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.     

Goal adjustment capacities, coping, and subjective well-being: The sample case of caregiving for a family member with mental illness.

This study examined the associations between goal adjustment capacities, coping, and indicators of subjective well-being in 2 waves of data from individuals who provide care for a family member with mental illness. We hypothesized that goal adjustment capacities would predict higher levels of subjective well-being by facilitating coping with caregiving stress. Results showed that goal disengagement was associated with effective care-specific coping (e.g., less self-blame and substance use). Goal reengagement was also associated with effective care-specific coping (e.g., positive reframing), but at the same time it predicted the use of less effective strategies (e.g., venting and self-distraction). Moreover, goal disengagement predicted lower levels of caregiver burden and depressive symptoms and buffered the longitudinal effect of caregiver burden on increases in depressive symptoms. Goal reengagement, by contrast, predicted higher levels of caregiver burden and purpose in life and buffered the cross-sectional association between caregiver burden and depressive symptoms. Finally, effective (and less useful) care-specific coping statistically explained the adaptive (and maladaptive) effects of goal adjustment capacities on participants' well-being. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Adjustment to multiple sclerosis: Application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n?=?96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Appraisal, coping, and social support as mediators of well-being in Black and White family caregivers of patients with Alzheimer's disease.

Family caregivers of patients with Alzheimer's disease (AD) commonly have high levels of psychological distress. Black caregivers often report less depression than White caregivers, but the process underlying this difference is poorly understood. With the use of a stress process model, 123 White and 74 Black family caregivers of patients with AD and other progressive dementias were studied. Black caregivers appraised patient problems as less stressful and reported higher self-efficacy in managing caregiving problems and less depression than did White caregivers. White and Black caregivers also differed significantly in coping responses but not in social supports. Structural equation analyses indicated that the correlational structure of the stress process was similar in White and Black caregivers. Caregiving stressors and race did not affect well-being through direct paths, but they were mediated by effects for appraisal, social support and activity, and coping. Possible cultural mechanisms explaining the better adjustment among Black caregivers are discussed. (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)     

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)     

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)     

A replicated prospective investigation of life stress, coping, and depressive symptoms in multiple sclerosis

Life stress and coping responses jointly contribute to psychological adjustment in many chronic illness populations, but their significance in multiple sclerosis (MS) has not been extensively investigated. Physical disability, cognitive status, negative life stress, coping strategies, and depressive symptoms were prospectively assessed in 27 adults with definite or probable MS. Of the original subjects, 22 provided two additional assessments at 6-month intervals. After accounting for cognitive status and physical disability, life stress was positively correlated with current as well as future depressive symptoms; the prospective relationship was replicated within the second pair of prospective data waves. Escape avoidance was the only coping strategy that added to the prediction of future mood symptoms, but this was not replicated. Results suggest that MS-related depressive symptoms are a function of prior disease-related impairment, life stress, and possibly escape avoidance coping.     

Predicting adjustment in children and adolescents with sickle cell disease: A test of the risk-resistance–adaptation model.

Objective: A theoretical model was used to examine the impact of risk and resistance factors on the psychological adjustment of children and adolescents with sickle cell disease (SCD). Participants: One hundred eighteen children and adolescents with SCD receiving treatment at a comprehensive sickle cell center and their mothers. Measures: Included risk factors (condition parameters, functional independence, and disability stressors), resistance factors (stress processing, intrapersonal factors, and social ecological factors), and adjustment. Results: Adaptive behavior was associated with child maladjustment, severity of disability was associated with disability stress, and child competence was associated with child maladjustment. Coping did not moderate the association between stress and maladjustment, and adaptive behavior and stress did not mediate the association between severity of disability and maladjustment, as the model had predicted. Conclusions: Results support the continued use of theoretically driven models to investigate the adjustment of children and adolescents with chronic conditions and to promote comparisons of different chronic illnesses and disabling conditions… (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors influencing adjustment of patients suffering from nasopharynx carcinoma--implications for oncology social work

A longitudinal study has been conducted in Hong Kong to identify important factors that affect short-term adjustment of patients suffering from nasopharynx carcinoma (NPC). A total of 125 newly diagnosed NPC patients were interviewed in the diagnostic phase, the number dropping to 119 in the treatment phase, and 111 in the post-treatment phase. Data were gathered by a pre-tested structured measuring instrument via face-to-face interviews. Those patients with poor adjustment in each phase of the illness were found to have higher perceived stress; they tended to interpret their illness as more threatening and less controllable, and they employed problem-focused coping less frequently but used emotion-focused coping more frequently. The health locus of control and the overall perceived social support had differential effects on short-term adjustment in different phases of the illness. Current stress was identified to be the most important factor accounting for patients' adjustment in the treatment phase, while adjustment in the post-treatment phase was predominantly accounted for by previous adjustment. Based on the results of this study, a new model of practice is proposed for oncology social workers in Hong Kong, which is proactive, comprehensive, preventive and stage-specific. This model of practice is applicable to other countries like USA.     

Personality, coping, and family resources in stress resistance: A longitudinal analysis.

A longitudinal analysis was conducted in which stress-resistance factors in the areas of personality, coping, and family support assessed at an initial testing were used to predict psychological and physical adjustment 1 yr later, controlling for initial adjustment. 245 men (mean age 46.8 yrs) and 248 women (mean age 44 yrs) in randomly selected families in the San Francisco Bay area were surveyed on psychosomatic symptoms and depression, negative life changes, personality characteristics, avoidance coping, and family support. Findings show that feelings of self-confidence, an easy-going disposition, a disinclination to use avoidance coping, and the availability of family support operated jointly to protect Ss from negative psychological consequences of life stress. For women, stress resistance was related to emotional and physical distress; for men, resistance was associated with emotional distress. Negative life changes predicted depression and psychosomatic complaints in both sexes even when initial distress was considered. Results support previous research on the causal role of stress resistance in emotional and physical health. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The association between threat appraisals and psychological adjustment in partners of people with spinal cord injuries.

Objective: To explore the psychological factors associated with adjustment in partners of people with spinal cord injuries (SCIs). Participants and Design: Forty partners of people with SCIs. The study had a cross-sectional design. Main Outcome Measures: Beck Depression Inventory, the State Trait Anxiety Inventory Form Y-1, Social Provisions Scale, COPE, and an appraisal scale. Results: Approximately one third of partners reported levels of anxiety and depressive symptoms above the clinical cut-off points indicating elevated levels of emotional distress. Factors hypothesized to account for levels of emotional distress on the basis of the cognitive-appraisal model of stress and coping were found to be explanative. In particular, high threat appraisal, higher use of avoidance (emotion-focused) coping, and lack of approach (problem-focused) coping were found to predict higher levels of anxiety and depressive symptoms. Conclusions: Partners of people with SCIs are at risk of emotional distress. Factors that might help identify at-risk partners are identified and psychological interventions that might help partners are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal expectations, social support, and adjustment to chronic illness.

Chronic illness places considerable burdens on patients and their interpersonal relations with families. In this study, patients' perceptions of family and medical staff expectations regarding responsibility for care and routine functions were examined. The authors hypothesized that a patient's perceived inability to meet others' expectations about coping with illness would lead to poorer adjustment. Forty-two chronically ill patients were assessed prospectively for perceptions of others' expectations, social support, and psychological adjustment. Findings confirmed that expectations predicted subsequent decreases in psychological adjustment over a 3-month period, even when social support was controlled. A test of the reverse hypothesis showed that poorly adjusted patients did not misperceive others' expectations. Theoretical interpretations of the findings and their relation to social support research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Telepathology diagnosis of prostrate needle biopsies

Studies have found that coping strategies are significant predictors of pain report, health care use, and psychosocial adjustment in children with sickle cell disease (SCD); however, the mechanisms of the relationship are not clear. In this study, 41 children with SCD completed a laboratory pain task to analyze their pain perception under standardized conditions. Sensory decision theory analyses were used to analyze the pain perception data. Children and their parents also completed measures of coping strategies and adjustment. Hierarchical regression analyses controlling for the child's age indicated that children who reported using active cognitive and behavioral coping strategies had a lower tendency to report pain during the laboratory pain task. Results are discussed in terms of the utility of using laboratory pain models with children and the need for future intervention studies to target coping strategies in children with SCD pain.     

Relation between coping strategies and distress, stress, and marital adjustment of multiple-role women.

This study examined time-management and self-care coping techinques that multiple-role women use and their relation to self-reported levels of distress, stress, and marital adjustment. The subjects (N?=?69) were married, had at least one child under the age of 12, and were employed outside the home for more than 20 hr per week. Subjects completed a demographic questionnaire, the Brief Symptom Inventory, the Derogatis Stress Profile, and the Locke-Wallace Marital Adjustment Test. In addition, subjects participated in a 15-min structured interview designed to assess number, type, and frequency of use of time-management and self-care coping strategies. Results of the study indicated that the number, type, and frequency of use of coping strategies were significantly related to self-reported levels of distress, stress, and particularly marital adjustment. Further analysis of high and low scorers on the marital-adjustment test revealed significant differences between the groups on measures of distress and coping. Subjects in the high-marital-adjustment group had significantly lower levels of distress, employed a greater number of coping strategies, and reported greater frequency of use of coping strategies than subjects in the low-marital-adjustment group. (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)     

Religiosity, coping, and psychological well-being among Latter-Day Saint Polynesians in the U.S.

There is limited knowledge about coping and psychological adjustment in Latter-Day Saint (LDS) Polynesians. This study examined religiosity, collectivistic coping, and psychological well-being among 94 LDS Polynesians residing in the Midwest. As hypothesized, religiously committed LDS Polynesians were more likely to have a healthy psychological well-being and were also likely to use collectivistic coping styles, such that high helpfulness ratings on family support and religion-spirituality coping styles were significantly correlated with a positive psychological well-being. Family support also moderated the relationship between LDS Polynesians' religious commitment and psychological well-being. Implications are discussed in terms of religiosity, culture, coping, and psychological well-being. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Coping effectiveness and coping diversity under traumatic stress.

The effectiveness of different strategies of coping and the impact of coping diversity were tested under traumatic stress conditions. Participants were 632 U.S. soldiers stationed in Iraq (mean age = 27.7, 98 male). Results indicate that four of nine functional coping strategies (including some emotion-focused coping) as defined by the COPE scale were inversely related to psychological symptom, whereas five of six dysfunctional strategies were positively related. Overall, in comparison to the norm group, soldiers showed a depressed level of functional coping strategies. Hierarchical regression, used to control for demographics and coping strategy intercorrelations, indicated that positive reinterpretation, emotional social support, and humor were most strongly related to lower psychological symptoms, whereas venting emotions, denial, mental disengagement, behavioral disengagement, and alcohol and drug use were related to higher levels of psychological symptoms. Two indices of coping diversity were tested. The index more strongly related to higher psychological adjustment was the sum of deviations from the mean of specific coping strategies combined with the alignment of functional and dysfunctional strategy clusters. Implications for research and application were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)