Key result
Depression linked to lower positive reappraisal coping scores.
Why the study?
Psychological distress is associated with poor prognosis in CAD, but the relationship between cognitive appraisal, coping strategies, Type D personality, and depression in chronic coronary syndrome required examination.
In patients with chronic coronary syndrome, Type D personality and depression are associated with distinct maladaptive cognitive appraisals and coping strategies, highlighting the need for targeted psychological interventions.
Supports coping assessment in depressed CAD patients; hypothesis-generating, needs prospective trials before guiding interventions.
Psychological distress is associated with a poor prognosis in patients with coronary artery disease (CAD). The development of specific coping strategies is preceded by a cognitive appraisal of a stressful situation. This study aimed to examine the relationship between cognitive appraisal, coping strategies, Type D personality, and depression levels in patients with chronic coronary syndrome. Material and methods — A total of 209 patients with CAD were enrolled. In addition to clinical evaluation and medical‐history data, patients completed questionnaires to assess Type D personality (DS-14), depression (Hospital Anxiety and Depression Scale, HADS), coping strategies (Ways of Coping Questionnaire, WCQ) and cognitive appraisal of stressful situations (criteria for assessing the complexity of a life situation and types of orientation in a difficult situation). Patients were divided into groups based on the presence or absence of Type D personality and depression. Results — Patients with depression had lower scores on the Positive reappraisal coping strategy compared to those without depression (p=0.03); no differences in coping strategies were found between patients with and without Type D personality. Patients with Type D personality were characterized by more frequent appraisals of situations as uncontrollable (p=0.003) and ambiguous (p=0.026), a focus on losses in difficult situations (p < 0.001), orientation towards obstacles (p=0.009), and inactivity (p=0.019). The depression group was characterized by a greater threat for the future (p=0.026), and simultaneously a less pronounced striving for difficulties (p=0.023) and a weaker focus on opportunities (p=0.008). Conclusion — In CAD patients, differences in cognitive appraisal and coping strategies for stress were revealed according to presence of Type D personality and depression. The most pronounced differences in cognitive appraisal were observed in patients with Type D personality, who more frequently perceived situations as uncontrollable and incomprehensible, focused on losses, and exhibited avoidance and inactivity.
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An et al. (2025) studied this question. Patients with depression had lower Positive reappraisal coping strategy scores than those without depression (p=0.03), highlighting the impact of emotional state on coping mechanisms.
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