Document Type
Article
Publication Date
6-1-2016
Abstract
PURPOSE: To investigate the mediating role of coping self-efficacy (CSE) between two types of illness cognitions (i.e., acceptance and helplessness) and depressive symptoms in persons with low vision.
METHODS: This was a single-group, cross-sectional study. Patients with visual acuity < 6/12 in the better eye and at least minimal depressive symptoms (≥5 on the Patient Health Questionnaire-9 [PHQ-9]) were recruited from vision rehabilitation services and participated in telephone-administered structured interviews at one time point. Measures were the PHQ-9, CSE Scale, and Illness Cognition Questionnaire. Structural equation modeling (SEM) devised the causal flow of illness cognitions and their observed indirect effects on depressive symptoms via the CSE mediators: problem focused, emotion focused, and social support.
RESULTS: The study comprised 163 patients (mean age 62 years; 61% female), most with age-related macular degeneration (26%) and moderate vision impairment (44%, <6/18-6/60). Structural equation modeling indices indicated a perfect fit (χ2 < 0.001, P = 1.00), accounting for 55% of the variance in depressive symptoms. Lower levels of acceptance and higher levels of helplessness illness cognitions were associated with lower self-efficacy in problem-focused coping (β = 0.38, P < 0.001, β = -0.28, P < 0.01, respectively), which in turn was associated with greater depressive symptom severity (β = -0.54, P < 0.001).
CONCLUSIONS: Lack of acceptance and greater helplessness relating to low vision led to a lack of perceived capability to engage in problem-focused coping, which in turn promoted depressive symptoms. Third-wave cognitive-behavioral treatments that focus on acceptance may be efficacious in this population.
Recommended Citation
Sturrock, Bonnie A; Xie, Jing; Holloway, Edith E; Hegel, Mark; Casten, Robin J.; Mellor, David; Fenwick, Eva; and Rees, Gwyneth, "Illness Cognitions and Coping Self-Efficacy in Depression Among Persons With Low Vision." (2016). Department of Psychiatry and Human Behavior Faculty Papers. Paper 30.
https://jdc.jefferson.edu/phbfp/30
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
27281268
Comments
This article has been peer reviewed. It is the author’s final published version in Investigative Ophthalmology and Visual Science
Volume 57, Issue 7, June 2016, Pages 3032-3038.
The published version is available at DOI: 10.1167/iovs.16-19110. Copyright © Association for Research in Vision and Ophthalmology