Age-Related Differences Among Adults Coping With Pain: Evaluation of a Developmental Life-Context Model.

The pain and coping literature is limited because of its almost exclusive focus on young adults. Our goal was to develop and evaluate a theoretically sound model of age-related differences in coping. Age-related increases in emotion-focused and avoidance-oriented coping and decreases in problem-focused coping were expected to arise from age-related differences in life-context (e.g., health status, stress levels) and in the pain experience. Questionnaire data were collected from 280 older and younger adults with pain. Increasing age was associated with lower pain severity/interference and greater perceived control over pain. Life-context partially mediated this relationship. As hypothesized, there were age-related declines in problem-focused coping. Contrary to expectations, however, older adults also used fewer emotion-focused coping strategies. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maladaptive Coping Strategies and Injury-Related Distress Following Traumatic Physical Injury.

Objectives: To identify coping strategies associated with injury-related distress in a mixed sample of physically injured adults. Study Design: Correlational. Setting: Level 1 trauma center. Participants: Orthopedic hand (n=22), multiple trauma (n=35), and burn-injured patients (n=11); ages 18-66; English speaking. Measures: Trauma Symptom Checklist-40 (TSC-40) and Brief Coping Orientations to Problems Experienced Scale. Results: Positive associations were found between 5 coping strategies and TSC-40 scores. Multiple regression revealed 3 strategies that explained significant variability in TSC-40 scores (R2=.36; emotional venting: β=.28, p=.02; behavioral disengagement: β=.25, p=.02; self-blame: β=.26, p=.05). Conclusions: Use of certain coping strategies was associated with injury-related distress among acutely injured adults. Psychosocial and educational interventions for coping in the immediate aftermath of traumatic physical injury may mediate and prevent injury-related distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adverse Life Events in Late Life: Their Manifestation and Management in Daily Life.

The purpose of this study was to investigate the relationships among major life events, chronic events, daily instrumental activities, and well-being. Fifty individuals between 73 and 93 years of age reported major life events, minor hassles and uplifts, and daily activities during 5 measurement periods. In addition, positive affect was assessed in situ 5 times per day on 6 consecutive days on the basis of a random time-sampling scheme. The effects of major life events on positive affect were transmitted through minor events. However, there was no evidence that the relationship between minor events and positive affect was moderated by the occurrence of a major event. The relationship between life events and positive affect, however, was moderated by change in instrumental activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with body image changes following a disfiguring burn injury.

The influence of emotion-focused coping on distress following disfiguring injury was examined. Two types of emotion-focused coping (i.e., venting emotions vs. mental disengagement) were assessed in 78 patients with burn injury at baseline during acute hospitalization. Body image dissatisfaction (BID) was assessed 1 week and 2 months following discharge. Use at baseline of both venting emotions and mental disengagement, compared with use of only one or neither of these coping methods, was associated at the 2-month postdischarge follow-up with significantly higher BID related to nonfacial aspects of appearance and with a greater negative social impact of disfigurement. D. M. Wegner's (1994) theoretical model of mental control and a proposed motivational analysis are used to interpret these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recent Life Events Preceding Suicide Attempts in a Personality Disorder Sample: Findings From the Collaborative Longitudinal Personality Disorders Study.

Few studies have examined the relationship between life events, suicide attempts, and personality disorders (PDs), in spite of the strong associations between PDs and suicidal behavior, and the poor coping strategies often exhibited by these individuals. The authors examined whether participants with PDs who attempted suicide during the first 3 years of a prospective, longitudinal study were more likely to experience specific life events in the month during and preceding the suicide attempt. Of 489 participants with PDs, 61 attempted suicide during the 3-year, follow-up interval. Results indicated that negative life events, particularly those pertaining to love-marriage or crime-legal matters, were significant predictors of suicide attempts, even after controlling for baseline diagnoses of borderline PD, major depressive disorders, substance use disorders, and a history of childhood sexual abuse. Therefore, certain types of negative life events are unique risk factors for imminent suicide attempts among individuals with PDs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional Distress in Nonmetropolitan Persons Living With HIV Disease Enrolled in a Telephone-Delivered, Coping Improvement Group Intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.

Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N=171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N=131). Coping strategies again mediated the relations among the measures of past and present control and distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unipolar Depression, Life Context Vulnerabilities, and Drinking to Cope.

This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses. Depressed patients engaged in more drinking to cope than did community controls. Within individuals, more negative life events and less family support were associated with more drinking to cope across the 4 observations. Depressed patients experienced more negative life events and less family support than did community controls. These underlying life context vulnerabilities explained the relationship between depressed patient status and drinking to cope. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping With Distress by Eating or Drinking: Role of Trait Urgency and Expectancies.

The authors propose that trait urgency (the tendency to act rashly when distressed) is a risk factor for both alcohol abuse and bulimic symptoms, that disorder-specific expectancies influence whether one engages in one behavior or the other, and that expectancies moderate urgency's influence on those behaviors. Cross-sectional findings were consistent with the model. Problems from alcohol use were comorbid with binge eating and purging. Trait urgency was associated with both behaviors. Alcohol expectancies were associated with drinking levels and with problem drinking, but not with eating. Eating expectancies were associated with binge eating, but not with alcohol use or problems. Urgency's effect on binge eating was moderated by expectancies, but its effect on alcohol use and problem drinking was not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Traumatic Stress, Perceived Global Stress, and Life Events: Prospectively Predicting Quality of Life in Breast Cancer Patients.

The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps     

The Unconscious Cost of Good Fortune: Implicit and Explicit Self-Esteem, Positive Life Events, and Health.

J. D. Brown and K. L. McGill (1989) found that positive life events were associated with better health only for people high in self-esteem. Among people low in self-esteem, positive life events were associated with poorer health. The authors of this study replicated this finding in a self-report survey of 61 male and 110 female college students. In addition, they showed that implicit self-esteem moderated the relation between positive life events and self-reported health in the same fashion as explicit self-esteem did. Whereas people high in implicit self-esteem reported being healthier when they experienced more positive life events, people low in implicit self-esteem reported being healthier when they experienced fewer positive life events. Moreover, the effects of implicit self-esteem were statistically independent of the effects of explicit self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How Does Negative Life Change Following Disaster Response Impact Distress Among Red Cross Responders?

The American Red Cross is the largest nongovernmental organization responding to disasters in the United States. This study investigated the impact of negative life change occurring in the year following the September 11, 2001, terrorist attacks on levels of distress among 757 Red Cross Disaster Services Human Resources (national disaster team) employees and volunteers who responded to this disaster. Negative life change in the year following disaster response fully mediated the relationship between disaster response and symptoms of depression and partially mediated the responses between disaster response and posttraumatic stress and anxiety symptoms. Results highlight the importance of life experiences in the year following disaster response and, therefore, the education and follow-up services provided to disaster workers prior to and following disaster assignment. Suggestions for monitoring disaster-related stress during and following assignment are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Put Your Money Where Your Mouth Is! Explaining Collective Action Tendencies Through Group-Based Anger and Group Efficacy.

Insights from appraisal theories of emotion are used to integrate elements of theories on collective action. Three experiments with disadvantaged groups systematically manipulated procedural fairness (Study 1), emotional social support (Study 2), and instrumental social support (Study 3) to examine their effects on collective action tendencies through group-based anger and group efficacy. Results of structural equation modeling showed that procedural fairness and emotional social support affected the group-based anger pathway (reflecting emotion-focused coping), whereas instrumental social support affected the group efficacy pathway (reflecting problem-focused coping), constituting 2 distinct pathways to collective action tendencies. Analyses of the means suggest that collective action tendencies become stronger the more fellow group members "put their money where their mouth is." The authors discuss how their dual pathway model integrates and extends elements of current approaches to collective action. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress Generation, Avoidance Coping, and Depressive Symptoms: A 10-Year Model.

This study examined (a) the role of avoidance coping in prospectively generating both chronic and acute life stressors and (b) the stress-generating role of avoidance coping as a prospective link to future depressive symptoms. Participants were 1,211 late-middle-aged individuals (500 women and 711 men) assessed 3 times over a 10-year period. As predicted, baseline avoidance coping was prospectively associated with both more chronic and more acute life stressors 4 years later. Furthermore, as predicted, these intervening life stressors linked baseline avoidance coping and depressive symptoms 10 years later, controlling for the influence of initial depressive symptoms. These findings broaden knowledge about the stress-generation process and elucidate a key mechanism through which avoidance coping is linked to depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping style, perceived uncertainty in illness, and distress in individuals with Parkinson's disease and their caregivers.

Examined the relationship of coping style and illness uncertainty to psychological distress in individuals with Parkinson's disease (PD) and their primary caregivers. Design: Correlational methods, within-group theory-driven hierarchical regression analyses, and transactional analyses. Ss were 44 dyads composed of individuals with PD and their caregivers. Main Outcome Measures: Hoehn and Yahr Clinical Disability Rating Scale, Instrumental Activities of Daily Living Scale, Symptom Distress Checklist-90—Revised, Mischel Uncertainty in Illness Scale-Community Form, and Revised Ways of Coping Checklist. Results: Emotion-focused coping was associated with higher levels of distress for persons with PD, whereas both emotion-focused coping and perceived uncertainty were associated with distress for the caregivers. Transactional analyses between patients and caregivers indicated that higher levels of patient problem-focused coping and perceived uncertainty in illness were associated with increased problems in caregiver distress. Adjustment to PD is influenced by several patient and caregiver variables. The results warrant consideration of a variety of clinical interventions involving patient and caregiver education about the disease and methods for managing the associated symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping, control, and adjustment in type 2 diabetes.

The relationships of both coping strategies and perceived control to psychological and physiological adjustment were investigated in 115 adults (65 women, 50 men) with Type 2 diabetes. Results showed that (a) emotional preoccupation and palliative coping were positively correlated with depression and state anxiety, whereas perceived control was negatively correlated with depression, state anxiety, and hemoglobin A1c (HbA1c); (b) instrumental coping predicted lower depression; (c) perceived control moderated the relationships between instrumental coping and depression, and emotional preoccupation coping and HbA1c; and (d) emotional preoccupation coping mediated the relationships between perceived control and depression, and perceived control and state anxiety. Results are discussed in terms of the goodness-of-fit hypothesis (V. J. Conway & D. J. Terry, 1992), optimal coping, and the importance of perceived control in psychological and physiological adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with increased uncertainty in the field of work and family life.

Globalization, demographic aging, and individualization and pluralization of life courses have led to individuals' increasing uncertainty regarding their future. The effects of social change on the lives of individuals, however, may depend on coping processes. The authors analyzed whether perceived uncertainty due to social change, problem-focused coping, and distancing from demands would be related to depressive symptoms in 1,975 German adolescents and adults. A higher number of perceived demands in the areas of work and family life (e.g., perceived increase of difficulties with finding adequate jobs and of instability of one's intimate relationship) were associated with higher levels of depressive symptoms. In addition, higher levels of problem-focused coping were related to fewer depressive symptoms, whereas higher levels of distancing from demands were related to more depressive symptoms. Problem-focused coping buffered the effect of family-related demands but not of work-related demands on depressive symptoms. Finally, distancing from demands buffered the effects of family-related demands but amplified the effects of work-related demands on depression. In sum, the present study supports the main effects model and the interaction effects model of coping. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's Perceived Illness Uncertainty as a Moderator in the Parent-Child Distress Relation in Juvenile Rheumatic Diseases.

Objective: Examine children's perceived illness uncertainty as a potential moderator in the parent-distress/child-depressive-symptom relation in youths with juvenile rheumatic disease (JRD). Participants and Study Design: 50 youths between the ages of 9 and 17 and their parents completed self-report measures. Main Outcome Measures: Parents completed the Brief Symptom Inventory (L. R. Derogatis & N. Melisaratos, 1983); youths completed the Children's Depression Inventory (M. Kovacs, 1992) and the Children's Uncertainty in Illness Scale (L. L. Mullins & V. L. Hartman, 1995). Results: Children's perceived illness uncertainty moderated the parent-distress/child-depressive-symptom relation. Parent distress was associated with child depressive symptoms only under conditions of high child-perceived uncertainty; under conditions of low illness uncertainty, parent distress was unrelated to child depressive symptoms. Conclusions: Results highlight the role of children's cognitive appraisals in parent-child adjustment relations in JRD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with intergenerational family conflict: Comparison of Asian American, Hispanic, and European American college students.

Using a stress-coping framework, the authors examined indirect and direct coping strategies as potential mediators in the relationship between intergenerational family conflict and psychological distress in Asian American, Hispanic, and European American college students. Asian American college students reported the highest likelihood of family conflict. Students from all cultural groups also used direct coping slightly more often than they did indirect coping. Only indirect coping mediated the effect of family conflict on distress for Asian Americans and European Americans, but it did so in the opposite direction than hypothesized. For these two cultural groups, indirect coping fully accounted for the variance shared between family conflict and psychological distress. For Hispanics, indirect coping partially mediated the effect of family conflict on psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of the Stepfamily Events Profile.

This project developed and examined the validity of a tailor-made life events checklist specific to the experiences of adolescents in stepfamilies (i.e., the Stepfamily Events Profile; STU). The STEP was developed from information gathered in focus groups and interviews and includes positive and negative events that are meaningful to adolescents in stepfamilies. The STEP was given to 90 adolescents residing with their biological mother and stepfather. Negative events were significantly related to adolescent report of maladjustment, and positive events were significantly related to mother and adolescent report of internalizing problems, above and beyond the effects of several covariates. Also, the effects of negative and positive events were uniquely predictive of adolescent maladjustment. Events reflecting interactions within the adolescent's dyadic family relationships were most strongly predictive of adolescent maladjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)