title: Health status, cognitive coping, and depressive symptoms: testing for a mediator effect.
abstract: OBJECTIVE
  Research has established a link between health status and symptoms of depression in persons with rheumatoid arthritis (RA), but the effects of "cognitive coping" variables have not been extensively studied. We examined the mediator effect of a cognitive coping variable (Pain Control and Rational Thinking factor score from the Coping Strategies Questionnaire) over the course of a pharmacological intervention.
  
  
  METHODS
  Data were analyzed from 54 persons with RA, all of whom met diagnostic criteria for major depression. Measures of depression, health status, and cognitive coping were collected at 4 different stages of a pharmacological (antidepressant) study as follows: (1) at baseline, (2) postintervention, (3) 6 month followup, and (4) 15 month followup.
  
  
  RESULTS
  Results indicated that a direct relationship existed between health status and depression at all 4 time periods. However, this relationship was mediated by cognitive coping only at the postintervention and the 6 month followup.
  
  
  CONCLUSIONS
  A cognitive coping variable was found to mediate the relationship between health status and depression, but only at moderate levels of depression.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Martens
authors.affiliation: Research Service, Harry S Truman Memorial Veterans' Hospital, University of Missouri-Columbia, 65201, USA.
authors.forename: Jerry C
authors.initials: JC
authors.lastname: Parker
authors.forename: Karen L
authors.initials: KL
authors.lastname: Smarr
authors.forename: James E
authors.initials: JE
authors.lastname: Hewett
authors.forename: Bin
authors.initials: B
authors.lastname: Ge
authors.forename: Kathleen Donovan
authors.initials: KD
authors.lastname: Hanson
authors.forename: James R
authors.initials: JR
authors.lastname: Slaughter
authors.forename: Sara E
authors.initials: SE
authors.lastname: Walker
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology*; D003071:Cognition; D003863:Depression / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires