Anxiety and depression symptoms, coping strategies, and appraisal of living with idiopathic pulmonary fibrosis: implications for psychological support.

Background: To determine whether the strategies people implement to cope with idiopathic pulmonary fibrosis (IPF) help to explain individual differences with regard to comorbid anxiety/depression, we investigated whether coping strategies moderate the associations between perceived stress and symptoms of anxiety/depression. The perception of living with fibrosis and its associations with coping strategies were also explored to better understand the processes underlying the use of different strategies. Method: Mixed-methods cross-sectional study design. Perceived stress, anxiety/depression symptoms and coping strategies were assessed among 35 people with IPF using the Beck Depression Inventory-II, Spielberg's State-Trait Anxiety Inventory-Y, 10-item Perceived Stress Scale and Brief Coping Orientation to Problems Experienced questionnaire scales. We created experimental videos showing an actor playing the role of a person with IPF accompanied by two extras, and interviewed participants about the emotions, thoughts, expectations, and behaviours they projected onto the characters in order to assess their perception of life with IPF. Results: "Self-blame" was associated with perceived stress, anxiety and depression symptoms and moderated the relationship between perceived stress and anxiety symptoms: perceived stress predicted anxiety symptoms only when participants blamed themselves. Anxiety symptoms were also negatively associated with the "humour" and "acceptance" strategies. Depression symptoms were predicted by perceived stress, "behavioural disengagement" and lower use of the "venting" strategy. Participants who described no positive aspects of living with IPF used "instrumental and social support", "active coping" and "distractibility" strategies the most. Discussion: The results highlight the relevance of assessing coping strategies in cases of anxiety/depression and suggest that adaptive strategies such as commitment to actions in line with personal values and acceptance should be prioritised.