Abstract
The objective of the present study was to determine the mediating role of self-efficacy between religiosity, social support, and depression in patients with lost limbs. We sampled 67 male and 33 female disabled patients who had lost limbs in accidents or amputations from four public hospitals in Lahore, Pakistan, and used Religiosity Index (Farooq and Imam, in The effect of religiosity on locus of control. Department of Psychology, Govt College University, Lahore, 1997), General Self-efficacy Scales (Tabassum et al., in Urdu adaptation of the general self-efficacy scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm, 2003), Berlin Social Support Scale (Schwarzer and Schulz, in Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm, 2000), and Siddiqui–Shah Depression Scale (Siddiqui and Shah, in Pychol Dev Soc 9(2):245–262, 1997), and used a correlation matrix and mediational analyses along with other inferential statistics to develop a model that suggested self-efficacy mediated between religiosity, social support, and depression with negative correlations that partially mediated this relationship. The findings suggest that low level of religiosity, social support, and self-efficacy may play a role in the onset and continuation of depression or its symptoms. We found no significant differences in gender, education, and cause of disability in patients with lost limbs. Results have implications for clinical psychologists, counselors, and health psychologists to develop a treatment plan for such patients with depression focusing on the factors implicated above.
Similar content being viewed by others
References
Allgower, A., Wardle, J., & Steptoe, A. (2001). Depressive symptoms, social support, and personal health behaviors in young men and women. Health Psychology, 20, 223–227. doi:10.1037/0278-6133.20.3.223.
Arnstein, P., Caudill, M., Mandle, C. L., Norris, A., & Beasley, R. (1999). Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients. Pain, 80(3), 483–491.
Auerbach, R. P., Bigda-Peyton, J. S., Eberhart, N. K., Webb, C. A., & Ringo-Ho, M. (2010). conceptualizing the prospective relationship between social support, stress, and depressive symptoms among adolescents. Journal of Abnormal Child Psychology. doi:10.1007/s10802-010-9479-x.
Bandura, A., Pastorelli, C., Barbaranelli, C., & Caprara, G. V. (1999). Self-efficacy pathways to childhood depression. Journal of Personality and Social Psychology, 76(2), 258–269.
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.
Bogard, K. L. (2005). Affluent adolescents, depression, and drug use: The role of adults in their lives. Adolescence, 40, 281–306.
Bonelli, R., Dew, R. E., Koenig, H. G., Rosmarin, D. H., & Vasegh, S. (2012). Religious and spiritual factors in depression: Review and integration of the research. Depression Research and Treatment, 179, 1–8. doi:10.1155/2012/962860.
Brummett, B. H., Barefoot, J. C., Vitaliano, P. P., & Siegler, I. C. (2003). Associations among social support, income, and symptoms of depression in an educated sample: The UNC alumni heart study. International Journal of Behavioral Medicine, 10(3), 239–250.
Byrne, P. F. (2012). I believe; I can : the relationship between religiosity, general self-efficacy and locus of control. Article retrieved from http://esource.dbs.ie/handle/10788/462
Comunian, A. L. (1989). Some characteristics of relations among depression, anxiety, and selfefficacy. Perceptual and Motor Skills, 69, 755–764.
Coultas, D. B., Edwards, D. W., Barnett, B., & Wludyka, P. (2007). Predictors of depressive symptoms in patients with COPD and health impact. Journal of Chronic Obstructive Pulmonary Disease, 4(1), 23–28.
Crocker, A. D., & Hakim-Larson, J. (1997). Predictors of pre-adolescent depression and suicidal ideation. Canadian Journal of Behavioural Science, 29, 76–82.
Davis, B. J. (1990). Physical self efficacy, perceived physical status, and depression symptomatology in older adults. Journal of Psychology, 124(2), 207–215.
Gull, F., & Dawood, S. (2012). Religiosity, social support, coping strategies and subjective well being among people living in old homes. (Unpublished Mphil thesis). Lahore: Center for Clinical Psychology, University of the Punjab.
Deno, M., Tashiro, M., Miyashita, M., Asakage, T., Takahashi, K., & Saito, K. (2012). The mediating effects of social support and self-efficacy on the relationship between social distress and emotional distress in head and neck cancer outpatients with facial disfigurement. Psychooncology, 21(2), 144–152.
DeVellis, B., & DeVellis, R. (2001). Self-efficacy and health. In A. Baum, T. Revenson, & J. Singh (Eds.), Handbook of Health Psychology (pp. 235–247). Hillsdale, NJ: Lawrence Earlbaum.
Dieserud, G., Roysamb, E., Ekeberg, O., & Kraft, P. (2001). Toward an integrated model of suicidal attempt: a cognitive psychological approach. Suicide & Life Threating Behavavior, 31(2), 153–168.
Ehrenberg, M. F., Cox, D. N., & Koopman, R. F. (1991). The relationship between self-efficacy and depression in adolescents. Adolescence, 26, 361–374.
Ellonen, N., Kääriäinen, J., & Autio, V. (2008). Adolescent depression and school support: a multilevel analysis of a Finnish sample. Journal of Community Psychology, 36, 552–567.
Farooq, N., & Imam, S. (1997). The effect of religiosity on locus of control. (Unpublished Masters thesis). Lahore: Department of Psychology, Govt College University.
Field, T., Diego, M., & Sanders, C. (2001). Adolescent depression and risk factors. Adolescence, 36, 491–498.
Flett, G. L., Panico, T., & Hewitt, P. L. (2011). Perfectionism, Type A behavior, and selfefficacy in depression and health symptoms among adolescents. Current Psychology, 30, 105–116.
Francis, L. J., Robbins, M., Lewis, C. A., Quigley, C. F., & Wheeler, C. (2004). Religiosity and general health among undergraduate students: A response to O’Connor (2003). Journal of Personality and Individual Difference, 37(3), 485–494.
Freedman, D. A. (1987). As others see us: A case study in path analysis. Journal of Educational Statistics, 12, 101–128.
Freedman, D. A. (1997). From association to causation via regression. In V. R. McKim & S. P. Turner (Eds.), Causality in crisis? Statistical methods and the search for causal knowledge in the social sciences (pp. 113–161, 177–182). Notre Dame, IN: University of Notre Dame Press.
Gee, C., & Rhodes, J. (2007). A Social support and social strain measure for minority adolescent mothers: A Confirmatory factor analytic study. Child: Care. Health and Development, 34, 87–97.
Goldman, D., & Lakdawalla, D. (2001). Understanding health disparities across education groups. WP: National Bureau of Economic Research. 8326.
Goldman, D., & Smith, J. (2002). Can patient self-management help explain the SES health? Proceedings, National Academy of Sciences, 99, 10929–10934.
Haber, M. G., Cohen, J. L., Lucas, T., & Baltes, B. B. (2007). The relationship between selfreported received and perceived social support: A meta-analytic review. American Journal of Community Psychology, 39, 133–144. doi:10.1007/s10464-007-9100-9.
Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin, 127, 773–796.
Hassan, S., & Malik, A. A. (2012). Psycho-social correlates of intimate partner violence. Pakistan Journal of Psychological Research, 27(2), 279–295.
Hobfoll, S. E., Freedy, J., Lane, C., & Geller, P. (1990). Conservation of social resources: Social support resource theory. Journal of Social and Personal Relationships, 7, 465–478.
Jette, A. M. (2006). Toward a common language for function, disability, and health. Physical Therapy, 86(5), 726–734.
Karademas, E. C. (2006). Self-efficacy, social support and well-being: the mediating role of optimism. Personality and Individual Difference, 40(6), 1281–1290.
Kendler, K. S., Myers, M. S., & Prescott, C. A. (2005). Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs. The American Journal of Psychiatry, 162, 250–256.
Kenkel, D. S. (1991). Health behaviour, health knowledge and schooling. Journal of Political Economy, 99, 287–305.
Koenig, H. G., George, L. K., & Peterson, B. L. (1998a). Religiosity and remission of depression in medically ill older patients. American Journal of Psychiatry, 155, 536–542.
Koenig, H. G., Pargament, K. I., & Nielsen, J. (1998b). Religious coping and health status in medically ill hospitalized adults. The Journal of Nervous and Mental Disease, 186, 513–521.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lepore, S. L., Glaser, D. B., & Roberts, K. J. (2008). On the positive relation between received social support and negative affect: a test of the triage and self-esteem threat models in women with breast cancer. Psycho-Oncology, 17(12), 1210–1215.
Levin, S. J., & Chatters, M. L. (1998). Religion health and psychological well-being in older adults. Journal of Aging and Health, 10, 504–531.
Levine, E. G., & Targ, E. (2002). Spiritual correlates of functional well-being in women with breast cancer. Integrative Cancer Therapies, 1, 166–174.
Luszczynska, A., & Schwarzer, R. (2005). The role of self-efficacy in health self-regulation. In W. Greve, K. Rothermund, & D. Wentura (Eds.), The adaptive self: Personal continuity and intentional self-development (pp. 137–152). Göttingen: Hogrefe/Huber.
Lutjen, L. J., Silton, N. R., & Flannelly, K. J. (2012). Religion, forgiveness, hostility and health: A structural equation analysis. Journal of Religion and Health, 51(2), 468–478. doi:10.1007/s10943-011-9511-7.
Makaremi, A. (2000). Self-efficacy and depression among Iranian college students. Psychological Reports, 86(2), 386–388.
Maltay, J., & Day, L. (2000). Depressive symptoms and religious orientation: examining the relationship between religiosity and depression within context of other correlates of depression. Personality and Individual Differences, 28, 383–393.
McFarlane, A. H., Kamath, M. V., Fallen, E. L., Malcolm, V., Cherian, F., & Norman, F. (2001). The effect of sertraline on the recovery rate of cardiac autonomic function in depressed patients following an acute myocardial infarction. American Heart Journal, 142(4), 617–623.
Meehl, P. E., & Waller, N. G. (2002). The Path analysis controversy: A New statistical approach to strong appraisal of verisimilitude. Psychological Methods, 7(3), 283–300.
Meraviglia, M. G. (2004). The effects of spirituality on well-being of people with lung cancer. Oncology Nursing Forum, 31, 89–94.
Miller, L., Wickramaratne, P., Gameroff, M. J., Sage, M., Tenke, C. E., & Weissman, M. M. (2012). Religiosity and major depression in adults at high risk: A ten-year prospective study. American Journal of Psychiatry, 169, 89–94.
Moatamedi, A., Ezhehei, J., Azad Fallah, P., & Kiamanes, A. R. (2005). The relationship between religious tendency and successful aging. Daneshvar Raftar, 12(10), 43–56.
Moreira-Almeida, A., Neto, F. L., & Koenig, H. G. (2006). Religiousness and mental health: A review. Revista Brasileira de Psiquiatria, 28(3), 242–250.
Mosqueiro, B. P., da Rocha, N. S., & Fleck, M. P. A. (2015). Intrinsic religiosity, resilience, quality of life, and suicide risk in depressed inpatients. Journal of Affective Disorders, 179, 128–133.
Nolen-Hoeksema, S. (2001). Abnormal Psychology. New York: McGraw Hill.
Pajares, F. (2002). Gender and perceived self-efficacy in self-regulated learning. Theory into Practice, 41(2), 116–125.
Palesh, O. G., Shaffer, T., Larson, J., Edsall, S., Chen, X. H., & Koopman, C. (2006). Emotional self-efficacy, stressful life events, and satisfaction with social support in relation to mood disturbance among women living with breast cancer in rural communities. The Breast Journal, 12(2), 123–129.
Pargament, K. I. (1997). The psychology of religion and coping: theory, research, practice. New York: The Guilford Press.
Pargament, K. I., Koenig, H. G., Tarakeshwar, N., & Hahn, J. (2001). Religious struggle as a predictor of mortality among medically ill elderly patients: A 2-year longitudinal study. Archives of Internal Medicine, 161(15), 1881–1885.
Ray, R., Dasgupta, P., & Basu, S. (2003). Unknown women: Aged, widowed, tribals & urbans. Kolkata: Classique Books.
Rizwan, M., & Syed, N. (2010). Urdu translation and psychometric properties of Social Provision Scale. The International Journal of Eductional Psychological Assessment, 4, 33–47.
Sacco, W. P., Wells, K. J., Vaughan, C. A., Friedman, A., Perez, S., & Matthew, R. (2005). Depression in adults with type 2 diabetes: the role of adherence, body mass index, and selfefficacy. Health Psychology, 24(6), 630–634.
Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy Scale. In J. Weinman, S. Wright, & M. Johnston. Measures in health psychology: A user’s portfolio. Causal and control beliefs (pp. 35–37). Windsor, England: NFER-NELSON. Scale retrieved from http://www.midss.org/sites/default/files/faq_gse.pdf
Schwarzer, R., & Schulz, U. (2000). Berlin Social Support Scales. Retrieved online from http://userpage.fuberlin.de/~gesund/skalen/Language_Selection/Turkish/BerlinSocialSupportScales/berlin_social_support_scales.htm
Segal, Z. V., & Ingram, R. E. (1994). Mood priming and construct activation in tests of cognitive vulnerability to unipolar depression. Clinical Psychology Review, 14, 663–695.
Shehni, Y. M., Movahhed, A., & Shokrkon, H. (2002). Relationships between religious attitudes, well-being, physical and mental health among students of Shahid Chamran university of Ahvaz. Journal of Psychological and Educational Science, 11(1–2), 19–34.
Siddiqui, S., & Shah, S. A. A. (1997). Siddiqui-Shah Depression Scale (SSDS): Development and Validation. Pychology and Developing Societies, 9(2), 245–262.
Singh, R., Ripley, D., Pentland, B., Todd, I., Hunter, J., Hutton, L., & Philip, A. (2009). Depression and anxiety symptoms after lower limb amputation: the rise and fall. Clinical Rehabilitation, 23(3), 281–286. doi:10.1177/0269215508094710.
Smith, C. (2003). Theorizing religious effects among American adolescents. Journal for the Scientific Study of Religion, 42, 17–30.
Smith, T. B., McCullough, M. E., & Poll, J. (2003). Religiousness and depression: Evidence for a main effect and the moderating Influence of stressful life events. Psychological Bulletin, 129(4), 614–636.
Srinivasan, C. (2013). Religiosity and well-being of older adults in Chennai. India. Aging & Mental Health, 17(7), 880–887.
Stroppa, A., & Moreira-Almeida, A. (2013). Religiosity, mood symptoms, and quality of life in bipolar disorder. Bipolar Disorders, 15, 385–393.
Tabassum, U., Rehman, G., Schwarzer, R., & Jerusalem, M. (2003). Urdu Adaptation of the General Self-Efficacy Scale. Retrieved from http://userpage.fu-berlin.de/~health/urdu.htm.
Thase, M. E., Jindal, R., & Howland, R. H. (2002). Biological aspect of depression. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 192–218). New York: Guilford Press.
Thoits, P. A. (1986). Social support as coping assistance. Journal of Consulting and Clinical Psychology, 54(4), 416–423.
Thoresen, C. E., & Harris, H. S. (2002). Spirituality and health: What’s the evidence and what’s needed? Annals of Behavioral Medicine, 24(1), 3–13.
Unwin, J., Kacperek, L., & Clarke, C. (2009). A prospective study of positive adjustment to lower limb amputation. Clinical Rehabilitation, 23(11), 1044–1050. doi:10.1177/0269215509339001.
Windle, M. (1992). A longitudinal study of stress buffering for adolescent problem behaviors. Developmental Psychology, 28, 522–530.
World Health Organisation. (2001). The international classification of functioning, disability and health–icf. Geneve: WHO.
Zung, W. W. K. (1965). A Self Rating Depression Scale. Archives of General Psychiatry, 12, 63–70.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Batool, S.S., Nawaz, S. Factors Affecting Disability-Related Depression in Patients with Lost Limbs: A Mediational Model. J Relig Health 55, 1381–1393 (2016). https://doi.org/10.1007/s10943-015-0098-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-015-0098-2