Psychometric properties and normative values of the revised demoralization scale (DS-II) in a representative sample of the German general population

• Published in: BMC psychiatry Vol. 23; no. 1; pp. 1 - 685
• Main Authors: Ramm, Markus, Jedamzik, Johanna, Lenz, Philipp, Poopana, Anileeta, Heuft, Gereon, Conrad, Rupert
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 20.09.2023; BioMed Central; BMC
• Subjects: Age; Age groups; Analysis; Cancer; Chronic diseases; Chronic illnesses; Coping; Demoralization; Evaluation; Gender; Gender identity; General population; Households; Interpreters; Mental depression; Palliative; Palliative care; Palliative treatment; Population; Prevention; Psychiatry; Psycho-oncology; Psychometrics; Quality of life; Quantitative psychology; Questionnaires; Risk factors; Sociodemographics; Statistical analysis; Surveys; Translations and translating; Germany
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-023-05187-9

Abstract Background Demoralization is a clinically relevant syndrome in chronic diseases. The demoralization scale (DS-II) was recently developed as an economic screening tool in clinical populations. Main aim of this study was to provide normative data of DS-II scores in the general population. Methods We developed a new German version, the DS-II Münster, and tested internal consistency as well as the previously proposed two-factor structure with confirmatory factor analyses. The DS-II was applied in a household survey of the general population. Associations between DS-II scores and age, gender and other sociodemographic variables were explored. Results The final sample consisted of N  = 2471 participants (mean age = 49.8 years, range: 18–96; 50.1% men, 49.8% women). The DS-II Münster showed nearly excellent internal consistency. The model fit indices of the two-factor structure were not superior to those of the one-factor model. Mean scores of the DS-II were as follows. Total score: M = 3.76 (SD = 5.56), Meaning and Purpose subscale: M = 1.65 (SD = 2.77), Distress and Coping Ability subscale: M = 2.11 (SD = 3.02). DS-II scores were increased in women with an effect size of Cohen’s d = 0.19. An age-related increase was specifically found for the Meaning and Purpose subscale (d = 0.21). Conclusions The study provides normative values of the DS-II with respect to age and gender in the general population to facilitate interpretation of DS-II scores in clinical samples. A DS-II total score > 5 is suggested as a cut-off value. The findings further our understanding of significant symptom burden that was previously suggested in young patients with cancer.