Functional Impairment and Depressive Symptoms: Mitigating Effects of Trait Hope Jameson K. Hirsch, Ph.D. 1,2, S. Kaye, B.S. 1, & Jeffrey M. Lyness, M.D. 2 Department of Psychology, East Tennessee State University 1 Department of Psychiatry, University of Rochester Medical Center 2 INTRODUCTION As adults age, chronic disease and functional impairment are common (Pope & Tarlove, 1991), and may result in depressive symptoms (Alexopoulos, 2005). Activity or role restriction due to failing health and perceived loss of physical independence may mediate the relationship between disease and depressive symptoms (Benyamini & Lomranz, 2004). Lewinsohn, Hoberman & Hautzinger, (1985) proposed an integrative model of depression suggesting that events which disrupt automatic functioning, such as functional impairment, and which increase negative or decrease positive events, may enhance vulnerability to depression. Positive or adaptive characteristics, such as trait hope, may contribute to resiliency in the face of illness or impairment, buffering against such poor outcomes (Scheier, et al., 2001; Snyder et al, 1991; Sood, et al., 2007). Snyder, et al. (1991) defined hope as an interactive, cognitive-motivational set composed of goal directed determination (agency) and the planning and resources needed to achieve goals (pathways). Older adults experiencing functional impairment or medical illness burden may benefit from interventions designed to enhance adaptive psychological functioning and well-being. RESULTS Correlations: Negative correlations between trait hope & depression; between agency subscale & depression; between age & pathways subscale. MODEL I: Functional impairment was significantly associated with depressive symptoms (p<.001), and dispositional hope total score moderated this relationship (p<.05), over and above the effects of covariates. Illness burden was also a significant, independent contributor to depressive symptoms. MODEL II: Neither the pathways or agency subscales of trait hope reached significance as moderators. Illness burden was a significant, independent contributor to depressive symptoms. DISCUSSION We found that trait hope total score was a significant moderator of the association between functional impairment and depressive symptoms. Patients with greater hopefulness reported less depressive symptoms as a result of functional impairment than patients who were less hopeful. Trait hope subscales of agency and pathways were not, of themselves, significant moderators, supporting the assertion of Snyder’s theory that both a sense of will (agency) and a perception of means toward goal attainment (pathways) must be present in order for an individual to benefit from trait hope (Snyder, 1999). Functional impairment may undermine sense of self- efficacy and independence, contributing to depressive symptoms (Gurland et al., 1983). In the face of adverse life events such as functional impairment and medical illness, positive, cognitive- emotional constructs, such as hopefulness, may buffer against poor psychological outcomes such as depressive symptoms and suicidal behaviors (Hirsch, et al., 2009). Promotion of self-efficacy and provision of environmental support for older adults may increase resilience in the context of chronic medical problems and functional impairment (Hirsch et al., 2009). IMPLICATIONS Our findings may have implications for the treatment of depressive symptoms in older primary care patients with functional impairment. Improving motivation, encouraging goal-setting and goal- directed activities, promoting intergenerational relationships, and facilitating future orientation may be targeted intervention strategies for improvement of depression in functionally-impaired older adults. LIMITATIONS Cross-sectional data does not allow assessment of causality; Bi-directionality is a possibility. Assessment of older adults is a strength; however, future research should examine these associations in additional clinical samples and age groups. ABSTRACT Older adults, perhaps due to illness or aging, may experience a loss of ability to function independently, potentially resulting in depressive symptoms. Positive cognitive and emotional characteristics may attenuate the relationship between functional impairment and depressive symptoms. We examined trait hope, and its subscales of agency and pathways, as potential moderators of the association between functional impairment and depression. Trait hope did, indeed, buffer this relationship; however, the separate subscales of agency and pathways were not moderators. Promotion of positive psychological characteristics may increase resilience in the context of functional impairment and chronic medical problems. ANALYSES Bivariate correlations Multivariate, hierarchical linear regressions to assess moderation Covariates = age, gender, medical illness burden (CIRS), and cognitive functioning (MMSE). HYPOTHESES Trait hope, and its subscales of agency and pathways, will moderate the relationship between functional impairment and depressive symptoms. METHODS Participants: Older Adult, Primary Care Patients N = 110; 62% Female Mean Age (SD=5.56) Measures: Hamilton Rating Scale for Depression Goals Scale (Trait Hope) Karnofsky Performance Status Scale (KPSS) TRAIT HOPE ITEMS 1.I can think of many ways to get out of a jam. 2.I energetically pursue my goals. 3.There are lots of ways around any problem. 4.I can think of many ways to get the things in life that are most important to me. 5.Even when others get discouraged, I know I can find a way to solve the problem. 6.I meet the goals that I set for myself.