Cognitive distortion and functional impairment in patients undergoing cardiac rehabilitation

This study examined, the influence of cognitive distortion (e.g., catastrop hizing, overgeneralization) on functional impairment among caronary heart d isease (CHD) patients undergoing outpatient cardiac rehabilitation. Forty-t wo CHD patients completed a version of the Cognitive Errors Questionnaire ( CEP; Lefebvre, 1981) shortly after hospital discharge at the initiation of the rehabilitation program. Functional impairment was assessed both pre- an d postrehabilitation using scales front the Sickness Impact Profile (SIP; B ergner et at, 1981) and a measure of peak exercise performance. Consistent with prediction, patients' CEQ scores were significantly associated with re sidualized change in two areas of illness-related functional impairment aft er controlling for disease severity and prerehabilitation levels of functio ning. Patients endorsing a high number of cognitive errors on the CEQ repor ted greater impairment in mobility and poorer social functioning after comp letion of the rehabilitation program relative to patients making a low numb er of cognitive errors. CEQ scores did not significantly predict changes in impairment in home management or recreational activity or in peak exercise performance These findings provide further evidence that cognitive constru cts might be useful in understanding individual differences in functional r ehabilitation in medical populations and may have implications for the desi gn of cardiac rehabilitation programs.