Does the disposition of passive coping mediate the association between illness perception and symptoms of anxiety and depression in patients with spinal cord injury during first inpatient rehabilitation?

PurposeTo examine associations between illness perception, also called illness cognitions or appraisals, disposition of passive coping, and symptoms of anxiety and depression, and to test whether passive coping mediates the associations between illness perception and symptoms of anxiety and depression.Materials and methodsLongitudinal, multicentre study. Participants were inpatients of spinal cord injury (SCI) rehabilitation. Measures included the Brief Illness Perception Questionnaire (B-IPQ), the Utrecht Coping List passive coping subscale (UCL-P), and the Hospital Anxiety and Depression Scale (HADS). Mediation was tested with the PROCESS tool.ResultsThe questionnaires were completed by 121 participants at admission and at discharge. Of them, 70% were male, 58% had a paraplegia, and 82% an incomplete lesion. Weak to strong (0.294-0.650) significant associations were found between each pair of study variables. The use of passive coping strategies mediated the associations between illness perception and symptoms of anxiety and depression.ConclusionSymptoms of anxiety and depression were more frequent in people who have a threatening illness perception combined with a lower use of passive coping strategies. Therefore, it is advised that patients are screened and treated for threatening illness perception and high use of passive coping strategies during rehabilitation after SCI. For rehabilitation professionals it is recommended to screen inpatients with spinal cord injury (SCI) for illness perception and disposition of passive coping to identify those who may be more vulnerable for symptoms of anxiety and depression at admission.Inpatients with SCI who report a threatening illness perception in combination with a high use of passive coping at admission, have an increased risk for symptoms of anxiety and depression.For rehabilitation professionals it is recommended to repeat this screening to support careful planning of psychological (follow-up) treatment and coordination of care at discharge.