Stigma, depression, and post-traumatic growth among Chinese stroke survivors: A longitudinal study examining patterns and correlations

Top Stroke Rehabil. 2022 Jan;29(1):16-29. doi: 10.1080/10749357.2020.1864965. Epub 2020 Dec 28.

Abstract

Background: With the development of positive psychology, several studies show that positive and negative emotions are not always opposing. Understanding how positive and negative emotions correlate and the factors contributing to resilience in stroke survivors requires further research.

Objectives: To identify the patterns and correlations of stigma, depression, and posttraumatic growth (PTG) among stroke survivors.

Methods: Stroke-related stigma, depression, PTG, and neurological status were evaluated at 1-month and 3 months post-stroke using the Stroke Stigma Scale (SSS), Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Posttraumatic Growth Inventory (C-PTGI), modified Rankin Scale (mRS), and Social Support Rating Scale (SSRS). The paired t-test, nonparametric test, and Spearman's correlation test were used to analyze differences and relationships between results at the two time points.

Results: At 3 months compared to 1-month post-stroke, we found significant reductions in mRS and stigma scores, and an increase in PTGI scores, while the PHQ-9 scores reduced non-significantly. SSS, PHQ-9, and mRS scores were positively correlated with each other at time1 (all P < .01), and all showed no significant relationships with PTGI scores (all P > .05). Social support scores were negatively correlated with stigma (P < .01), PHQ-9 (P < .01), and PTGI scores (P > .05) at 3 months.

Conclusions: Stroke-related stigma is strongly associated with depression while neither of them has significant relationships with PTG during the early stage of survivors' rehabilitation in our study. Neurological impairment is a risk factor for negative emotions and increasing individualized support may reduce stigma, depression, and promote PTG in the long term.

Keywords: Stroke; depression; posttraumatic growth; social support; stigma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • China
  • Depression / etiology
  • Depression / psychology
  • Humans
  • Longitudinal Studies
  • Posttraumatic Growth, Psychological*
  • Stroke* / complications
  • Stroke* / psychology
  • Survivors / psychology