Illness representations, coping and psychological adjustment to Parkinson's disease

Abstract

The present study reports an application of the common sense model (CSM) of illness representations to the prediction of psychological distress in people with Parkinson's disease (PD). The study sought to (i) examine cross-sectional and prospective associations between illness representations, coping and psychological distress, and (ii) test the hypothesis that coping would mediate any relationships between illness representations and psychological distress. Patients with PD (n = 58) completed the Illness Perception Questionnaire-Revised, the Medical Coping Modes Questionnaire and the Hospital Anxiety and Depression Scale. Patients (n = 57) were followed-up at 6 months. Illness representations explained large amounts of variance in time 1 anxiety (R ² = 0.42) and depression (R ² = 0.44) as well as additional variance in time 2 anxiety (ΔR ² = 0.12) and depression (ΔR ² = 0.09) after controlling for baseline scores. In addition, avoidance mediated the effect of emotional representations on time 1 anxiety, and acceptance-resignation mediated the effects of both consequences and emotional representations on time 1 depression. The present study therefore provides partial support for the mediational model outlined in the CSM, as significant mediation effects were found only in the cross-sectional analyses.

Keywords:

• illness representations
• coping
• anxiety
• depression
• Parkinson's disease

Notes

Notes

1. The meta-analysis did not examine associations between the cause dimension and psychological distress given the large variation in how causal beliefs have been measured. In addition, emotional representations and illness coherence, which are included in the IPQ-R, were not included in the meta-analysis.

2. Analyses revealed no significant differences between patients recruited from the two centres on any of the psychosocial, demographic or clinical variables assessed in the study.

3. Further analyses revealed the correlations between the two individual items and anxiety and depression (at time 1 and time 2) were non-significant.

4. Correlations were also computed between the demographic and clinical variables (i.e. age, gender, marital status, time since diagnosis, disease severity) and anxiety and depression at time 1 and time 2. Martial status was found to correlate with anxiety at time 1, r(56) = −0.28, p = 0.04, and at time 2, r(55) = −0.27, p = 0.04, such that lower levels of anxiety were observed among those who were married/cohabiting than among those who were single, divorced or widowed. Time since diagnosis was found to correlate positively with depression at time 1, r(56) = 0.29, p = 0.03, and at time 2, r(55) = 0.28, p = 0.04, and disease severity was found to correlate positively with depression at time 2, r(56) = 0.35, p = 0.01.

5. The regression analyses were repeated controlling for those demographic and clinical variables that were found to correlate significantly with the outcome variable of interest. The pattern and significance of the results remained unchanged and, for the sake of brevity, only the regression analyses including the illness representations and coping variables are reported here.