[Dynamics of depression symptoms after myocardial infarction--the importance of changes in hope].

AIM The mechanism of dynamics of depression symptoms after myocardial infarction (MI) during six months was examined with reference to (a) whether the changes in coping strategies mediate the effect of changes in cognitive appraisal on changes in the level of depression, and (b) whether this mediation is moderated by the changes in hope. METHODS Cognitive appraisal (threat/harm, challenge), hope, coping strategies (problem-, emotion- and avoidance-focused) and depression were assessed two times among 173 cardiac patients: a few days after first MI and then six months later. RESULTS Only emotion-focused coping partly mediated the relationship between changes in threat/harm appraisal and changes in depression (both direct and indirect effects were positive). The effect of changes in challenge appraisal on depression was only direct and negative. Both direct effects were moderated by the level of changes in hope: the associations between changes in appraisal and depression were significant only when hope do not change or decreased in time. CONCLUSIONS Associations between dynamics of appraisal and depression during six months after MI were more direct and depended on changes in hope.