Differences in appraisal and coping between elderly coronary artery disease patients high and low in depressive symptoms

Abstract

Coronary artery disease (CAD) is frequently found in the elderly and many CAD patients present depressive symptoms. The purpose of this study was to determine if elderly CAD patients high and low in depressive symptoms differ on how they appraise stressors associated with angina pectoris and how they cope with these stressors. Twenty elderly CAD patients high in depressive symptoms and 35 elderly CAD patients low in depressive symptoms identified their most severe chronic stressor attributed to angina and reported their appraisal and coping in relation with this stressor. Groups did not differ on sociodemographic, health-related or stressor-related characteristics. Compared with CAD patients low in depressive symptoms, CAD patients high in depressive symptoms reported appraisal of more harm to their own physical well-being and more threat to their self-esteem and a loved one's well-being. CAD patients high in depressive symptoms also reported using more escape-avoidance coping. These results suggest that primary appraisal and escapist coping may be useful in the explanation of depressive symptoms in elderly CAD patients with angina.