Changes in alcoholic patients' coping responses predict 12-month treatment outcomes.

Patient subtypes (Types A and B alcoholism), determinants, and outcomes associated with changes in coping responses of 133 alcoholic patients in the year following admission to treatment were examined. In general, patients' use of avoidance coping declined and use of approach coping increased. Type B patients used more avoidance coping than did Type A patients, but the subtypes did not differ in rate of change in coping. As a determinant of coping, cognitive appraisal of threat showed a trend toward predicting avoidance coping at 6- and 12-month follow-ups. Decreased cognitive avoidance coping (e.g., daydreaming) predicted fewer alcohol, psychological, and interpersonal problems. Increased behavioral approach coping (e.g., taking action) predicted lower severity of alcohol problems. Further study of changes in the cognitive aspects of coping (i.e., appraisals and cognitive avoidance coping) is needed to determine mechanisms underlying cognitive processes associated with treatment outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Approach and avoidance coping responses among older problem and nonproblem drinkers.

The Coping Responses Inventory (CRI) was used to study coping among older problem and nonproblem drinkers. The CRI organizes coping efforts according to their focus (approach or avoidance) and method (cognitive or behavioral). Compared with nonproblem drinkers, older problem drinkers were more likely to use cognitive and behavioral avoidance responses to manage life stressors. Problem drinkers who experienced more negative life events and more severe stressors used both more approach and more avoidance coping. Those who had more financial and social resources relied more on approach and less on avoidance coping. Problem drinkers who relied more on avoidance coping tended to have more drinking problems and to report more depression and physical symptoms and less self-confidence. Positive reappraisal was associated with less depression and more self-confidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with sexual harassment: Reconceptualizing women's resistance.

This study explored the underlying structure of women's coping with sexual harassment from a rational-empirical approach. On the basis of multidimensional scaling, clustering, and confirmatory factor analysis across 8 data sets, 4 clusters of coping behaviors emerged, with little variance across the data sets. These clusters bear resemblance to Moos and colleagues' (C. J. Holahan, R. H. Moos, & J. A. Schaefer, 1996; R. Moos, 1992; R. H. Moos & J. A. Schaefer, 1993) distinction between coping strategies that differ in both method and foci. The four clusters that emerged are behavioral engagement, behavioral disengagement, cognitive engagement, and cognitive disengagement. This framework provides insight into the complex forms that women's coping with sexual harassment takes and has important legal implications. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Smoking screening and management in primary care practices

This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.     

Cognitive coping, affective distress, and maternal sensitivity: Mothers of children with Down syndrome.

This study investigated relations among maternal cognitive coping style (approach-avoidance), affective state, and sensitivity. Fifty-six mothers and their children with Down syndrome were followed for 2 years. Cognitive coping and affective distress inventories were administered and sensitivity was rated on the basis of mother-child observations. Results indicated that approach and avoidance have been widely studied under different designations and are stable across time. These cognitive coping variables may mediate the stress of parenting a child with a disability in complex ways. Mothers with a strong tendency to monitor stressors report greater affective distress than do mothers who adopt a less vigilant coping style. At the same time, cognitive avoidance of stressors and affective distress reduce the behavioral sensitivity of the mother toward her child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Approach and avoidance coping responses among older problem and nonproblem drinkers": Clarification.

Reports a clarification in the article by R. H. Moos et al (Psychology and Aging, 1990[Mar], Vol 5[1], 31–40). The authors wish to note that research reported in the article by P. L. Brennan and R. H. Moos (see record 1991-10154-001) was based on the sample used in the research reported by Moos et al and that this information was inadvertently deleted in the Brennan and Moos article. (The following abstract of the article by Moos et al originally appeared in PA, Vol 77:14961.) The Coping Responses Inventory (CRI) was used to study coping among older problem and nonproblem drinkers. The CRI organizes coping efforts according to their focus (approach or avoidance) and method (cognitive or behavioral). Compared with nonproblem drinkers, older problem drinkers were more likely to use cognitive and behavioral avoidance responses to manage life stressors. Problem drinkers who experienced more negative life events and more severe stressors used both more approach and more avoidance coping. Those who had more financial and social resources relied more on approach and less on avoidance coping. Problem drinkers who relied more on avoidance coping tended to have more drinking problems and to report more depression and physical symptoms and less self-confidence. Positive reappraisal was associated with less depression and more self-confidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain.

Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving, emotional expression, and emotional regulation), Secondary Control Engagement Coping (positive thinking, cognitive restructuring, acceptance, and distraction), and Disengagement Coping (denial, avoidance, and wishful thinking). Structural equation modeling using latent variables revealed that secondary control engagement coping predicted lower levels of anxiety/depression symptoms and somatic complaints, and disengagement coping was related to higher levels of anxiety/depression and somatic complaints. Implications for understanding child and adolescent coping with pain are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment to a low-control situation: Reexamining the role of coping responses.

The aim of the study was to test a revised conceptualization of the role of coping in adjustment to a low-control stressor—women's adjustment to a failed in vitro fertilization (IVF) attempt. Data were collected prior to the IVF treatment (Time 1) and twice after the failed IVF attempt (1 to 2 weeks after finding out the results, n?=?171, and 6 weeks later, n??139). Initial adjustment was assessed at Time 1, whereas measures of coping and both self-report and partner ratings of adjustment were obtained at Times 2 and 3. As predicted, escapist strategies and problem-management strategies (mainly at Time 2) were associated with poor adjustment, whereas problem-appraisal coping was associated with better adjustment. There was also support for the proposed positive relationship between adjustment and emotional approach coping (on self-report adjustment). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between attachment scales and group therapy alliance growth differs by treatment type for women with binge-eating disorder.

The impact of the treatment context in influencing the relationship between attachment anxiety/avoidance and group therapy alliance growth was examined. Sixty-five women treatment completers with binge-eating disorder received 16 sessions of group cognitive behavioral therapy (GCBT) or group psychodynamic interpersonal psychotherapy (GPIP). Attachment scales were completed before treatment, and a group therapy alliance measure was completed after each therapy session. Growth curve modeling indicated an increasing linear growth in group therapy alliance for both treatments. For GPIP, higher attachment anxiety and lower attachment avoidance were each associated with alliance growth. These relationships were not evident for GCBT. The context of therapy likely activated (in the case of GPIP) or did not activate (in the case of GCBT) defensive attachment strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with perceived peer stress: Gender-specific and common pathways to symptoms of psychopathology.

This study investigated gender differences in the moderating and mediating effects of responses to stress on the association between perceived peer stress and symptoms of psychopathology. A sample of 295 middle school students (63.7% female; Mage = 12.39 years, SD = 0.99) completed self-report surveys on stress, coping, and behavioral problems. Involuntary responses to stress (e.g., physiological arousal, intrusive thoughts, impulsive action) mediated the association between perceived stress and anxiety/depression and aggression for girls and for boys. Disengagement coping (e.g., denial, avoidance) partially mediated the association between peer stress and anxiety/depression for boys and for girls. In contrast, disengagement coping mediated the association between peer stress and overt aggression for boys only. Finally, engagement coping (e.g., problem solving, emotion regulation, cognitive restructuring) buffered the indirect effect of peer stress on symptoms of psychopathology for girls only. Implications for prevention and intervention efforts are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions of responsibility and persuasion: Increasing mammography utilization among women over 40 with an internally oriented message.

197 women over 40 yrs old and not adhering to national guidelines for screening mammography viewed persuasive messages varying in attributional emphasis (internal, external, or information-only). Internal attributions of responsibility for health-promoting behavior were expected to motivate the greatest change in women's attitudes and behaviors in relation to breast cancer and mammography. Attitudes about breast cancer and mammography were measured immediately and 6 mo after the presentation. 12 mo later, women who viewed the internal message were more likely to have obtained a screening mammogram than women assigned to the other 2 conditions. The attributions of responsibility encouraged by the persuasive messages were associated with whether viewing the presentation led to behavior change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive behavioral interventions for adolescents with cystic fibrosis

Examined the effectiveness of a cognitive behavioral intervention to help adolescents with cystic fibrosis (CF) cope with daily stressors. Five youths were referred for the therapy by medical staff because of perceived problems with anxiety or coping. Treatment impact was assessed on measures of coping, anxiety, perceptions of functional disability, and parental reports of behavior. A multiple baseline design across subjects was used. Reductions in anxiety, a decrease in maladaptive coping efforts with CF-related problems, and an increase in positive coping with CF-related problems were obtained. Youths also reported a decrease in functional disability due to CF after the initiation of the intervention. Follow-up assessment indicated that most youths maintained gains in anxiety and perceived functional disability, but not coping efforts. Results suggest that cognitive behavioral treatment is a viable intervention for anxious youths with CF.     

Predictors of posttraumatic stress disorder symptomatology following bone marrow transplantation for cancer.

This study examined the prevalence and predictors of posttraumatic stress disorder (PTSD) symptoms in 70 men and women treated with bone marrow transplantation for cancer. Findings indicated that number of symptoms present ranged from 0 to a possible high of 17 (M = 3.0, SD = 3.9). As predicted lower social support and higher avoidance coping I month pretransplant predicted greater PTS symptom severity an average of 7 months posttransplant. These variables remained significant predictors of symptom severity even after accounting for pretransplant levels of psychological distress. Addition analyses indicated the presence of a significant interaction between social support and avoidance coping with patients high in avoidance coping and low in social support reporting the most severe symptoms. These findings identify patients at risk for psychological disturbance posttransplant and can serve guide future intervention efforts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Approach, avoidance, and coping with stress.

Notes that the study of stress and coping points to 2 concepts central to an understanding of the response to trauma: approach and avoidance. This pair of concepts refers to 2 basic modes of coping with stress. Approach and avoidance are simply metaphors for cognitive and emotional activity that is oriented either toward or away from threat. Formulations of the approach–avoidance dimension are reviewed along with coping effectiveness literature. A general approach–avoidance model of coping is presented in the context of contemporary theoretical approaches to coping. The potential costs and benefits of approach and avoidance are outlined, and an ideal case of coping with stress, in which both modes would be operative, is presented. It is suggested that research focus on studying one stress or trauma at a time and following the coping processes over time. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Avoidance as a predictor of the biological course of HIV infection over a 7-year period in gay men.

The present study prospectively investigated the relation between avoidance coping and active cognitive and behavioral coping and the progression of HIV infection over 7 years in 181 gay men. Findings revealed that for a number of medical and behavioral factors, (a) avoidance coping predicted a lower rate of decline in CD4 cells, (b) the proportional hazard (PH) attributable to avoidance of developing a syncytium-inducing HIV variant was 0.72 (95% confidence interval [CI]: 0.53–0.99, p?p?     

Long-term cognitive and emotional impact of genetic testing for carriers of cystic fibrosis: The effects of test result and gender.

The cognitive and emotional responses to genetic testing for carriers of cystic fibrosis (CF) of 241 female and 36 male carriers and a matched sample who had received a negative screening result were compared 3 years after testing. The main predictor of responses to testing was the type of result received. Gender differences in response to screening were also found: Women were more likely to feel relieved and less likely than men to feel indifferent, regardless of test results. There was an interaction between test results and gender for feeling happy and healthy about test results. The greater impact of testing on women may reflect gender differences in appraisal or in coping with the threat of being a carrier for a genetic disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of situation and coping on relapse crisis outcomes after smoking cessation.

Examines the influence of situational characteristics and coping on the outcome of a relapse crisis for 232 Ss followed for 1 month after a self-initiated smoking cessation attempt. Survival of a relapse crisis was most strongly related to the number of coping strategies used. All coping strategies were equally effective; furthermore, combining cognitive and behavioral coping strategies was not more effective than using multiple cognitive or multiple behavioral strategies. During the second half of the follow-up period (Weeks 3 and 4 postcessation), the presence of smokers resulted in a decreased likelihood of coping and an increased likelihood of smoking. In addition, active coping was marginally related to higher baseline levels of motivation to quit. When motivation and the presence of smokers were controlled, however, coping still significantly predicted outcome. Results are discussed with reference to previous relapse studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antecedents of stressful experiences: Depressive symptoms, self-esteem, gender, and coping.

Numerous studies have identified depressive symptoms as antecedent to stressful experiences. However, the interrelations of depressive symptoms, personal resources, and coping as antecedents of stressful experiences are largely unknown. For this investigation, a prospective design was used to test a model estimating two categories of daily hassles at Time 2 in relation to depressive symptoms, self-esteem, gender, coping, and daily hassles at Time 1. Utilizing simultaneous equations, direct effects were observed for depressive symptoms, Time 1 hassles, gender, and avoidance coping in relation to category of hassles at Time 2. Depressive symptoms and avoidance coping were observed to be mediators for gender and self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Procedural variation in behavioral avoidance tests.

Varied level of demand for approach to a live snake in a behavioral avoidance test by presenting the test either as a measure of degree of avoidance (low demand) or as a measure of physiological components of anxiety which required that Ss handle the target object (high demand). Mode of presentation of instructions was also manipulated; 1/2 of the 50 female undergraduates in each condition heard "1-shot" tape-recorded instructions and were alone in the test room (impersonal mode), while the other 1/2 heard the instructions presented by a "live" E who accompanied the S to the test room and provided sequential instructions for each step in the behavioral avoidance test (personal mode). The main effect of context was significant on latency to touch and overt fear measures (with low-demand Ss displaying more fear), while the main effect of mode was significant for behavior approach score as well as overt fear (the personal mode was associated with less avoidance). Implications for psychotherapy outcome research employing behavioral avoidance tests are discussed. (61 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived coping as a mediator between attachment and psychological distress: A structural equation modeling approach.

This study examined perceived coping (perceived problem-solving ability and progress in coping with problems) as a mediator between adult attachment (anxiety and avoidance) and psychological distress (depression, hopelessness, anxiety, anger, and interpersonal problems). Survey data from 515 undergraduate students were analyzed using structural equation modeling. Results indicated that perceived coping fully mediated the relationship between attachment anxiety and psychological distress and partially mediated the relationship between attachment avoidance and psychological distress. These findings suggest not only that it is important to consider attachment anxiety or avoidance in understanding distress but also that perceived coping plays an important role in these relationships. Implications for these more complex relations are discussed for both counseling interventions and further research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)