Role of child and maternal processes in the psychological adjustment of children with sickle cell disease.

In this study, 64% of children aged 7–12 yrs with sickle cell disease were found to have a parent-reported behavior problem, and 50% met the criteria for a Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R) diagnosis based on a structured clinical interview of the child. Internalizing types of behavior problems and diagnoses were the most frequent. Support was provided for a transactional stress and coping model in delineating the processes associated with child adjustment. In particular, maternal anxiety accounted for 16–33% of the variance in mother-reported internalizing and externalizing behavior problems, respectively, and child pain-coping strategies accounted for 21% of the variance in child-reported adjustment problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up of coping skills training in adults with sickle cell disease: Analysis of daily pain and coping practice diaries.

This study examined the 3-month follow-up effects of a pain coping skills intervention in African American adults with sickle cell disease. Sixty-seven participants were randomly assigned to either a coping skills condition or a disease-eduction control condition. Multivariate analyses applied to summary measures of coping, laboratory pain perception, and clinical measures indicated that participants in the coping intervention reported significantly lower laboratory pain and significantly higher coping attempts at 3-month follow-up in comparison with the control condition. Multilevel random effects models applied to prospective daily diaries of daily pain, health care contacts, and coping practice indicated that on pain days when participants practiced their strategies, they had less major health care contacts in comparison with days when they did not use strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.

The present study examined whether training in cognitive coping skills would enhance pain coping strategies and alter pain perception in adults with sickle cell disease (SCD). Sixty-four African Americans with SCD were randomly assigned to either a cognitive coping skills condition (three 45-min sessions in which patients were trained to use 6 cognitive coping strategies) or a disease-education control condition (three 45-min didactic-discussion sessions about SCD). Pain sensitivity to calibrated noxious stimulation was measured at pre- and posttesting, as were cognitive coping strategies, clinical pain, and health behaviors. Results indicated that, compared with the randomly assigned control condition, brief training in cognitive coping skills resulted in increased coping attempts, decreased negative thinking, and lower tendency to report pain during laboratory-induced noxious stimulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment of mothers of children and adolescents with sickle cell disease: the role of stress, coping methods, and family functioning

Assessed the psychological adjustment of 78 mothers of children and adolescents (7-17 years of age) with sickle cell disease. Support was provided for a transactional stress and coping model in delineating the processes associated with maternal adjustment. In particular, poor maternal adjustment was associated with use of palliative coping methods and high levels of stress related to daily hassles. Variables of the model accounted for 55% of the variance in maternal psychological distress.     

Stability and change in the psychological adjustment of mothers of children and adolescents with cystic fibrosis and sickle cell disease

Found moderate stability in the classification of maternal adjustment in two longitudinal studies of mothers of children and adolescents with cystic fibrosis and sickle cell disease. In terms of the transactional stress and coping model, stable poor maternal adjustment was associated with higher levels of appraisal of daily stress and palliative coping and low levels of family supportiveness. With initial levels of maternal adjustment, demographic parameters, and follow-up interval controlled, concurrent levels of daily stress accounted for significant portions of variance in maternal adjustment at follow-up for both illness groups. In addition, illness severity, child psychological adjustment, and family conflict added significant increments to maternal adjustment at follow-up in the cystic fibrosis group. Findings are discussed in terms of a basis for subsequent intervention studies to enhance the adjustment of mothers of children with chronic illness.     

Stress, coping and psychological illness: A cross-cultural study.

This cross-cultural research study aimed to explore the relationship of stress and coping with psychological illness or symptoms among university students in Canada and India. The predictor variables were stress (hassles and life experience), 8 ways of coping (Folkman & Lazarus, 1988), and selected personal-social variables, namely, locus of control, self-esteem, and social support. The criterion variables were 9 psychological symptoms of the Brief Symptom Inventory (BSI; Derogatis & Spencer, 1982). The results revealed that the Indian students reported more psychological symptoms compared to the Canadian students. Stepwise multiple-regression analyses also revealed considerable differences between the 2 samples with respect to the contribution of predictor variables in accounting for variance in the BSI scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sickle cell disease pain: Relation of coping strategies to adjustment.

This study examines pain coping strategies in a relatively neglected pain population, sickle cell disease (SCD) patients. Seventy-nine patients diagnosed with SCD were given a structured interview to assess pain, activity level, and health care use during painful episodes. Patients also completed the SCL-90—R as an index of psychological distress and the Coping Strategies Questionnaire. Regression analyses controlled for age, sex, and disease severity measures. Results indicated that the coping strategies factors were important predictors of pain and adjustment. Individuals high on Negative Thinking and Passive Adherence had more severe pain, were less active and more distressed, and used more health care services. Individuals high on Coping Attempts were more active during painful episodes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disability and coping as predictors of psychological adjustment to rheumatoid arthritis.

Rheumatoid arthritis (RA) patients have been identified as a medical population at risk for psychological disorder, largely because of the pain and functional disability that are the hallmarks of the disease. This study examined the degree to which self-reported functional disability and coping efforts contribute to psychological adjustment among adult RA patients over a 6-month period. Adaptive outcomes included maintaining a sense of worth, mastery, and positive affect despite the illness. Hierarchical multiple regression analyses indicated that increases in disability were related to decreased acceptance of illness and increased negative affect. Coping efforts were related to increases in positive affect. The findings provide modest support for the role individual coping efforts play in shaping illness-related outcomes. Although disability is not easily reversed, knowledge about coping strategies that moderate its psychological impact may provide a useful basis for designing psychological interventions to promote adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment of adolescents with sickle cell disease: relations with demographic, medical, and family competence variables

OBJECTIVE: Investigate the hypothesis that family competence in addressing challenges associated with sickle cell disease (SCD) contributes to adolescents' adjustment. METHOD: During routine clinic appointments, 80 adolescents (M age = 14.4 years) and their parents independently completed the Self-Report Family Inventory (SFI), which assesses family competence, and measures of adolescent adjustment problems. Information related to disease severity was obtained from clinic files. RESULTS: Regression analyses controlling for demographic and medical variables revealed that higher family competence was associated with fewer internalizing and externalizing behaviors by the adolescent; these relations were particularly true for younger adolescents and for girls. Parental reports of somatic complaints in girls were predicted by parental ratings of family competence. DISCUSSION: Interventions for adolescents with SCD should be family-centered and should focus on strengthening the family's ability to manage stressors associated with parenting an adolescent with a chronic illness.     

Emotionally expressive coping predicts psychological and physical adjustment to breast cancer.

This study tested the hypothesis that coping through emotional approach, which involves actively processing and expressing emotions, enhances adjustment and health status for breast cancer patients. Patients (n ?=?92) completed measures within 20 weeks following medical treatment and 3 months later. Women who, at study entry, coped through expressing emotions surrounding cancer had fewer medical appointments for cancer-related morbidities, enhanced physical health and vigor, and decreased distress during the next 3 months compared with those low in emotional expression, with age, other coping strategy scores, and initial levels on dependent variables (except medical visits) controlled statistically. Expressive coping also was related to improved quality of life for those who perceived their social contexts as highly receptive. Coping through emotional processing was related to one index of greater distress over time. Analyses including dispositional hope suggested that expressive coping may serve as a successful vehicle for goal pursuit. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment of children with sickle cell disease: Stability and change over a 10-month period.

Rates of poor psychological adjustment of children with sickle cell disease remained relatively constant over initial and follow-up assessment points. 50 children (aged 7–12 yrs) and their mothers completed the initial protocol. 30 children completed the follow-up plus 5 additional children and their mothers. These Ss were aged 7–24 yrs at follow-up. With initial levels of adjustment controlled, children's strategies for coping with pain accounted for a significant increment in child-reported symptoms and mother-reported internalizing behavior problems at follow-up beyond the contribution of illness and demographic parameters and follow-up interval. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spouse criticism and support: Their association with coping and psychological adjustment among women with rheumatoid arthritis.

Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patient's selection of adaptive or maladaptive coping responses. (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)     

The role of optimism in social network development, coping, and psychological adjustment during a life transition.

The authors investigated the extent to which social support and coping account for the association between greater optimism and better adjustment to stressful life events. College students of both genders completed measures of perceived stress, depression, friendship network size, and perceived social support at the beginning and end of their 1st semester of college. Coping was assessed at the end of the 1st semester. Greater optimism, assessed at the beginning of the 1st semester of college, was prospectively associated with smaller increases in stress and depression and greater increases in perceived social support (but not in friendship network size) over the course of the 1st semester of college. Mediational analyses were consistent with a model in which increases in social support and greater use of positive reinterpretation and growth contributed to the superior adjustment that optimists experienced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion regulation, coping, and psychological symptoms.

The question of whether emotion control and coping are separate independent concepts or overlapping constructs was explored with a sample of 422 university students using the Emotional Control Questionnaire and the Coping Inventory for Stressful Situations. In addition, the relationship between emotion control, coping, and psychological symptoms was explored using the Brief Symptom Inventory. Evidence was found for both independence and overlap between emotion control and coping. Emotion focused coping was a strong predictor of psychopathology. Rehearsal and benign control were associated with the set of psychological symptoms. Aggression control was related to hostility and interpersonal sensitivity. Coping-emotion control combinations and gender differences were also examined in terms of the psychological symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symposium: Family caregiving to dependent older adults: Stress, appraisal, and coping.

Articles presented in this 1987 APA symposium adopt a stress, appraisal, and coping framework for conceptualizing the experience of family caregiving. Each article emphasizes 2 themes: (a) caregivers' adaptation to the chronic demands of in-home caregiving and (b) factors that mediate the relationship between caregiving stress and caregiver's adaptation. The articles presented in this symposium illustrate both the utility of this theoretical approach to studying caregiving stress and the difficulty inherent in its use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Illness uncertainty, attributional style, and psychological adjustment in older adolescents and young adults with asthma

Examined psychological adjustment in a college sample of older adolescents and young adults (n = 49) with histories of childhood asthma. A substantial number of subjects evidenced clinically significant levels of overall distress. In addition, greater perceived asthma uncertainty and increased stable attributions for negative events were significantly associated with poorer psychological adjustment after controlling for demographic and disease variables. Further analyses revealed a moderating influence of uncertainty on attribution-adjustment relationships. These findings provide initial support for a cognitive diathesis-stress view of adjustment in long-standing asthma. Results also support a growing body of evidence suggesting that the focus of efforts to enhance adjustment to asthma need to be expanded beyond childhood and early adolescence.     

Dysphoria: Relations to appraisals, coping, and adjustment.

Previous research has shown that individual differences in dysphoria are linked to adjustment, but the potential mediating influence of appraisals and coping has not been studied until now (R. Lazarus & S. Folkman, 1984). This study examined the direct and indirect influences of dysphoria on primary and secondary appraisal, coping, and psychological and physical adjustment in 361 college students. Results from conducting path analyses indicated that the link between dysphoria and adjustment was mediated by appraisals and coping. These results also suggest that dysphoria has both direct and indirect influences on adjustment. Implications for future research and development of appropriate interventions for working with dysphorics are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular features in adolescents and adults with sickle cell anaemia

Fifty five sickle cell anaemia (SCA) patients at the Kenyatta National Hospital were studied with a view to elucidating their cardiovascular status. Their age range was 13 to 27 years (median 18.9 years). They comprised 27 males and 28 females and their mean haemoglobin concentration was 8.5 +/- 1.4 g/dl. Haemoglobin level of 8.0-9.9 g/dl seen in 30 patients was noted to confer the lowest incidence of exertional dyspnoea and palpitation. Similarly, patients with this haemoglobin level had the lowest mean heart rate. The mean blood pressure was 114.9 +/- 9.9 mmHg systolic and 64.6 +/- 10 mmHg diastolic. Blood pressures, ejection fraction (EF) and differential fibre shortening (%D) were found to be directly related to haemoglobin level, whereas cardio-thoracic index (CTI) and left ventricular dimensions were inversely related to haemoglobin level. Mean echocardiographic measurements were within normal limits and left ventricular functions were found to be normal in 80.9% of the patients indicating that the majority of SCA patients at the Kenyatta National Hospital have good cardiac function.     

Stress, coping, and high-risk sexual behavior.

Examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse [UAI]) in 398 nonmonogamous gay and bisexual men. UAI during the previous month, the amount of stress experienced during the previous month in each of 10 domains, 6 types of coping, and spiritual beliefs and activities were assessed through self-report. There was no relation between stress and UAI, but there was between coping and UAI. Ss who reported UAI used sex more to help cope with stressful situations. UAI was negatively associated with seeking social support and spiritual activities and positively associated with self-controlling coping, which involves keeping one's feelings to oneself, and positive reappraisal. (PsycINFO Database Record (c) 2010 APA, all rights reserved)