The Mediational Role of Perceived Competence in Psychological Adjustment to Rheumatoid Arthritis<sup>1</sup>

Smith, Craig A.; Dobbins, Carolyn J.; Wallston, Kenneth A.

doi:10.1111/j.1559-1816.1991.tb00467.x

Cited by 87 publications

(60 citation statements)

References 59 publications

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“…with a high internal health locus of control and a low orientation to chance) evaluate haemophilia äs less demanding. This corresponds with studies among patients with rheumatoid arthritis (Smith et al, 1991;Smith and Wallston, 1992), in which a generalized sense of competence contributed to an increased life satisfaction and buffered against depressive Symptoms. From other studies it also appeared that patients who strongly believe that they must hold back from domg what they want are more prone to poor psychological adjustment (Turner et a/., 1987;Bombardier et al, 1990).…”

Section: Interpretation and Implicationssupporting

confidence: 85%

“…A sense of control or a feeling of competence, low levels of affective traits and dispositional optimism are all reported to favour well-being (e.g. Weinberger et al, 1990;Smith et al, 1991;Schwarzer, 1994). Social support has been hypothesized to benefit well-being directly äs well äs indirectly by acting äs a mediator or a buffer in coping with stress or illness (Lazarus and Folkman, 1984;Cohen and Wills, 1985;Schulz and Decker, 1985).…”

Section: ( Onceptual Frameworkmentioning

confidence: 99%

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Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Triemstra

Ploeg

Smit³

et al. 1998

Social Science & Medicine

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Abstract-This study outlines the development and evaluation of a structural equation model for establishing the consequences of haemophilia. The hereditary disorder is characterized by a high tendency to haemorrhages, with recurrent bleeding mto the joints causing irreversible joint damage. The model is, in general, an attempt to answer the following questions: what is the effect of haemophilia on the wellbeing (i.e. satisfaction, health, somatic complaints and self-esteem) of patients and what is the additional or mediating role of other individual characteristics in this pathway? Disease severity, joint impairment and disability are defined äs antecedents of well-being and the mediating roles of appraisal (i.e. the personal evaluation of the disease), health beliefs (i.e. locus of control), psychological characteristics (i.e. anxiety, anger, depression and optimism) and social Support are investigated. Psychological variables turned out to be the strengest determinants of well-being and partly mediated the detrimental effect of disability on well-being. The role of appraisal remained somewhat unclear, äs no significant relationship was established between this personal evaluation of haemophilia and well-being. Nevertheless, appraisal very well reflected the level of disability. An internal locus of control and favourable psychological characteristics appeared to reduce the perceived seriousness of haemophilia. No evidence was found for social Support to act äs a mediator between disability and well-being. The perception of support did show moderately strong associations with psychological characteristics (i.e. anxiety and depression) and satisfaction ratings. The study merits further research on quantifying the relationships between clinical parameters and psychosocial outcomes in patients with a chronic disease.

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Section: Interpretation and Implicationssupporting

confidence: 85%

Section: ( Onceptual Frameworkmentioning

confidence: 99%

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Triemstra

Ploeg

Smit³

et al. 1998

Social Science & Medicine

View full text Add to dashboard Cite

show abstract

“…One explanation might be that depressed people receive more instrumental support because they arouse sympathy. Others argue that receiving considerable instrumental support causes feelings of helplessness or dependency, both of which may cause depression (Penning & Strain, 1994; T. W. Smith, Christensen, Peck, & Ward, 1994). In diabetes mellitus, this association was most obvious.…”

Section: Discussionmentioning

confidence: 97%

Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?

Penninx¹,

Tilburg²,

Boeke³

et al. 1998

Health Psychology

219

139

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Effects of psychosocial coping resources on depressive symptoms were examined and compared in older persons with no chronic disease or with recently symptomatic diabetes mellitus. lung disease, cardiac disease, arthritis, or cancer. The 719 persons without diseases reported less depressive symptoms than the chronically ill. Direct favorable effects on depressive symptoms were found for having a partner, having many close relationships, greater feelings of mastery, greater self-efficacy expectations, and high self-esteem. Buffer effects were observed for feelings of mastery, having many diffuse relationships, and receiving emotional support Buffer effects were differential across diseases for emotional support (in cardiac disease and arthritis only) and for diffuse relationships (in lung disease). Receiving instrumental support was associated with more depressive symptoms, especially in diabetes patients.

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“…Dekker, Boot, van der Woude & Bijilsma, 1992, Summers, Haley, Reveille & Alarcon, 1988. Smith, Dobbins and Wallston (1991) found that despite there being a relationship between pain and depression, when pain is controlled for, there is still considerable variation in ILLNESS REPRESENTATIONS, COPING AND ILLNESS OUTCOME 5 psychological adjustment to rheumatoid arthritis -as with similar levels of pain some do better than others.Within the field of rheumatoid arthritis very few studies have examined the basic elements of the self-regulatory model together-that is, illness representations, coping strategies, outcome appraisals -and related these to each other as well as illness outcome measures. Studies have tended to focus on one or two aspects of the model (e.g.…”

mentioning

confidence: 99%

mentioning

confidence: 99%

The self‐regulatory model in women with rheumatoid arthritis: Relationships between illness representations, coping strategies, and illness outcome

Carlisle

John

Fife‐Schaw

et al. 2005

British J Health Psychol

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Objectives. The self-regulatory model proposes that an individual"s cognitive representations of illness threat (illness representations) influence the selection and performance of strategies to cope with that illness (Leventhal, Meyer & Nerenz, 1980). Also implicit in the model is the proposal that such coping strategies influence illness outcomes. These relationships represent a mediational model (Baron & Kenny, 1986). The aim of the present study was to test the hypothesis that coping strategies partially mediate the relationship between illness representations and illness outcome in women with rheumatoid arthritis.Design and Methods. The study was an observational cross-sectional design. Self-report measures of illness representations, coping strategies, and illness outcome were collected from 125 women with rheumatoid arthritis attending rheumatology outpatient clinics. Clinical measures of disease activity and severity were obtained from hospital records.Results. Avoidant and resigned coping was found to partially mediate the relationship between symptom identity and the illness outcome measures of disability and psychiatric morbidity. As in other studies, strong relationships were found between illness representations and illness outcome.Conclusions. The finding that avoidant and resigned coping partially mediated the relationships between the illness representation dimension of symptom identity and two of the illness outcome measures (disability and psychiatric morbidity) provided some support for the hypothesis.However, the hypothesis was not fully supported, as coping did not partially mediate the relationship between any of the other illness representations and illness outcomes. (1977). Such social-cognition models have been used to help identify the complex processes involved in mediating between disease, pain, disability & adjustment.However this research has been inconclusive, as none of the individual factors studied have consistently predicted health and illness behaviours (Turk, Rudy & Salovey, 1986). Marteau (1993) suggests that this may either be due to inadequacies in the research, or may indicate that the above theories do not contain the cognitions that predict health behaviour and outcomes. In the last decade much attention has been directed towards Leventhal"s self-regulatory model (Leventhal et al. 1980) in the hope that this will provide a more complete model of health behaviour.An advantage of utilising the self-regulatory model with individuals who are diagnosed with a chronic illness is the potential to explore sophisticated responses to an illness from a number of domains. The self-regulatory model proposes that an individual"s cognitive representations of illness threat (illness representations) influence the selection and performance of strategies to cope with that illness, which in turn influence outcome appraisals (Leventhal et al., 1980). Also implicit in the model is the proposal that such coping strategies influence illness outcomes (Leventhal et al., 1980). The mode...

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The Mediational Role of Perceived Competence in Psychological Adjustment to Rheumatoid Arthritis¹

Cited by 87 publications

References 59 publications

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?

The self‐regulatory model in women with rheumatoid arthritis: Relationships between illness representations, coping strategies, and illness outcome

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The Mediational Role of Perceived Competence in Psychological Adjustment to Rheumatoid Arthritis1

Cited by 87 publications

References 59 publications

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Well-being of haemophilia patients: a model for direct and indirect effects of medical parameters on the physical and psychosocial functioning

Effects of social support and personal coping resources on depressive symptoms: Different for various chronic diseases?

The self‐regulatory model in women with rheumatoid arthritis: Relationships between illness representations, coping strategies, and illness outcome

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The Mediational Role of Perceived Competence in Psychological Adjustment to Rheumatoid Arthritis¹