Stefanie J Schmidt1,2, Nina Schnyder1, Michael Kaess1,3, Andjela Markovic1, Liz Rietschel4, Susann Ochenbein1, Chantal Michel1, Frauke Schultze-Lutter1,5, Nicola Groth1; 1University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland, 2Clinical Psychology for Children and Adolescents, University of Bern, Switzerland, 3Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany, 4Academy for Psychotherapy, SRH University Heidelberg, Germany, 5Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
Mental disorders are regarded as major causes of disability-adjusted life years. Thus, there is a clear need to investigate the impact of preventive and risk factors on mental health as they might be worthwhile targets for future psychosocial mental-health promotive interventions. A crucial step towards this goal is to synthesize findings and to develop a better understanding of the interplay of locus of control, self-efficacy and coping as important predictors of mental health. The aim of this study was to perform a two-staged structural equation modeling meta-analysis (TSSEM) to examine whether coping mediates the associations between locus of control, self-efficacy and mental health outcomes in the general population and clinical samples. TSSEM included 15 studies and using a pooled sample of 3986 respondents and 225 cross-sectional effect sizes indicated that maladaptive coping mediates the associations between maladaptive locus of control and poor mental health outcomes. In contrary, adaptive coping did not mediate this relationship, and was only significantly associated with self-efficacy and adaptive locus of control and unexpectedly not with mental health outcomes. Both maladaptive and adaptive locus of control but not self-efficacy had direct links to mental health that were independent from coping. Interventions should not only focus on enhancing adaptive coping as it might be more promising to diminish maladaptive locus of control, which may result in reduced maladaptive coping and finally improved mental health.
