Antecedents of Mental Health in Parents of Individuals Born with ARM: The Association Between Illness Representations, Negative and Positive Coping, and Depressive Symptoms

J Pediatr Surg. 2025 Oct 23:162755. doi: 10.1016/j.jpedsurg.2025.162755. Online ahead of print.

ABSTRACT

INTRODUCTION: The Common-Sense Model of Illness Self-Regulation (CSM) provides a theoretical framework for understanding how individuals make sense of health conditions and regulate their emotional responses through coping strategies. This study aimed to apply the CSM to parents of children with anorectal malformations (ARMs), exploring whether illness representation (threat and control perceptions) is associated with depressive symptoms directly and indirectly through coping strategies.

METHODS: A total of 106 caregivers (Mage = 48.07) of individuals diagnosed with ARMs completed a self-report questionnaire including the Brief Illness Perception Questionnaire, the Brief-COPE Inventory, the Brief-Coping Health Inventory for Parents, and the Depression subscale of the Hospital Anxiety and Depression Scale. Path analysis was conducted to evaluate direct and indirect associations between illness representation, coping strategies (negative and positive), and depressive symptoms.

RESULTS: The model showed excellent fit to the data. Illness representation as threat was significantly and positively associated with depressive symptoms, while illness representation as control was not directly related to depressive symptoms. Threat representation predicted greater use of negative coping, which in turn was associated with higher depressive symptoms. Conversely, higher illness control was related to greater use of positive coping strategies, which predicted lower depressive symptoms. The model accounted for 36% of the variance in depressive symptoms.

DISCUSSION: These findings underscore the importance of targeting illness representation and coping strategies in interventions for parents of children with ARM. Psychological support and psychoeducation aimed at reframing threat-focused representation and reinforcing positive coping may help mitigate depressive symptoms in this caregiving context.

PMID:41138776 | DOI:10.1016/j.jpedsurg.2025.162755