This article explores manifestations of demoralization, addresses the issue of demoralization in relation to depression, and proposes a theoretical definition and model of demoralization as part of a continuum of depressogenic responses. The proposed model links selected person-environment factors, such as negative life events and perceived stress, with deficit coping and selected cognitive-attributional, affective, and social responses. In addition, pertinent psychotherapeutic nursing interventions to assist clients in combating demoralization and implications for research are discussed. With an understanding of the manifestations of demoralization, nurses can better recognize it in their clients and implement interventions to prevent the development of serious depression.
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References
1.
Abramson, L. Y., Alloy, L. B., & Metalsky, G. I. (1995). Hopelessness depression. In G. M. Buchanan & M. E. P. Seligman (Eds.), Explanatory style (pp. 113-134). Hillsdale, NJ: Lawrence Erlbaum.
2.
Abramson, L.Y., Dykman, B. M., & Needles, D. J. (1991). Attributional style and theory: Let no one tear them asunder. Psychological Inquiry, 2(1), 11-13.
3.
de Figueiredo, J. M. (1993). Depression and demoralization: Phenomenological differences and research perspectives. Comprehensive Psychiatry, 34, 308-311.
4.
Dohrenwend, B. P., & Shrout, P. E. (1988). Changing time frames on symptom inventories: Effects on the Psychiatric Epidemiology Research Interview. Journal of Consulting and Clinical Psychology, 56, 267-272.
5.
Dohrenwend, B. P., Shrout, P. E., Egri, G., & Mendelsohn, F. S. (1980). Nonspecific psychological distress and other dimensions of psychopathology. Measures for use in the general population. Archives of General Psychiatry, 37, 1229-1236.
6.
Dyer, J. G., & Giles, D. E. (1994). Familial influence in unipolar depression: Effects of parental cognitions and social adjustment on adult offspring. Comprehensive Psychiatry, 35, 290-295.
7.
Frank, J. D. (1984). Interview with Jerome Frank, Ph.D., MD. Exploring concepts of influence, persuasion, and healing. Journal of Psychosocial Nursing & Mental Health Services, 22(9), 32-34, 36-37.
8.
Frank, J. D. (1973). Persuasion and healing. Baltimore: The Johns Hopkins University Press.
9.
Frank, J. D. (1978). Psychotherapy and the human predicament. New York: Schocken Books.
10.
Frankl, V. E. (1963). Man’s search for meaning. Boston: Beacon Press.
11.
Gilbert, P. (1992). Depression: The evolution of powerlessness. New York: Guilford Press.
12.
Hodgson, R., Abasi, T., & Clarkson, J. (1996). Effective mental health promotion: A literature review. Health Education Journal, 55, 55-74.
13.
Kriedman, E. (1996). Light your fire: Program l: The power of words [Audiotape]. Commerce, CA: Mega systems International.
14.
Link, B., & Dohrenwend, B. P. (1980). Formulation of hypotheses about the true prevalence of demoralization in the United States. In B. P. Dohrenwend, B. S. Dohrenwend, M.S. Gould, B. Link, R. Neugebauer, & R. Wunsch-Hitzig (Eds.), Mental illness in the United States: Epidemiological estimates (pp. 114-132). New York: Praeger.
15.
Maxwell, J. C. (2000). Failing forward: Turning mistakes into stepping stones for success. Nashville, TN: Thomas Nelson.
16.
Miller, S. D., de Shazer, S., Berg, I. K., & Hopwood, L. (1993). From problem to solution: The solution-focused brief therapy approach. New York: W. W. Norton.
17.
Nadzam, D. (1986). Depression and demoralization of the aged. Unpublished doctoral dissertation, Case Western Reserve University, Cleveland, OH.
18.
Peden, A. R. (2000). Negative thoughts of women with depression. Journal of the American Psychiatric Nurses Association, 6, 41-48.
19.
Peden, A. R., Hall, L. A., Rayens, M. K. & Beebe, L. L. (2000). Reducing negative thinking and depressive symptoms in college women. Journal of Nursing Scholarship, 32, 145-151.
20.
Perrah, M., & Wichman, H. (1987). Cognitive rigidity in suicide attempters. Suicide & Life-Threatening Behavior, 17, 251-255.
21.
Peterson, C., & Buchanan, G. M. (1995). Explanatory style: History and evolution of the field. In G. M. Buchanan & M. E. P. Seligman (Eds.), Explanatory style (pp. 1-20). Hillsdale, NJ: Lawrence Erlbaum.
22.
Random House Webster’s Dictionary. (1998). New York: Ballantine Books.
23.
Schotte, D. E., Cools, J., & Payvar, S. (1990). Problem-solving deficits in suicidal patients: Trait vulnerability or state phenomenon? Journal of Consulting & Clinical Psychology, 58, 562-564.
24.
Seligman, M. E. P. (1995). The optimistic child. Boston: Houghton Mifflin.
25.
Walter, J. L., & Peller, J. E. (1992). Becoming solution-focused in brief therapy. New York: Brunner/Mazel.
26.
Yalom, I. D. (1980). Existential psychotherapy. New York: Basic Books.
27.
Zauszniewski, J. A., & Rong, J. R. (1999). Depressive cognitions and psychosocial functioning: A test of Beck’s cognitive theory. Archives of Psychiatric Nursing, 13, 286-293.
