Center for Biobehavioral Health, Nationwide Children's Hospital.
Department of Pediatrics.
J Pediatr Psychol. 2018 Sep 1;43(8):906-915. doi: 10.1093/jpepsy/jsx154.
Executive functioning deficits have been documented among congenital heart disease (CHD) survivors and may contribute to emotional distress. Little research has investigated the role of coping in this association. This study examined the role of coping in accounting for the association between self-reported executive function problems and internalizing symptoms among adolescents and emerging adults (AEAs), as well as young adults (YAs) with CHD.
Participants included 74 AEA (Mage = 19.32 ± 3.47 years, range 15-25 years) and 98 YA CHD survivors (Mage = 32.00 ± 3.69 years, range 26-39 years), recruited from pediatric and adult outpatient cardiology clinics. Participants completed self-report measures of executive function problems, coping (primary control, secondary control, and disengagement coping), and internalizing symptoms. Lesion severity classification and functional impairment due to symptoms of heart failure were determined from medical chart review.
Significant problems in executive function were reported by 5% of AEA and 13% of YA. Coping was not associated with executive function problems or internalizing symptoms for AEA. However, among YA, less use of adaptive coping strategies and more maladaptive coping responses was associated with both more executive function problems and internalizing symptoms. An indirect effect of executive function problems on internalizing symptoms via secondary control coping emerged for YA.
Executive function problems may disrupt the ability to use important adaptive coping skills, such as cognitive reappraisal, positive thinking, and acceptance, thereby resulting in greater emotional distress among YA CHD survivors.
已记录到先天性心脏病（CHD）幸存者存在执行功能缺陷，这可能导致情绪困扰。很少有研究调查应对策略在这种关联中的作用。本研究考察了应对策略在解释报告的执行功能问题与青少年和成年早期（AEAs）以及患有 CHD 的年轻成年人（YAs）的内化症状之间的关联中的作用。
参与者包括 74 名 AEA（Mage = 19.32 ± 3.47 岁，范围 15-25 岁）和 98 名 YA CHD 幸存者（Mage = 32.00 ± 3.69 岁，范围 26-39 岁），他们是从儿科和成人门诊心脏病诊所招募的。参与者完成了执行功能问题、应对策略（主要控制、次要控制和脱离应对）和内化症状的自我报告测量。根据病历回顾确定病变严重程度分类和因心力衰竭症状导致的功能障碍。
AEA 中有 5%报告存在显著的执行功能问题，而 YA 中有 13%报告存在显著的执行功能问题。应对策略与 AEA 的执行功能问题或内化症状无关。然而，在 YA 中，较少使用适应性应对策略和更多的适应不良应对反应与更多的执行功能问题和内化症状有关。YA 中执行功能问题对次要控制应对的内化症状存在间接影响。
执行功能问题可能会破坏使用重要适应性应对技能的能力，例如认知重评、积极思考和接受，从而导致 YA CHD 幸存者的情绪困扰更大。
