Researchers in the Yale Departments of Psychiatry and Neurology found that in patients with Parkinson disease, depression, anxiety, and subjective incompetence are mediators between perceived stress and demoralization.
Using a statistical technique called path analysis, a type of structural regression modeling, they demonstrated that subjective incompetence was the largest contributor to demoralization and that depression connected to demoralization indirectly via subjective incompetence.
These findings, published in Frontiers in Psychiatry, are consistent with the hypothesis that subjective incompetence is the clinical hallmark of demoralization. This hypothesis was formulated years ago on the basis of clinical observations by the senior author and principal investigator, John M. de Figueiredo, MD, ScD, clinical professor of psychiatry at Yale, who was stimulated by the writings of Dr. Jerome D. Frank.