title: Self-esteem stability and depressive symptoms in acute stroke rehabilitation: methodological and conceptual expansion.
abstract: OBJECTIVE
  Explore the relationship of self-esteem level, self-esteem stability, and other moderating variables with depressive symptoms in acute stroke rehabilitation.
  
  
  METHODS
  One hundred twenty participants completed measures of state self-esteem, perceived recovery, hospitalization-based hassles, impairment-related distress, and tendency to overgeneralize negative self-connotations of bad events. Self-report of depressive symptoms was collected at admission and on discharge. Four regression analyses explored the relationship of self-esteem level and stability and each of 4 moderating variables (perceived recovery, hassles, impairment-related distress, and overgeneralization) with depressive symptoms at discharge.
  
  
  RESULTS
  Analyses indicated significant 3-way interactions in the 4 regression models. In general, individuals with unstable high self-esteem endorsed greater depressive symptoms under conditions of vulnerability (e.g., lower perceived recovery) than did individuals with stable high self-esteem. Under conditions of vulnerability, participants with stable low self-esteem indicated the highest levels of depressive symptoms.
  
  
  CONCLUSIONS
  Self-esteem level and stability interact with psychological, environmental, and stroke-specific variables to predict depressive symptoms at discharge from stroke rehabilitation. This suggests the viability of self-esteem stability in exploring depressive symptoms in this setting and the complexity of emotional adjustment early after stroke.
authors.affiliation: Department of Neurology, Methodist Rehabilitation Center, Jackson, Mississppi 39216, USA. chadvickery@hotmail.com
authors.forename: Chad D
authors.initials: CD
authors.lastname: Vickery
authors.forename: Clea C
authors.initials: CC
authors.lastname: Evans
authors.forename: Arash
authors.initials: A
authors.lastname: Sepehri
authors.forename: Linsa N
authors.initials: LN
authors.lastname: Jabeen
authors.forename: Monee
authors.initials: M
authors.lastname: Gayden
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012047:Rehabilitation Centers; D012649:Self Concept; D012650:Self Disclosure; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology / Q000523:psychology; D020521:Stroke / Q000150:complications / Q000523:psychology*; D000071939:Stroke Rehabilitation