Coping with illness: Interrelationships across family members and predictors of psychological adjustment.

This study examined coping in families in which there was a chronically ill parent. Husbands, wives, and one child (aged 7–18 yrs) from 75 families in which the husband had hemophilia participated. Coping styles and psychological adjustment were assessed, and patterns of coping among family members were examined. Avoidant coping was associated with poorer adjustment for all family members. In addition, the coping style of one family member was found to be related to the psychological adjustment of other family members. Avoidant coping by one spouse related to poorer psychological functioning in the other spouse, and avoidant coping by either parent related to greater child adjustment problems for girls and boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arthritis and perceptions of quality of life: An examination of positive and negative affect in rheumatoid arthritis patients.

The utility of measuring both positive and negative affective states for assessing rheumatoid arthritis (RA) patients was examined in 3 independent samples of male and female RA patients (Sample A: 179 women, 48 men; Sample B: 177 women, 24 men; Sample C: 134 women, 38 men). Confirmatory factor analyses of each sample indicated that positive and negative affect constituted separate, negatively correlated factors. The relations among disease variables, coping, and affects were consistent with a model in which coping mediates the relationship between disease variables and positive and negative affect. Patients with higher pain and limitation from RA had higher levels of maladaptive coping, and maladaptive coping was associated with lower positive affect and higher negative affect. Those RAs with higher activity limitation also reported less adaptive coping, which was associated with less positive affect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intrusive thoughts and psychological distress among cancer patients: The role of spouse avoidance and criticism.

This study examined whether perceived spouse criticism and avoidance impacted cognitive processing in 129 cancer patients. It was hypothesized that intrusive thoughts would be associated with an increase in psychological distress among patients who felt their spouses were critical or avoiding them and that intrusive thoughts would not be positively associated with distress among patients who did not feel their spouses were critical or avoidant. The impact of spouse criticism was predicted to be stronger than the impact of spouse avoidance. A moderating effect for spouse criticism on the association between early intrusive thoughts and later distress was present. Spouse avoidance did not have a significant moderating effect on the relation between intrusive thoughts and later distress. Results suggest spouse criticism and avoidance may have differential effects on the cognitive processing of cancer. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer.

Objective: Relationship maintenance strategies help to ensure the continuation of valued relationships by keeping them at a certain level of intimacy. This study evaluated how lung cancer patients' and spouses' efforts to maintain their relationships affected their psychological and marital adjustment over time. Design: Psychosocial questionnaires were administered within 1 month of lung cancer treatment initiation (baseline) and 3 and 6 months later to 158 lung cancer patients and their spouses. Main Outcome Measures: Study outcomes were global severity index scores on the Brief Symptom Inventory, and total scores on the Dyadic Adjustment Scale. Results: Multilevel modeling analyses using the Actor-Partner Interdependence Model showed that, regardless of gender or social role (i.e., patient or spouse), individuals who engaged in the strategies of positivity, networks, and shared tasks reported less distress at baseline than other participants. Over time, the effects of providing more assurances and experiencing a partner's increased reliance on social networks differed: patient distress was exacerbated, and spouse distress was alleviated. Couples where both partners engaged in more frequent maintenance behaviors reported greater dyadic adjustment at baseline and over time. Conclusion: For couples coping with lung cancer, the initial treatment period may be an important time that sets the tone for future spousal interactions. Engaging in relationship maintenance during this stressful time may help mold more resilient relationships and facilitate adjustment as the disease progresses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A developmental-contextual model of couples coping with chronic illness across the adult life span.

A developmental-contextual model of couples coping with chronic illness is presented that views chronic illness as affecting the adjustment of both the patient and the spouse such that coping strategies enacted by the patient are examined in relation to those enacted by the spouse, and vice versa. The developmental model emphasizes that dyadic coping may be different at various phases of the life span, changing temporally at different stages of dealing with the illness as well as unfolding daily as spouses interact around dyadic stressors. In addition, couples engaged in dyadic coping are affected by broad sociocultural factors (culture and gender) as well as more proximal contextual factors (quality of the marital relationship and the specific demands of the chronic illness). The model provides a framework for understanding how couples coping with chronic illness may together appraise and cope with illness during adulthood and for determining when spousal involvement is beneficial or harmful to both patient and spousal adjustment. The developmental-contextual model to dyadic appraisal and coping has numerous research implications for the field, and the authors conclude with specific recommendations for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diet and humoral responsiveness of lines of chickens divergently selected for antibody response to sheep red blood cells

OBJECTIVE: To assess everyday life stress and emotional adjustment in patients with rheumatoid arthritis (RA) and their children. METHODS: We conducted a 6 month study of 14 patients with RA with children aged 4-16 years (25 children) and 24 control families (53 children). Life event stress and functional capacity were assessed at the beginning and end of the study, and minor stressors (hassles), positive events (uplifts), and salivary cortisol were recorded weekly. Emotional adjustment was measured monthly in adults by self-report, and bimonthly in children using the Child Behavior Checklist (completed by parents). Social support and psychological coping responses were also measured. RESULTS: Patients with RA experienced fewer positive events than did controls, and they tended to have smaller support networks. Daily hassle levels correlated with severity of disability, and differences in psychological coping were also observed. Children from RA families reported nearly 50% more hassles per week than did controls, and their social networks were significantly smaller. They were rated as having greater problems of social adjustment than controls. Cortisol concentration was greater among children who experienced more life event stress over the study period, but did not differ between groups. CONCLUSION: The patients with RA in this study showed good adaptation, but experienced less pleasure in their daily lives. The children of patients with RA may have heightened vulnerability to stress related problems, with fewer social resources and difficulties in behavioral adjustment.     

Self-critical perfectionism and daily affect: Dispositional and situational influences on stress and coping.

This study of university students (64 men and 99 women) examined both dispositional and situational influences of self-critical (SC) perfectionism on stress and coping, which explain its association with high negative affect and low positive affect. Participants completed questionnaires at the end of the day for 7 consecutive days. Structural equation modeling indicated that the relation between SC perfectionism and daily affect could be explained by several maladaptive tendencies associated with SC perfectionism (e.g., hassles, avoidant coping, low perceived social support). Multilevel modeling indicated that SC perfectionists were emotionally reactive to stressors that imply possible failure, loss of control, and criticism from others. As well, certain coping strategies (e.g., problem-focused coping) were ineffective for high-SC perfectionists relative to low-SC perfectionists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hiding worries from One's spouse: associations between coping via protective buffering and distress in male post-myocardial infarction patients and their wives

The relationship between protective buffering, a style of coping in which the individual hides his/her concerns from spouse, and level of distress was studied among post-myocardial infarction (MI) patients and their spouses. Forty-three male married MI survivors and their wives completed measures of psychological distress and protective buffering at 4 weeks and 6 months post-hospital discharge. At both time periods, a greater propensity for protective buffering by the patient was related to higher levels of patient distress. Protective buffering by wife was also associated with higher levels of wife distress. In addition, patient buffering at 4 weeks predicted increased patient distress at 6 months. The results suggest that male MI patients who conceal their worries from their spouses adjust more poorly over time.     

Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment.

Longitudinal data on the coping strategies used by 151 41–89 yr old middle-aged and older adults faced with 1 of 4 chronic illnesses were used to evaluate the role of coping in the explanation of psychological adjustment. The authors distinguished between illnesses that offer few opportunities for control (rheumatoid arthritis and cancer) and those more responsive to individual and medical efforts at control (hypertension and diabetes) and evaluated the emotional consequences of 2 coping strategies—information seeking and wish-fulfilling fantasy—expected to play different roles in adjustment. Results show that information seeking had salubrious effects on adjustment and that wish-fulfilling fantasy had deleterious consequences; contrary to expectation, neither strategy's effects were modified by illness controllability. Analyses of the direction of causation between coping and adjustment suggest that wish-fulfilling fantasy is linked to poor adjustment in a mutually reinforcing causal cycle. The modesty of the effects of coping, however, demands replication of results to confirm the conclusions drawn in the present study. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism and bulimic symptoms in African American college women: Dimensions of perfectionism and their interactions with perceived weight status.

This study had 2 primary aims: (a) to examine the unique relations between maladaptive and adaptive dimensions of perfectionism and bulimic symptoms and (b) to test an interactive model of perfectionism and perceived weight status for bulimic symptoms in a sample of African American female undergraduates. The sample consisted of 97 women at Time 1 and 70 women at Time 2 about 5 months later, with bulimic symptoms assessed at both time points. Results showed that maladaptive perfectionism, but not adaptive perfectionism, was uniquely related to bulimic symptoms in cross-sectional analyses. Tests of interaction effects indicated that maladaptive perfectionism interacted with perceived weight status to identify elevated bulimic symptoms such that women with high levels of maladaptive perfectionism who felt overweight exhibited the highest levels of bulimic symptoms, both concurrently and prospectively after controlling for Time 1 levels of bulimic symptoms. This study highlights the relevance of maladaptive perfectionism to bulimic symptoms in African American college women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Insecure attachment moderates women's adjustment to inflammatory bowel disease severity.

Objective: Insecure attachment was explored as a moderator of the relationship between disease severity and psychosocial variables in a study of adjustment in women with inflammatory bowel disease (IBD). Method: Participants were 218 women recruited through notices placed in the community, in gastroenterologists' offices, and through online postings to support groups and message boards specifically for people with Crohn's disease, colitis, or IBD in general. Participants completed a mail-in or online survey assessing severity and frequency of symptoms, attachment style (separated into anxious and avoidant subscales), perceived social support, negative affect, and efficacy of coping with IBD. Results: Anxious and avoidant attachment styles were correlated positively with disease severity and negative affect and negatively with perceived social support and coping efficacy. Hierarchical regressions indicated that disease severity was most strongly associated with negative affect for high avoidant attachment, as compared with moderate and low avoidant attachment. Disease activity was inversely related to perceived social support and coping efficacy for high and moderate, but not low, anxious attachment. Conclusion: Our study indicates that attachment moderates associations between disease severity in women with different kinds of IBD and psychological indicators of adjustment. Limitations and relationship to previous research on attachment and health are discussed. (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)     

En las Manos de Dios [in God's Hands]: Religious and Other Forms of Coping Among Latinos With Arthritis.

This study tested a theoretical model concerning religious, passive, and active coping; pain; and psychological adjustment among a sample of 200 Latinos with arthritis. Respondents reported using high levels of religious coping. A path analysis indicated that religious coping was correlated with active but not with passive coping. Religious coping was directly related to psychological well-being. Passive coping was associated with greater pain and worse adjustment. The effects of active coping on pain, depression, and psychological well-being were entirely indirect, mediated by acceptance of illness and self-efficacy. These findings warrant more research on the mechanisms that mediate the relationship between coping and health. This study contributes to a growing literature on religious coping among people with chronic illness, as well as contributing to a historically under-studied ethnic group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Functional impairment, marital quality, and patient psychological distress as predictors of psychological distress among cancer patients' spouses.

This study investigated contextual determinants of psychological distress among 197 spouses of cancer patients. women, 30–82 years old). It was hypothesized that higher levels of patient functional impairment would lead to greater patient distress. Patient distress, in turn, would lead to lower spouse marital satisfaction and ultimately to higher spouse distress. Spouses completed measures of distress and marital quality at three time points. Cancer patients rated their functional impairment and psychological distress at the same time points. Results indicated that at all time points, greater patient impairment was associated with higher levels of patient distress which, in turn, was related to lower marital satisfaction. However, marital quality was related to spouse distress at only 1 time point, but spouse distress was directly associated with patient distress at each time point. Implications for cancer patients and spouses are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat.

How do people cope with a threat when they do not plan to adopt an adaptive, protective reponse? We explored this question by examining the effects of information about a health threat and two aspects of coping ability, self-efficacy and response efficacy, on two adaptive and five maladaptive coping strategies (e.g., avoidance, wishful thinking). The results disclosed that the high-threat condition energized all forms of coping; it did not differentially cue specific coping strategies. The critical factor in determining the specific strategies used was the coping information. The high-response-efficacy and high-self-efficacy conditions strengthened adaptive coping and did not foster any maladaptive coping. A supplementary path analysis revealed an intriguing pattern of relations, including the finding that the most maladaptive strategy was avoidant thinking, which simultaneously reduced fear of the threat and weakened intentions to adopt the adaptive response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived social support, self-efficacy, and adjustment to abortion.

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of couple illness perception congruence on psychological adjustment in women with rheumatoid arthritis.

Objective: To characterize similarities and differences in illness perceptions between women with rheumatoid arthritis (RA) and their husbands, and examine whether illness perception congruence predicted wives' subsequent psychological adjustment. Design: Women with RA and their husbands (N = 190 couples) recruited from community and clinical settings completed mailed surveys at baseline and 4-month follow-up. Main Outcome Measures: Data for this investigation included illness perceptions in partners and illness severity, marital variables, and psychological adjustment in wives. Results: In general, wives and husbands had similar views of RA. Couple congruence concerning women's personal control over RA and its cyclic nature predicted better psychological adjustment in women 4 months later. Post hoc tests showed better psychological adjustment in wives from couples with similar optimistic beliefs about personal control, illness coherence, and RA consequences, when compared to those in couples with similar pessimistic beliefs. Furthermore, when partners disagreed about RA's consequences, wives fared better when husbands overestimated rather than underestimated their beliefs. In contrast, couple congruence about the emotions and timeline of RA was unrelated to adjustment. Conclusion: It may be important for husbands to understand wives' views on their control over RA and its cyclic nature. Furthermore, wives may benefit when they share optimistic views with their husbands about RA, and when their husbands avoid underestimating RA's consequences. Developing interventions to enhance partners' illness understanding may be beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of relapse in unipolar depressives: Expressed emotion, marital distress, and perceived criticism.

The predictive validity of expressed emotion (EE) and two conceptually related but more easily measured alternatives—marital distress, and patients' perceptions of criticism from spouses—were examined in a sample of hospitalized unipolar depressives. All three psychosocial variables were significantly associated with 9-month relapse rates. Expressed emotion and marital distress predicted the same proportion of variance in patients' outcomes. The single best predictor of relapse, however, was a patient's response to the question "How critical is your spouse of you?" Patients who relapsed rated their spouses as significantly more critical than did patients who remained well. Alone, the perceived criticism variable accounted for more of the variance in relapse rates than that explained by EE and marital distress combined. The results suggest that asking depressed patients how critical they believe their relatives are may facilitate the identification of individuals at high risk for relapse subsequent to hospital discharge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations of SARS-related stressors and coping to Chinese college students' psychological adjustment during the 2003 Beijing SARS epidemic.

This study examined the main and interactive relations of stressors and coping related to severe acute respiratory syndrome (SARS) with Chinese college students' psychological adjustment (psychological symptoms, perceived general health, and life satisfaction) during the 2003 Beijing SARS epidemic. All the constructs were assessed by self-report in an anonymous survey during the final period of the outbreak. Results showed that the relations of stressors and coping to psychological adjustment varied by domain of adjustment. Regression analyses suggested that the number of stressors and use of avoidant coping strategies positively predicted psychological symptoms. Active coping positively predicted life satisfaction when controlling for stressors. Moreover, all types of coping served as a buffer against the negative impact of stressors on perceived general health. These findings hold implications for university counseling services during times of acute, large-scale stressors. In particular, effective screening procedures should be developed to identify students who experience a large number of stressors and thus are at high risk for developing mental health problems. Intervention efforts that target coping should be adapted to take account of the uncontrollability of stressors and clients' cultural preferences for certain coping strategies. A multidimensional battery of psychological adjustment should be used to monitor clients' psychological adjustment to stressors and evaluate the efficacy of intervention. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Adjustment to occupational stress: The relationship of perceived control to effectiveness of coping strategies.

A sample of 187 medical center nurses described 2 stressful occupational episodes varying in perceived controllability and provided information regarding the coping strategies used. Outcome measures assessed effectiveness of coping across 3 dimensions: perceived coping effectiveness, job affect, and psychological adjustment. Negative affectivity was measured to control for its tendency to inflate stress-adjustment relationships. Use of problem-solving strategies was related to perceived coping effectiveness only for high-control episodes. However, differential use of coping across levels of controllability was not related to job affect or psychological adjustment. Avoidant coping was strongly associated with negative affect at work. In contrast, problem-reappraisal and problem-solving strategies were related to positive affect at work. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)