Journal of Behavioral Medicine, Vol. 27, No. 1, February 2004 ( C  2004) Independent and Mediated Contributions of Personality, Coping, Social Support, and Depressive Symptoms to Physical Functioning Outcome Among Patients in Cardiac Rehabilitation Biing-Jiun Shen, 1,5 Charles P. McCreary, 2,3 and Hector F. Myers 4 Accepted for publication: May 11, 2003 This study examined the direct and mediated contributions of psychosocial variables to posttreatment physical functioning among 142 patients receiv- ing cardiac rehabilitation. Two models were proposed and tested. In the first model, psychosocial factors were correlated and made to predict baseline and 6-week physical functioning. The results showed that after controlling for age, illness severity, baseline physical functioning, and other psychoso- cial correlates, optimism and social support still significantly predicted better posttreatment physical functioning. In the second model, we explored both the direct and mediational relationships between psychosocial factors and phys- ical health outcomes. Optimism and social support were found to contribute to health outcomes not only directly but also indirectly through the medi- ation of less engagement in detrimental coping and lower depressive symp- toms, whereas hostility and negative coping only predicted outcomes indirectly through mediators. These findings highlighted the importance of addressing psychosocial issues and their interrelationships in cardiac rehabilitation. KEY WORDS: coronary heart disease (CHD); depression; hostility; optimism; social support. 1 University of Miami, Department of Psychology, P.O. Box 248185, Coral Gables, Florida 33124- 2070. 2 UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California 90095. 3 VA Greater Los Angeles Health Center, Los Angeles, California 90073. 4 UCLA Department of Psychology, Los Angeles, California 90095-1563. 5 To whom correspondence should be addressed; e-mail: bshen@miami.edu. 39 0160-7715/04/0200-0039/0 C  2004 Plenum Publishing Corporation