The relationship between illness perception and anxiety and depression: The mediating effect of passive coping
Summary
A spinal cord injury (SCI) is a traumatic life-event with significant physical and psychological consequences. SCI patients are found to experience more psychological distress and to be more at risk for developing anxiety or depressive disorders. It is important to reduce these psychological problems, because they may limit physical recovery. This study investigated the effect of illness perception (i.e. cognitive representation of an illness) on anxiety and depression, and whether passive coping mediates this effect. Illness perception was expected to have a direct effect on anxiety and depression, as well as an indirect effect via passive coping. A total of 273 SCI patients admitted to eight Dutch rehabilitation centers with specialized SCI units completed the Brief Illness Perception Questionnaire (BIPQ), Utrechtse Coping Lijst (UCL) and Hospital Anxiety and Depression Scale (HADS) within 2 weeks of admission. The PROCESS tool was used to test the presence of mediation. Results confirmed the expectations; the effect of illness perception was partially mediated by passive coping. Effects of illness perception however were small, whereas the direct effect of the mediator passive coping on anxiety and depression was much larger. Results indicate that the effect of passive coping may be more important than the (mediated) effect of illness perception, and that interventions aimed at improving coping may therefore be more useful than those aimed at improving illness perception