title: Coping self-efficacy as a mediator between catastrophizing and physical functioning: treatment target selection in an osteoarthritis sample.
abstract: The purpose of this study was to assess the relative effects of coping self-efficacy and catastrophizing on physical functioning. Over a 9-month period, studying changes in self-efficacy as possible mediator between catastrophizing changes and physical functioning changes might provide evidence for the most promising treatment target. Data came from a randomized, longitudinal controlled trial comparing exercise, self-management and the two combined to treat 254 individuals with early knee osteoarthritis. A secondary analysis using a bootstrapped linear mixed-effects mediational model produced estimates of both the direct and indirect effects. Results indicated that self-efficacy partially mediated the effect between catastrophizing and physical functioning suggesting that self-efficacy was the more direct treatment target compared to catastrophizing. Treatments targeting both self-efficacy and catastrophizing may have greater impact on physical functioning compared to treatments that focus on only one.
authors.affiliation: Department of Psychology, George Mason University, MSN 3F5, 4400 University Drive, Fairfax, VA 22030-4400, USA. pmcknigh@gmu.edu
authors.forename: Patrick E
authors.initials: PE
authors.lastname: McKnight
authors.forename: Alex
authors.initials: A
authors.lastname: Afram
authors.forename: Todd B
authors.initials: TB
authors.lastname: Kashdan
authors.forename: Shelley
authors.initials: S
authors.lastname: Kasle
authors.forename: Alex
authors.initials: A
authors.lastname: Zautra
mesh_terms: D000223:Adaptation, Psychological; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D020370:Osteoarthritis, Knee / Q000523:psychology* / Q000628:therapy*; D010551:Personality; D010809:Physical Fitness; D012648:Self Care; D020377:Self Efficacy; D012720:Severity of Illness Index