The Mediating Roles of Health Locus of Control and Coping on the Pain-Depression Pathway

Abstract

The literature on health locus of control (HLC) suggests that individuals who believe that their health is internally determined are more likely to use active coping strategies than those who believe their health is determined by chance or powerful others (Brosschot, Gebhardt, & Godaert, 1994; Gibson & Helme, 2000). Coping strategies (Klapow et al., 1995) and HLC (Campbell, Hope, & Dunn, 2017) have been found to influence the relation between chronic pain and depression. We hypothesized that the relation between osteoarthritis pain and depression would be serially mediated by HLC and coping. Self-report measures of osteoarthritis pain (Meenan, Mason, Anderson, Guccione, & Kazis, 1992; Parmelee, Katz, & Lawton), HLC (Wallston, Wallston, & DeVellis, 1978), coping strategies (Felton & Revenson, 1984; Rosenstiel & Keefe, 1983), and depression (Radloff, 1977) were examined in 367 older adults with osteoarthritis of the knee. Hayes’ (2013) PROCESS macro was used to test the hypothesized serial multiple mediation for three subscales of HLC: internality (IHLC), chance (CHLC), and powerful others (PHLC). After controlling for age, the hypothesized serial mediation was statistically significant for IHLC and CHLC but not PHLC. More specifically, osteoarthritis pain significantly increased CHLC, which increased negative coping and depression in turn. Osteoarthritis pain significantly decreased IHLC, which was associated with both positive and negative coping strategies in a complex serial mediation. These findings suggest that interventions targeting HLC and/or coping strategies may be able to alter the pain-depression pathway for older adults with chronic osteoarthritis pain. (Supported by R01-MH51800, P. Parmelee, PI).

Relationship between loci of control and health-promoting behaviors in Pakistani women with polycystic ovary syndrome: coping strategies as mediators

“…Despite knowing what is beneficial and what is not, some people still do not engage in health-promoting behaviors. An important reason for involvement in active goal-directed activities may be a person’s locus of control [ 28 , 29 ]. It was observed that women with an internal locus of control used more active practical coping strategies, which in turn led to more use of health-promoting behaviors.…”

“…The use of problem-focused coping strategies has been reported to be effective in the management of many symptoms related to PCOS in Iran [ 26 ] and in the United States [ 27 ]. Furthermore, it has been observed that individuals who have a high internal locus of control use practical coping strategies to improve their health [ 28 ]. One Chinese study demonstrated that confrontation coping strategies that involve practical efforts to confront and combat disease mediate the relationship between internal locus of control and healthy behaviors [ 29 ]…”