First Advisor

Richard Schulz

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Urban Studies


Urban Studies and Planning




Mental Depression, Sick -- Psychology, Older people -- Psychology



Physical Description

4, viii, 318 leaves: ill. 28 cm.


Recent research in gerontology and geriatrics has identified that one factor repeatedly associated with depression in the elderly is the presence of physical illness. The increasing numbers of elderly persons in the population and their high rate of chronic physical illness make it important to identify critical disease and individual characteristics that play a role in the association of depression and physical illness. In order to investigate and clarify these relationships and concerns, a panel survey of 133 middle aged and elderly persons with recent exacerbations of various physical illnesses was completed. Subjects were referred by medical offices and agencies in the Portland metropolitan area. Two in-depth interviews were completed approximately three months apart. The data were analyzed using descriptive statistics, correlational analysis, analysis of variance, multiple regression, and dynamic (change focused) correlational analysis. Results indicated a slight but consistent decrease in level of depression with increasing age. Increased levels of income, social support, religiosity, subjective health, internal locus of control for health, and life expectancy were associated with decreased levels of depression. Conversely, increased levels of pain, physical dependency, progressiveness of the disease, death anxiety, external locus of control for health, and worry about medical resources were associated with increased levels of depression. While the residential setting of urban, suburban, or rural had a significant effect on income and a slight effect on size of support system, it had no significant impact on level of depression. The four best predictors of level of depression at Time 1 were subjective health, pain, death anxiety, and income. Analysis of change over time revealed moderate stability in levels of depression. The best predictor of level of depression at Time 2 was level at Time 1. Only change in pain added significantly to the prediction of depression at Time 2. The results of this study will help to identify physically ill middle aged and elderly persons at risk for the development of depression. Analysis of change over time suggests causal relationships for further investigation.


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Portland State University. School of Urban and Public Affairs.

Persistent Identifier