Coping style, perceived uncertainty in illness, and distress in individuals with Parkinson's disease and their caregivers.

Examined the relationship of coping style and illness uncertainty to psychological distress in individuals with Parkinson's disease (PD) and their primary caregivers. Design: Correlational methods, within-group theory-driven hierarchical regression analyses, and transactional analyses. Ss were 44 dyads composed of individuals with PD and their caregivers. Main Outcome Measures: Hoehn and Yahr Clinical Disability Rating Scale, Instrumental Activities of Daily Living Scale, Symptom Distress Checklist-90—Revised, Mischel Uncertainty in Illness Scale-Community Form, and Revised Ways of Coping Checklist. Results: Emotion-focused coping was associated with higher levels of distress for persons with PD, whereas both emotion-focused coping and perceived uncertainty were associated with distress for the caregivers. Transactional analyses between patients and caregivers indicated that higher levels of patient problem-focused coping and perceived uncertainty in illness were associated with increased problems in caregiver distress. Adjustment to PD is influenced by several patient and caregiver variables. The results warrant consideration of a variety of clinical interventions involving patient and caregiver education about the disease and methods for managing the associated symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping, stress, and social resources among adults with unipolar depression.

Used a stress and coping paradigm to guide the development of indices of coping responses and to explore the roles of stress, social resources, and coping among 424 men and women (mean age 40.7 yrs) entering treatment for depression. An expanded concept of multiple domains of life stress was used to develop several indices of ongoing life strains. A variety of measures were obtained from Ss, family members, and treatment staff. Two questionnaires completed by Ss included the Health and Daily Living Form and the Work Environment Scale. Although most prior studies have focused on acute life events, results of the present study show that chronic strains were somewhat more strongly and consistently related to the severity of dysfunction. The coping indices generally showed acceptable conceptual and psychometric characteristics and only moderate relationships to Ss' sociodemographic characteristics or to the severity of the stressful event for which coping was sampled. Coping responses directed toward problem solving and affective regulation were associated with less severe dysfunction, whereas emotional-discharge responses, more frequently used by women, were linked to greater dysfunction. Stressors, social resources, and coping were additively predictive of an S's functioning, but coping and social resources did not have stress-attenuation or buffering effects. (72 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment.

To examine the associations between changes in cognitions and coping and multidisciplinary pain treatment outcomes, the authors had 141 patients with chronic pain complete measures of adjustment, beliefs, catastrophizing, and coping; in addition, their significant others rated patient physical functioning at pretreatment, posttreatment, and 6- and 12-month follow-ups. Decreases in guarding and resting and in the belief that pain signals damage were associated with decreases in patient disability. Increases in perceived control over pain and decreases in catastrophizing and in the belief that one is disabled were associated with decreases in self-reported patient disability, pain intensity, and depression. The results are consistent with the hypothesis, derived from cognitive-behavioral models of chronic pain, that the outcomes of multidisciplinary pain treatment are associated with changes in patient cognitions and coping responses. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping patterns of African American adolescents: A confirmatory factor analysis and cluster analysis of the Children's Coping Strategies Checklist.

The current study examined patterns of coping strategies in a sample of 497 low-income urban African American adolescents (mean age = 12.61 years). Results of confirmatory factor analysis indicated that the 4-factor structure of the Children's Coping Strategies Checklist (T. S. Ayers, I. N. Sandler, S. G. West, & M. W. Roosa, 1996) was not replicated in the current sample. The final model was a 3-factor model that was invariant across gender. The Active Coping factor and Revised Avoidant Coping factor were highly correlated in the present sample. Results of cluster analyses identified 2 coping groups differing on the frequency of coping use and preferred coping methods. The 1st group was more likely to use avoidant coping and less likely to use social support-seeking coping than the 2nd group, which showed more consistent use across coping strategies. There were no significant differences in the association between stressors and symptoms across the 2 groups. The results highlight the importance of examining factor structures of coping measures with underrepresented groups. (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)     

Sickle cell disease pain in children and adolescents: change in pain frequency and coping strategies over time

Examined 9-month follow-up data obtained from children and adolescents with sickle cell disease (SCD) and their parents participating in a longitudinal study of pain coping strategies. Of 87 subjects completing the baseline assessment of pain coping strategies, 70 (80%) of their parents completed a structured pain interview assessing their child's health care use and activity reduction during painful episodes over the follow-up period. Regression analyses controlling for age and pain frequency revealed that baseline Coping Attempts were associated with higher levels of school, household, and social activity during painful episodes. Baseline Passive Adherence was associated with more frequent health care contacts during the subsequent 9 months. Increases in Negative Thinking over time were associated with further increases in health care contacts during the follow-up period. Comparing pain coping strategies assessed at baseline to pain coping strategies measured at follow-up revealed that pain coping strategies were relatively stable over time for younger children but changed more for adolescents.     

Age-related changes in cardiovascular response as a function of a chronic stressor and social support.

The effects of aging, chronic stress, and social support on cardiovascular functioning were examined using a cross-sectional design. 36 family caregivers of Alzheimer's disease victims and 34 control Ss performed 2 active coping tasks while continuous noninvasive measures of cardiovascular activity were monitored. Results revealed that caregivers high in social support displayed typical age-related decreases in heart-rate reactivity, whereas caregivers low in social support displayed age-related increases in heart-rate reactivity. Analyses further indicated that only Ss with low social support were characterized by age-related increases in systolic blood pressure. These results suggest that social support can moderate age-related changes in cardiovascular functioning, particularly in Ss exposed to a chronic stressor. (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)     

Coping, expectancies, and alcohol abuse: A test of social learning formulations.

The model proposed here postulates that alcohol abuse can be predicted from a causal chain that includes alcohol consumption and "drinking to cope" as proximal determinants and general coping skills and positive alcohol expectancies as more distal determinants. To evaluate this model in a way that permits simultaneous consideration of its multiple determinants and control for demographic influences, path analytic techniques were applied to data from problem and nonproblem drinkers drawn from a general population sample. The hypothesized model accounted for significant variance in abuse status. Drinking to cope emerged as the most powerful predictor, exerting influence via direct and indirect pathways. Coping styles indicative of avoidance of emotion emerged as more important predictors of abuse than problem-focused coping. The predictive value of coping was moderated by alcohol expectancies such that avoidant styles of coping with emotion were predictive of abuse status only among drinkers expressing greater belief in alcohol's positive reinforcing properties. Findings both support and refine the social learning perspective on alcohol abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personal values and goal orientations of chronically ill adolescents and young adults

For all those involved in the care of the chronically ill, to provide support in a professional manner implies to strive for a comprehensive understanding of the specific coping strategies in the light of the individual person's priorities. Coping research has yet to present a systematic analysis of personal values, goals and expectations of the chronically ill. The reader is invited to approach the topic by a review of the relevant literature and presentation of our own study on the classification of individual values and goals in 164 chronically ill adolescents and young adults (cystic fibrosis, Crohn's disease, haemophilia). Regarding personal values, the responses by the young patients were allocated to three main categories: pursuit of social contacts, striving for acceptance of the disease, the striving for joyful and intense living. Finally the relevance of personal values for appropriately coping with a serious illness is discussed.     

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)     

Parent, family, and disease factors as predictors of psychosocial functioning in children with cystic fibrosis.

Examined the relative contribution of disease, parental, and family factors on the psychological and social functioning of children with cystic fibrosis. 33 patients (7–16 yrs old) and 29 mothers completed a battery of tests, including a state-trait anxiety inventory, the Beck Depression Inventory, and a coping health inventory for parents developed by H. I. McCubbin et al (1983). Results show that Ss' self-esteem and occurrence of behavioral problems were associated with maternal trait anxiety, overprotection, and the impact of disease on family functioning. Social competence and athletic self-esteem were associated with nutritional status. Results reflect the need for clinicians to be sensitive to parental and family functioning when dealing with behavioral problems and to consider physical status when providing treatment of social problems. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do psychological factors modify survival of cancer patients? II: Results of an empirical study with bronchial carcinoma patients

The present prospective test study of hypotheses addressed the question whether psychological factors are predictive of survival time in lung cancer patients. The hypotheses were: Emotional distress, depression and depressive coping are associated with shorter survival; hope and active coping with longer survival. The study was based on a sample of n = 103 patients who were investigated post-diagnosis and before the beginning of primary treatment. Emotional distress and hope were assessed by clinical scales (self-reports and interviewer ratings), depression by the Depression Scale of von Zerssen, depressive coping and active coping by the Freiburg Questionnaire on Coping with illness by Muthny. At follow-up, which took place three to five years later, n = 74 patients had died, for n = 29 patients the survival data are censored. The prediction of the survival time was performed applying multivariate analyses (Kaplan-Meier-method, Cox-Regression), adjusting for biological risk factors (histological classification, stage of the disease, type and amount of treatment, Karnofsky performance status, age). Results were as follows: Active coping and hope were associated with longer survival, emotional distress, depression and depressive coping with shorter survival, respectively. These associations were found consistently across assessment methods. The predictive effects of coping and distress were statistically independent of the influence of the somatic risk factors. The best psychological predictor was the interviewer rating of active coping. Its predictive power equalled that of the Karnofsky performance status. However, there was evidence that the effects of the psychological factors varied somewhat in interaction with treatment modalities. The findings are discussed from a methodological perspective. Possible causal models and mechanisms are presented which could account for interactions of psychological measures and the course of the disease: Thus, it can be conceived that psychological effects were mediated by patients' compliance with medical treatment. In addition, it cannot be ruled out that psychological factors themselves were influenced by the physical status of the patients at the time of entry to the study.     

The relationship between coping styles, performance, and responses to stressful scenarios in police recruits.

This study investigated the relationship between coping styles and police recruits' stress responses and performance during a stressful event and the relationship between coping styles and traumatic symptoms. Recruits participated in a simulated stressful policing situation and were scored by expert raters. Distress measures included biological and psychological indicators of stress. Coping styles were associated with subjective and physiological distress but not with performance. Different coping styles were associated with different patterns of traumatic symptoms in the participants. Police recruits appear to rely on their training and skill sets in stressful situations regardless of how they manage their emotional response. Furthermore, the results suggest that different posttraumatic stress disorder manifestations may represent different pathologies, each associated with a different style of coping. (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)     

Life stressors, resistance factors, and improved psychological functioning: An extension of the stress resistance paradigm.

This study applied a set of factors previously identified as being linked with stress resistance to the prediction of both stable and improved psychological functioning over a 1-year interval with more than 400 community-resident adults. Stable psychological functioning under high stressors is predicted at the beginning of the year by personal and social resources that are linked to functioning through their influence on increased approach coping during the year. In contrast, improved psychological functioning under low stressors is predicted directly by initial resources. As predicted by crisis theory, improved functioning under high stressors is related to an increase in resources during the year. The findings are discussed in the context of an extension of the stress-resistance paradigm beyond illness prevention toward a general, adaptively oriented health framework. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A longitudinal analysis of cognitive dysfunction, coping, and depression in multiple sclerosis.

Using a longitudinal design, the authors examined coping and cognitive functioning in the development of depression in individuals with multiple sclerosis (MS). Coping style was evaluated in 2 conceptually distinct roles: as moderator and mediator of the impact of cognitive dysfunction on depression. Using indices derived from the COPE (C. S. Carver, M. F. Scheier, & J. K. Weintraub, 1989), the authors operationalized coping in 3 ways—as active, avoidant, and an index accounting for relative levels of both. Coping both moderated and partially mediated the relationship between cognitive dysfunction and depression. Moderation results suggest that the relationship between cognitive dysfunction and depression is dependent on coping style—adaptive coping protects individuals from experiencing depression related to their cognitive deficits; however, when individuals use maladaptive coping, cognitive dysfunction puts them at risk for depression. Mediational results suggest that cognitive dysfunction leads to depression partially due to cognitive dysfunction’s effects on coping. That is, cognitive deficits may impair individuals’ ability to use adaptive coping strategies, leaving them more likely to use maladaptive strategies. Clinical and theoretical implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in coping styles among persons with spinal cord injury: A cluster-analytic approach.

Two subgroups were identified and validated in a group of 53 persons with spinal cord injury by applying cluster-analytic procedures to subjects' self-reported coping and health locus-of-control belief scores. Subjects in Cluster 1 relied extensively on all seven scales of the Ways of Coping Questionnaire, had elevated external health attributions, and reported higher levels of psychological distress and depression. Subjects in Cluster 2 emphasized internal health attributions, reported less distress, and relied less on coping methods described in the Ways of Coping Questionnaire. Treatment implications of results for the two subgroups are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Locus of control, cognitive appraisal, and coping in stressful episodes.

Investigated locus of control and coping processes in relation to specific stressful episodes reported by 171 female student nurses. Scores of each of 3 measures (General Coping, Direct Coping, and Suppression) that were derived from the Ways of Coping Questionnaire were analyzed to examine the role of appraisal (in terms of the extent to which the situation was perceived as amenable to control) and the perceived importance of the episode as mediators of the relation between locus of control and coping. Ss were also administered Rotter's Internal–External Locus of Control Scale, the Defensiveness scale of the Adjective Check List, and the Lie scale of the Eysenck Personality Questionnaire. Results show significant interactions between locus of control and appraisal for each of the measures. Further examination of the interactions showed that the patterns of coping reported by internals were potentially more adaptive in relation to types of appraisal than those of externals. The perceived importance of the episode was significantly related, negatively, to suppression, but the interaction with locus of control was not significant. (59 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)