Perceived control and coping strategies in relation to anxious and depressive symptoms in women with activity restriction due to osteoarthritis

Abstract

In later life, osteoarthritis is a prevalent (Badley, 1995; Health Canada, 1999) and chronic disabling condition (e.g. Blixen & Kippes, 1999; Buckwalter & Martin, 1995; Burke & Flaherty, 1993; Croft, Lewis, Jones Wynn, Coggon, & Cooper, 2002; Hochberg, 1984) which is also associated with psychological distress. Adaptation to stressful life circumstances, including a chronic illness such as osteoarthritis, appears to be influenced by perceived control and coping strategies (Lazarus & Folkman 1984; Moos & Schaeffer, 1993). The present cross-sectional correlational study examined the relationships between perceived control and coping strategies when faced with a specific osteoarthritis-related stressor, that is, specifically limitations in activity, and assessed their capacity to predict two possible outcomes, i.e. anxious and depressive symptoms. This study also addressed the effect of the interaction of perceived control with coping strategies on both anxious and depressive symptoms. Self-report data were obtained from 92 older women suffering from osteoarthritis, through four hospital-based orthopaedic clinics located in the Ottawa-Gatineau region, where they were awaiting hip or knee surgery. The findings revealed that perceived control did not predict anxious symptoms, while coping strategies (approach-type coping, in particular) did. In contrast, for the prediction of depressive symptomatology; perceived control and coping strategies (approach-type coping, specifically) individually predicted depressive symptoms. However, perceived control did not hold higher predictive value than coping strategies in the prediction of depressive symptoms. Finally, the interaction of perceived control with coping strategies was significant only in the prediction of depressive symptoms, with higher perceived control combined with lower use of avoidance-type coping strategies predicting lower depressive symptomatology, specifically. Overall, results suggest that perceived control and coping strategies with regard to activity restriction are differently related to anxious and depressive symptoms. Regarding anxiety symptoms, only a specific type of approach coping, i.e. positive interpretation, was negatively associated with them. As for depressive symptoms, higher perceived control, higher use of approach-type coping strategies and lower use of avoidance-type coping strategies, individually predicted lower depressive symptomatology. All approach-type coping strategies (active coping, planning and positive reinterpretation) were negatively related to depressive symptoms, while one type of avoidance-type coping strategy, behavioural disengagement, was positively associated with them. Additionally, higher perceived control combined with lower use of avoidance coping contributed to lower depressive symptomatology. The cross-sectional nature of the study and correlational analyses do not allow to state causal relationships. The strengths and limitations of the study, as well as its implications for future research and clinical applications, are discussed.