Functional impairment and coping style.

The study of how patient attributes interact with psychological treatments (i.e., aptitude by treatment interactions [ATI's]) is a complex and often neglected area of research. ATI research includes patient dimensions and covariates or moderators that selectively and predictably alter the effect of various models of psychotherapy. A number of patient dimensions that moderate treatment effects have been identified. This article focuses on two of these patient variables: patient level of functional impairment and patient coping style. This article describes these concepts and the methods of their measurement and then reviews empirical literature that identifies the effects of these patient contributions on treatment outcome. The practical implications for treatment are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clinician confidence in coping with patient aggression: Assessment and enhancement.

Training programs intended to enhance clinician confidence in coping with patient aggression have been only cursorily researched. In previous studies researchers have typically used ad hoc instrumentation and have omitted control conditions and follow-up assessment. This investigation included psychometric development of an instrument to assess self-attributed clinician confidence in coping with patient aggression, and a comparison of groups who did and who did not undergo training. Although untrained groups showed no change in confidence over time, trained groups reported substantial pretest/posttest gains in confidence that were maintained during an 18-mo follow-up period. Implications of this study for subsequent research and training are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping style in hypertensive patients: Nature and consequences.

Examined the coping styles and health behaviors of hypertensive and normotensive patients visiting a primary care setting for acute medical problems. Hypertensive individuals were far more likely to display a "high-monitoring" (information-seeking) mode of coping than normotensive individuals, who tended to be "low-monitoring" (information avoiding) in their coping. Although hypertensive patients reported less dysfunction in their current medical problems than did normotensive patients, they nonetheless reported greater concerns about their condition and its impact. Finally, hypertensive patients were rated by physicians as more likely to desire help with both their presenting medical problem and their stress-related problems. Future research should help to specify the exact relations among coping style, stress, and symptom reporting in hypertension. (PsycINFO Database Record (c) 2010 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)     

Progress in resolving problems: A problem-focused style of coping.

This investigation reports the development of a multidimensional instrument of stable coping styles that focused on whether one's problem-focused coping efforts were facilitating or inhibiting progress toward resolution of a problem. Study 1 describes the steps in scale construction, including the factor analyses, normative information, and reliability estimates. Study 2 provides initial estimates of the stability of the factor structure and construct, concurrent, and discriminant validity. Study 3 provides evidence for the test–retest stability of the Problem-Focused Style of Coping (PF-SOC) factors, an examination of the relations between the PF-SOC factors and neuroticism as another estimate of discriminant validity, and additional concurrent validity by comparisons with a well-developed coping styles inventory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recall of early experience and the repressive coping style.

Investigated recall of early experience and the repressive coping style by testing hypotheses concerning restricted access to negative childhood memories and eliciting accounts of quality of parenting received. Ss were 37 undergraduate women (aged 18–38 yrs). Repressors free recalled fewer negative childhood memories than nonrepressors, and the age of 1st negative memory for repressors was older both in free recall and cued recall. Repressors also took longer to retrieve negative childhood memories but not positive memories. Repressors' accounts of their childhoods were more likely to be characterized by paternal antipathy and indifference, and they were less likely to report an emotionally or physically close relationship with their fathers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with bone marrow transplantation. A contribution to adaptive vs. maladaptive coping

The coping strategies of 36 adult leukemia patients admitted for bone marrow transplantation have been investigated systematically by trained raters using audio-taped material from semi-structured interviews. So-called long term survivors with a median survival time of 978 days after BMT displayed significantly lower passive-stoic acceptance and resignation than non-survivors who died within a median time of 229 days after BMT. These copings were of high prognostic value prior to all treatment regimes in strong correlation with a negative hematological prognosis and age. Non-survivors showed significantly higher passive-stoic acceptance and resignation coping. Form of leukemia and other sociodemographic variables or stress had neither a significant impact on coping intensity nor on coping quality. Consequences for further coping research and possible treatment interventions prior to or immediately after BMT are being discussed.     

Understanding marital stressors. The importance of coping style

Previous survey work with 1591 married Chicago adults has demonstrated a close connection between symptoms of depression and current marital stressors (nonfulfillment of basic role expectations, lack of reciprocity between partners, and nonacceptance by spouse). The pertinent question now becomes which factors predispose toward marital stressors. We address this issue here by examining a broad array of variables to see which are most predictive of marital stressors by employing multiple regression analysis on data from the survey sample. A descending order of explanatory power of marital stressors occurs for the following categories of variables: respondent's style of coping with marital problems, behavior patterns within the marriage, personality factors of the respondent, other current social stressors, demographic variables, and marital circumstances. One coping style in particular, that of optimistic action, is more predictive of low marital stressors than any other single variable studied. The findings contradict several common beliefs about marital stressors: the presence of background differences between the spouses, a lack of consensus between the partners, and the presence of other social stressors (job, parenting, finances) are relatively poor predictors of marital discord.     

Perceptual style and behavioral pattern of individuals with functional gastrointestinal disorders.

The present research examined the perceptual style and coping pattern characterizing individuals with functional gastrointestinal disorders. A matched case–control design was adopted to compare differences among the target group of individuals with functional gastrointestinal disorders (n?=?40), a pain control group of individuals with rheumatism (n?=?40), and the community control group of healthy individuals (n?=?40). Perceptual style was measured by both monitoring and blunting responses to hypothetical stressful situations, and coping pattern was measured by the use of coping strategies in real-life stressful events. Results revealed that participants with functional gastrointestinal disorders differed from their healthy and rheumatic counterparts in having higher monitoring and lower blunting scores and using action-oriented coping strategies regardless of the controllability of stressful situations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A factor analytically derived measure of coping: The Coping Strategy Indicator.

Three stages of factor-analytic investigation aimed at uncovering general strategies that underlie the myriad specific coping responses to stress. Each stage utilized a separate, large, heterogeneous sample, yet analyses consistently revealed 3 fundamental strategies: Problem Solving, Seeking Social Support, and Avoidance. Over the course of studies, a short self-report questionnaire evolved that indicates the extent to which each of the strategies has been employed in a recent stressful event. A 4th stage of study, focusing on the instrument's psychometric properties, revealed orthogonality of scales and good internal consistency, test–retest reliability, and construct validity. Advantages over existing measures, as well as potential problems in the instrument, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with daily events and short-term mood changes: An unexpected failure to observe effects of coping.

This study examined the relationship between coping efforts and stress-related mood changes. Men and women with high levels of work or marital stress reported stress and coping efforts approximately once an hour for 2 days using an electronic diary. Stress episodes were identified as a stress-free time followed by a stressor at the next time point. Analyses examined how appraisals and coping influenced pre- to poststress mood change and how problem appraisals were related to coping efforts. Greater mood changes were associated with appraisals of high stress and high disruptiveness. Appraisals of high control and high desirability were associated with more planning, direct action, and fewer acceptance coping efforts. Coping failed to predict any pre- to poststressor mood changes. Possible explanations for the overall failure of coping to predict momentary mood changes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-efficacy as a component of active coping: effects on cardiovascular reactivity

Active coping remains a poorly understood construct in cardiovascular reactivity testing. We have shown that active coping comprises two independent effects: the enhanced control and the effort of exercising control. The present study tested the proposition that, with effort left unconstrained, increased self-efficacy will increase cardiovascular response. Forty women were assigned to low or high self-efficacy conditions; self-efficacy was manipulated using false feedback. Subjects then engaged in a video game shape-matching task, while blood pressure and heart rate were monitored. SBP and DBP changes were smaller in the low self-efficacy group, as predicted: 17.9 versus 25.2 mmHG for SBP (p < 0.05); and 8.7 versus 13.0 mmHG for DBP (p = 0.07). Heart rate was similar for the two conditions. We conclude that self-efficacy for a task may be an integral part of the active coping process, indirectly affecting the blood pressure response by acting on the effort involved in the coping response.     

Changes in coping style and treatment outcome following motor vehicle accident.

Background: Motor vehicle accidents (MVAs) are highly prevalent and can result in a complex interplay of physical injury, disability, and emotional distress. It has been suggested that the manner in which individuals cope with pain experienced after injury may determine how much recovery of function can be achieved. Only a limited number of studies have examined this process in the context of a rehabilitation program, and to date few studies have examined both functional and quality of life outcomes in MVA recovery in a tertiary level program as a function of coping style. Methods: A sample of 96 consecutive referrals to a tertiary-level multidisciplinary functional restoration program completed physical performance measures pre- and post-treatment, as well as a standardized self-report measure of quality of life (QOL) at the same time points and 6-month follow-up. Results: Findings suggested that improvements from pre- to post-treatment were evident on the 6-minute walk test, left and right grip strength, and most QOL measures. Increases in active coping during treatment were associated with pre- to post-treatment increases in QOL across most domains, and improvements in performance on the 6-minute walk test. Likewise, decreases in passive coping during the course of treatment were associated with improved performance on the 6-minute walk test, right-handed standing reach test, and most QOL indicators. Conclusion: Findings suggest that those who adopt an active approach (and avoid taking a passive approach) to rehabilitation following complex musculoskeletal injury benefit along both QOL and functional dimensions relative to those who do not. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Conscious sedation with high-dose midazolam for pediatric gastrointestinal endoscopy

Ribonucleotide reductase contains a stable organic free radical essential for its activity located on a tyrosine residue in the small subunit of the enzyme called R2. The substrate binding site is, however, found in the catalytic subunit called R1. A long-range protein-mediated radical transfer pathway appears to be responsible for the delivery of the radical from the tyrosine in R2 to the substrate on R1. The active site is located deep inside the protein in a very stable beta/alpha-barrel structure and a hydrogen bonded system leads from the surface to Cys439 at the active site which is in excellent position to remove a hydrogen from the 3' of the ribose of a bound substrate nucleotide.     

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)     

The influence of preferred coping style and cognitive strategy on laboratory-induced pain.

Objective: To evaluate the effects of matching an individual's coping style (low, mixed, or high monitoring) to an appropriate cognitive strategy (distraction or sensation monitoring) to improve pain management. Design: This study used a split-plot factorial design in a laboratory setting. Main Outcome Measures: Main outcomes were pain threshold, pain tolerance, pain intensity, pain affect, and anxiety. Results: The results of the 2 × 3 × 3 (Experimental Condition × Coping Style × Trial) analysis of variance (ANOVA) interaction were significant for pain threshold scores, F(4, 178) = 2.95, p     

Paediatric upper gastrointestinal endoscopy: a 2-year review

OBJECTIVE: To review the paediatric upper gastrointestinal endoscopy service in a paediatric department in Hong Kong. METHODS: Records of all endoscopies undertaken in this department from May 1995 to January 1996 were retrieved and analysed. RESULTS: The commonest indication for upper endoscopy was dyspepsia with 88% positive histological findings. Helicobacter pylori (H. pylori) was found in 25% of this group of children. CONCLUSION: Paediatric upper gastrointestinal endoscopy service is invaluable in a paediatric department by providing useful diagnostic information which would otherwise be missed.     

Self-efficacy and expectancy: Old wine with new labels.

Discusses inconsistent definitions of self-efficacy and outcome expectancies, which have been a source of conceptual confusion. A. Bandura (1977; see also PA, Vols 58:5733 and 71:6766) used the term outcome expectancy in 2 different ways, each implying a different relation to self-efficacy. In tests of ability, self-efficacy had been operationalized in ways that are virtually identical to J. B. Rotter's (1954, 1972, 1982) expectancy construct, and both theories generate identical predictions. In these situations, low self-efficacy does not elicit fear. Bandura's examples of low snake-approach self-efficacy are inconsistent with his method of measuring the construct. Questionnaires purporting to measure people's judgments about their ability to approach a feared stimulus actually measure their willingness to approach the stimulus. Willingness to approach a feared stimulus is affected by anticipated harm, expected anxiety, and the magnitude of expected reinforcements. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)