Psychological Distress in Patients with Chronic Coronary Syndrome: Features of Coping Strategies and Cognitive Appraisal in Depression and Type D Personality

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.