Coping, Attributions, and Health Functioning Among Adolescents with Chronic Illness and Their Parents: Reciprocal Relations Over Time

  • Christina M. D’Angelo
  • Sylvie Mrug
  • Daniel Grossoehme
  • David C. Schwebel
  • Nina Reynolds
  • Kimberly Guion Reynolds


The purpose of the study was to identify bidirectional and longitudinal links between attributions, coping, and health functioning among adolescents with chronic illness and their parents. Religious/spiritual coping, attributional styles, and health functioning were assessed among adolescents with chronic illness at two time points approximately 21 months apart. Parental coping and attributions at both time points were also measured. Longitudinal links between variables were tested using an autoregressive cross-lagged path model; adolescent age and disease differences were evaluated via multigroup modeling. Poorer adolescent health functioning at baseline predicted higher use of parent optimistic attributional style at follow-up. Adolescent optimistic attributional style at baseline predicted more positive and less negative religious/spiritual coping at follow-up; adolescent negative religious/spiritual coping at baseline predicted more positive religious/spiritual coping at follow-up. Parent optimistic attributional style and positive religious/spiritual coping at baseline predicted the same constructs among adolescents at follow-up. With respect to age differences, parental negative religious/spiritual coping at baseline was associated with poorer health functioning among younger, but not older, adolescents at follow-up. There were no disease differences in the model. Important links were identified in this family-based model of coping, attributions, and health functioning. The results highlight specific targets for interventions to improve health functioning and coping among adolescents with chronic illness, including parental religious/spiritual coping and adolescent attributional style.


Religious/spiritual coping Attributional style Adolescents Chronic illness Parents 



This work was supported in part by the National Science Foundation Graduate Research Fellowship (Grant Number 1450078) awarded to the first author.

Compliance with Ethical Standards

Conflict of interest

The authors Christina M. D’Angelo, Sylvie Mrug, Daniel Grossoehme, David C. Schwebel, Nina Reynolds, and Kimberly Guion Reynolds declare that they have no conflict of interest.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of Alabama at BirminghamBirminghamUSA
  2. 2.Division of Pulmonary MedicineCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  3. 3.Children’s Behavioral Health Ireland CenterChildren’s of AlabamaBirminghamUSA
  4. 4.Child Development and Rehabilitation CenterOregon Health and Science UniversityPortlandUSA

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