Stefanie J Schmidt1,2, Chantal Michel1, Michael Kaess1,3, Nina Schnyder1, Frauke Schultze-Lutter4, 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, 4Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
Coping plays a crucial role in the development of mental disorders as well as in quality of life (QoL). Next to coping, competence beliefs (i.e. self-esteem/self-efficacy) and locus of control (i.e. external attributions) have been emphasized as risk factors to and promotors of mental health. However, the interplay of these factors and their relative contribution to mental health and QoL remains poorly understood. This study aimed to investigate whether coping mediates the associations between competence/control beliefs and mental health as well as QoL. Coping, competence/control beliefs and QoL were assessed in a representative general population sample of 468 participants living in the Swiss Canton Bern (n=784, 16–40 years, response rate of 69%) using established questionnaires. The sample was interviewed in a telephone survey for mental health outcomes (current axis-I problems/disorders). We used structural equation modeling (SEM) to estimate the relationships between model-variables. The resulting model had a good fit to the data and identified three significant mediation pathways. Dysfunctional competence/control beliefs were significantly associated with more negative coping strategies and more mental health problems (path 1) and lower QoL (path 2). Additionally, higher levels of positive competence/control beliefs were significantly associated with better mental health through more positive coping (path 3). Competence/control beliefs had a significant direct positive effect on QoL but no mediation effect. Our results indicate that interventions promoting mental health and QoL should not only focus on enhancing common positive coping strategies but also on reducing dysfunctional coping strategies and enhancing positive competence/control beliefs directly.
