Adjustment to Parkinson's disease: The role of coping, control, and goal orientation

The present study investigates a possible causal model for the prediction of subjective well-being in Parkinson's disease (PD). The primary hypothesis proposed that, controlling for disease severity, validation-seeking attitudes among individuals with PD would predict less use of secondary control coping strategies, more relinquishing of control in the face of PD symptoms, lower psychosocial adjustment to PD, and lower subjective well-being. I also proposed that validation-seeking would indirectly contribute to lower adjustment to PD through the type of coping strategies used, as well as indirectly affect subjective well-being through both coping strategies and adjustment to PD (operationalized as fewer restrictions to work and social participation). First, the concept of relinquished control could not be investigated due to validity issues with the measure or the construct, so the results were limited to only secondary control coping efforts. Consistent with the hypotheses, validation-seeking attitudes did predict lower positive subjective well-being and better adjustment to PD predicted better overall subjective well-being (i.e., lower depressive symptoms and enhanced positive subjective well-being), controlling for all other variables. However, hypotheses regarding relationships between secondary control coping strategies and validation-seeking, adjustment to PD, and subjective well-being were not supported. Furthermore, exploratory analyses of these relationships suggested that, contrary to the hypothesis that secondary control coping would predict positive outcomes, the use of secondary control coping strategies predicted higher depressive symptoms and poorer adjustment to PD. Closer investigation of the secondary control coping measure suggests that individuals may not have distinguished between voluntary use of secondary control coping strategies and restrictions in activities that had to be made due to PD, especially when reporting changes in what they were doing as a result of PD.