention.
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The SIS is a newly developed scale with 12 items (score range 0-36).
“The SIS is a newly developed scale with 12 items (score range 0–36).7”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [7]
In the SIS validation study, the SIS yielded two factors, 'Basic Subjective Incompetence' and 'Severity Subjective Incompetence.'
“In this study, the SIS yielded two factors, “Basic Subjective Incompetence” and “Severity Subjective Incompetence.””
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [7]
There was a positive relationship between demoralization and denial, behavioral disengagement, and self-blame.
“denial, behavioral disengagement, and self-blame”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [7]
The SIS demonstrated convergent validity with the Brief Cope Scale and internal reliability for the total scale of α = 0.90.
“In addition, the SIS demonstrated convergent validity with the Brief Cope Scale, and internal reliability for the total scale was α = 0.90.”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [7]
There is less evidence to suggest that the SIS has adequate psychometric properties, given there was only one published validation study at the time of this review.
“Thus far, there is less evidence to suggest that the SIS has adequate psychometric properties, given there was only one published validation study at the time of this review.7”
From A systematic review of the demoralization syndrome in individuals with progressive disease and cancer: a decade of research (2015) · cites this paper as [7]
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- Authors
- Cockram, C. A., Doros, G., & de Figueiredo, J. M.
- Affiliations
- University of South Florida (US)
- Boston University (US)
- ORCID
- Doros, Gheorghe
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2009
- Volume
- 78
- Issue
- 6
- Pages
- 342-345
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2094263743
- Cited by
- 79
- References
- 12
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 5 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 8 · 2013: 7 · 2012: 5
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- demoralization, depression, cancer patients, Brief COPE scale, coping, scale development, psychometric properties, stress response, psychosomatic disorders
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Morale, Neoplasms, Psychiatric Status Rating Scales, Psychophysiologic Disorders, Stress, Psychological, Young Adult
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