Monti Jennifer D, Jackson Jamie L, Vannatta Kathryn
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
J Clin Psychol Med Settings. 2018 Dec;25(4):441-451. doi: 10.1007/s10880-018-9554-y.
Living with congenital heart disease (CHD) presents survivors with numerous stressors, which may contribute to emotional problems. This study examined (a) whether coping with CHD-related stress predicts symptoms of depression and anxiety, and (b) whether associations between coping and emotional distress are moderated by involuntary stress reactivity. Adolescents and young adults diagnosed with CHD (M = 26.4) were recruited from pediatric and adult outpatient cardiology clinics. Participants (N = 168) completed online self-report measures. Hierarchical multiple regression analyses revealed that secondary control coping (e.g., cognitive restructuring, positive thinking) predicted lower depression and anxiety. Primary control coping (e.g., problem-solving) and stress reactivity (e.g., rumination, emotional numbing) interacted to predict depression and anxiety: the higher individuals were in involuntary stress reactivity, the stronger was the association between primary control coping and lower depression and anxiety. These results can inform clinical efforts to prevent or reduce emotional distress among CHD survivors.
患有先天性心脏病（CHD）给幸存者带来了诸多压力源，这可能导致情绪问题。本研究考察了：（a）应对与先天性心脏病相关的压力是否能预测抑郁和焦虑症状；（b）应对方式与情绪困扰之间的关联是否会受到非自愿应激反应的调节。从儿科和成人门诊心脏病诊所招募了被诊断患有先天性心脏病的青少年和年轻人（平均年龄M = 26.4岁）。参与者（N = 168）完成了在线自我报告测量。分层多元回归分析显示，二级控制应对方式（例如认知重构、积极思考）可预测较低的抑郁和焦虑水平。一级控制应对方式（例如解决问题）与应激反应（例如反复思考、情感麻木）相互作用，共同预测抑郁和焦虑：个体的非自愿应激反应越高，一级控制应对方式与较低的抑郁和焦虑之间的关联就越强。这些结果可为预防或减轻先天性心脏病幸存者的情绪困扰提供临床参考。
