The role of self-blame and responsibility in adjustment to inflammatory bowel disease.

Objective: S. C. Roesch and B. Weiner's (2001) theoretical model of adjustment to chronic illness was adapted to examine the role of attributions, avoidant coping strategies, and disease severity in the psychological adjustment of people with inflammatory bowel disease (IBD). Research Method and Design: People with IBD (N = 259) completed an online survey including measures of health-related self-blame and responsibility attributions, disease severity, avoidant coping strategies, and psychological adjustment indexes (coping efficacy, acceptance, and helplessness). Results: Structural equation modeling revealed that avoidant coping mediated the relationship between attributions and psychological adjustment. Attributions of self-blame were directly related to increased avoidant coping, which was in turn associated with poor adjustment. Beliefs about responsibility were associated with decreased use of avoidant coping strategies and subsequently improved psychological adjustment. Higher scores on disease severity were linked to the use of avoidant coping strategies and poor psychological adjustment. Conclusions: Distinguishing between self-blame and responsibility attributions has important implications for understanding the psychological adjustment of individuals with IBD and may be useful for creating intervention strategies aimed at enhancing the psychological functioning of people with IBD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Psychological Adjustment of Children With Sickle Cell Disease: Family Functioning and Coping.

Objective: Using a risk and resistance model (J. L. Wallander, J. W. Varni, L. Babani, H. T. Banis, & K. T. Wilcox, 1989) to determine the effects of coping style and family functioning on children's adjustment to sickle cell disease (SCD). Participants: A sample of 73 caregivers and 23 children (ages birth to 18 years) admitted to a hematology acute care unit for pain or fever associated with SCD. Setting: A children's hospital on the East Coast of the United States. Outcome Measures: Disability stress, disease severity, child and parent coping, family functioning, and child adjustment were assessed with standard paper-and-pencil measures. Results: Results provide partial support for J. L. Wallander et al.'s (1989) risk-resistance model. Disability stress did not mediate the relation between disease severity and child adjustment, and severity of medical condition and medical stress did not predict adjustment. Child gender and child age predicted family functioning and child adjustment to SCD. Child or parent coping strategies did not moderate the association of disability stress and child adjustment. Conclusions: Individuals working with patients should be aware of other factors that may affect child outcome above disease severity; specifically, concerns of boys and girls with SCD and their caregivers should be assessed. (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)     

The role of attachment in responses to victims of life crises.

Attachment effects on affect, cognitions, and behavior during an interaction with a confederate who purportedly had cancer and whose attachment orientation had been manipulated in a prior context were examined among 241 participants. Results supported theoretically derived predictions: Participant anxious attachment predicted anxiety, participant avoidant attachment predicted supportiveness, and participant avoidant attachment interacted with confederate avoidant attachment to predict rejection. Results suggest (a) the importance of attachment in predicting interpersonal responses in a nonromantic stressful context, (b) that anxious attachment is an important predictor of anxiety in a situation with implicit support demands, (c) that avoidant attachment is a potentially important predictor of the likelihood of supportive responses to victims, and (d) that attachment orientation can be successfully manipulated in experimental studies of attachment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of attachment styles on romantic relationships.

Examined the impact of secure, anxious, and avoidant attachment styles on romantic relationships in a longitudinal study involving 144 dating couples. For both men and women, the secure attachment style was associated with greater relationship interdependence, commitment, trust, and satisfaction than were the anxious or avoidant attachment styles. The anxious and avoidant styles were associated with less frequent positive emotions and more frequent negative emotions in the relationship, whereas the reverse was true of the secure style. 6-mo follow-up interviews revealed that, among those individuals who disbanded, avoidant men experienced significantly less post-dissolution emotional distress than did other people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A stress-coping profile of opioid dependent individuals entering naltrexone treatment: A comparison with healthy controls.

Background: Stress is known to increase addiction vulnerability and risk of relapse to substance use. Purpose & Method: We compared opioid dependent individuals entering naltrexone treatment (n = 57) with healthy controls (n = 75) on measures of stress, coping, and social support and examined the relative contribution of group membership, coping, and social support to stress within the sample. Analyses of variance (ANOVA) and covariance (ANCOVA), and stepwise multiple regression were conducted. Results: Compared with controls, opioid dependent subjects reported greater stress, less use of adaptive coping, but comparable use of maladaptive/avoidant coping. No group differences were found with respect to social support. Perceived stress was predicted by group membership, low social support, and greater use of maladaptive/avoidant coping, and the prediction by social support and maladaptive/avoidant coping did not differ by group. Conclusion: Opioid dependent individuals entering naltrexone treatment experience higher levels of stress and report less use of adaptive coping strategies when compared with controls. Group membership, maladaptive/avoidant coping, and social support independently contribute to perceived stress. Findings suggest that novel treatment approaches that decrease maladaptive/avoidant coping and improve social support are important aspects of decreasing stress during early recovery from opioid addiction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relation between perfectionism and distress: Hassles, coping, and perceived social support as mediators and moderators.

This study of university students (136 men and 307 women) examined the roles of hassles, avoidant and active coping, and perceived available social support in the relation between evaluative concerns and personal standards perfectionism and distress symptoms (i.e., depression, anxiety). Confirmatory factor analysis supported the measurement model used in this study. Structural equation modeling results indicated that hassles, avoidant coping, and perceived social support are each unique mediators that can fully explain the strong relation between evaluative concerns perfectionism and distress. Personal standards perfectionism had a unique association with active coping only. Hassles and social support also moderated the relation between both dimensions of perfectionism and distress. Clinical implications of distinguishing between evaluative concerns and personal standards perfectionism are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maladaptive perfectionism, hassles, coping, and psychological distress in university professors.

This study examined the roles of hassles, avoidant and problem-focused coping, and perceived social support as mediating the relationship between maladaptive perfectionism and psychological distress in a sample of university professors. Hassles and avoidant coping both partially mediated a strong association between maladaptive perfectionism and psychological distress. These results are discussed in terms of the need to better understand how coping styles and social support are associated with the negative impact of perfectionism on the lives of university professors. The implications of these findings for counseling practice are also explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness, attachment, and the perception and use of social support in university students.

This study examined factors related to family, social, and romantic loneliness in 173 undergraduate students (66 males, 107 females). Participants completed measures of attachment style, perceived availability of social support, use of social support coping, and loneliness. Results indicated that participants with greater attachment security reported lower levels of all types of loneliness compared to those with less attachment security, and this was partially mediated by perceived social support but not the use of social support coping. When examining underlying attachment constructs, a more positive model of others was related to less family and social loneliness, and these associations were mediated by greater perceived social support. Model of others also was associated with less romantic loneliness and model of self was associated with less loneliness in all domains, and these relations were partially mediated by perceived social support. Findings are discussed with respect to possible interventions to increase students' perceptions of available social support and to decrease overall loneliness levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies.

Female Navy recruits (N=5,226) completed surveys assessing history of childhood sexual abuse (CSA), childhood strategies for coping with CSA, childhood parental support, and current psychological adjustment. Both CSA and parental support independently predicted later adjustment. In analyses examining whether CSA victims' functioning was associated with CSA severity (indexed by 5 variables), parental support (indexed by 3 variables), and coping (constructive, self-destructive, and avoidant), the negative coping variables were the strongest predictors. A structural equation model revealed that the effect of abuse severity on later functioning was partially mediated by coping strategies. However, contrary to predictions, the model revealed that childhood parental support had little direct or indirect impact on adult adjustment. (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)     

Attachment, attractiveness, and social interaction: A diary study.

To what extent are attachment styles manifested in natural social activity? A total of 125 participants categorized as possessing secure, avoidant, or anxious–ambivalent attachment styles kept structured social interaction diaries for 1 week. Several theoretically important findings emerged. First, compared with secure and anxious–ambivalent persons, avoidant persons reported lower levels of intimacy, enjoyment, promotive interaction, and positive emotions, and higher levels of negative emotions, primarily in opposite-sex interactions. Analyses indicated that avoidant persons may structure social activities in ways that minimize closeness. Second, secure people differentiated more clearly than either insecure group between romantic and other opposite-sex partners. Third, the subjective experiences of anxious-ambivalent persons were more variable than those of the other groups. Finally, the authors examined and rejected the possibility that attachment effects might be confounded with physical attractiveness. These findings suggest that feelings and behaviors that arise during spontaneous, everyday social activity may contribute to the maintenance of attachment styles in adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Curvilinear associations between benefit finding and psychosocial adjustment to breast cancer.

Two previously studied cohorts of women with nonmetastatic breast cancer (Ns = 230 and 136) were reexamined. Participants were assessed during the year after surgery and 5-8 years later. Associations were examined between benefit finding (BF) and several indicators of psychosocial adjustment (e.g., perceived quality of life, positive affect, negative affect, social disruption, and intrusive thoughts). Significant curvilinear relations between BF and other outcomes were observed cross-sectionally during initial assessment and at long-term follow-up in both samples. Compared with the intermediate BF group, low and high BF groups had better psychosocial adjustment. Further analyses indicated that the high BF group reported higher optimism and more use of positive reframing and religious coping than the other BF groups. Discussion highlights the need to examine nonlinear as well as linear relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Class climate moderates peer relations and emotional adjustment in children with an early history of anxious solitude: A child × environment model.

Classroom emotional climate was hypothesized to moderate psychosocial adjustment in 1st grade for children with an early childhood history of anxious solitude. Participants were 1,364 children in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and their mothers, child-care providers, and teachers. As anticipated, children with an early childhood history of anxious solitude were more rejected, poorly accepted (boys), and victimized (girls) by peers and demonstrated more depressive symptoms (girls) in 1st-grade classrooms with negative observed emotional climate. Results support a Child × Environment model of children's social and emotional adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Working Models of Attachment Shape Perceptions of Social Support: Evidence From Experimental and Observational Studies.

Two studies examined the association between attachment style and perceptions of social support. Study 1 (N = 95 couples) used an experimental paradigm to manipulate social support in the context of a stressful task. Insecure participants (anxious and avoidant) who received low-support messages appraised these messages more negatively, rated a prior behavioral interaction with their partner as having been less supportive, and performed significantly worse at their task compared with secure participants. Study 2 (N = 153 couples) used a similar paradigm except that partners were allowed to send genuine support messages. Insecure participants (especially fearful) perceived their partners' messages as less supportive, even after controlling for independent ratings of the messages and relationship-specific expectations. These studies provide evidence that individuals are predisposed to appraise their support experiences in ways that are consistent with their chronic working models of attachment, especially when the support message is ambiguous. (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)     

Conscientiousness predicts disease progression (CD4 number and viral load) in people living with HIV.

Objective: Psychosocial factors (e.g., depression, avoidant coping, life stress) have been related to disease progression in HIV. This study examined the relationship between the Big Five Conscientiousness factor and HIV disease progression (CD4 cell and viral load) over 1 year in 119 seropositive participants. The study also examined whether Conscientiousness effects were mediated by adherence, perceived stress, depression, or coping measures. Design: In a 1-year longitudinal design, participants completed the NEO Five-Factor Inventory Conscientiousness scale (P. T. Costa & R. R. McCrae, 1992). Participants also completed psychosocial assessments and underwent blood draws at initial assessments and 1-year follow-up. Main Outcome Measures: Multiple hierarchical regression models were used to predict change in CD4 cell numbers and viral load log 10, controlling for demographic variables, initial disease status, and antiretroviral medications. Results: Conscientiousness predicted significant increases in CD4 number and significant decreases in viral load at 1 year. Conscientiousness was related positively to medication adherence and active coping and negatively to depression and perceived stress. Only perceived stress emerged as a possible mediator. Conclusion: The significant relationship between Conscientiousness and medication adherence, distress, and coping suggests that an assessment of Conscientiousness in patients with HIV may help specify or target behavioral interventions to promote optimal disease management. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment style and affect regulation: Relationships with health behavior and family experiences of illness in a student sample.

Questionnaire measures of attachment style and health behavior were completed by 287 university students on 2 occasions, 10 wks apart. At Time 1, Ss also provided reports of emotionality and early family experiences of illness. Reports of early family illness showed theoretically meaningful relationships with attachment style. Symptom reporting was predicted most strongly by anxious/ambivalent attachment and negative emotionality, with the link between anxious/ambivalent attachment and symptom reporting partially mediated by negative emotionality. Visits to health professionals at Time 2 were directly related to reports of chronic illness in the family but inversely related to paternal illness and avoidant attachment, controlling for symptom reporting. The results are discussed in terms of theories of attachment and affect regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress, coping, and psychological adjustment of adults with sickle cell disease.

Examined a transactional model of psychological adjustment to chronic illness with 109 African-American adults with sickle cell disease (SCD). Good psychological adjustment was associated with lower levels of perceived daily stress and stress regarding SCD illness tasks, higher efficacy expectations, less use of palliative coping methods, less use of negative thinking/passive adherence pain-coping strategies, and family functioning characterized by high levels of support and low levels of conflict and control. Overall, the underlying stress and coping conceptual model accounted for 44–50% of the variance in psychological adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)