State and trait anxiety, coping styles and depression among psychiatric inpatients.

Examined relationships among state and trait anxiety, coping styles, and depression in 17 male and 26 female adult psychiatric inpatients. Ss completed measures of state and trait anxiety, situation perception, depression and coping styles (Multidimensional Anxiety Scales, Multidimensional Coping Inventory, and Beck Depression Inventory) at 2 times (approximately 2 days after admission to the hospital and approximately 4 days after the 1st test administration). Results reveal significant positive correlations between level of depressive symptomatology and both state and trait anxiety. Emotion-oriented coping was positively correlated with depression, whereas task-oriented coping was negatively correlated with depression. (French abstract) (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)     

Benefit finding, affective reactions to diabetes stress, and diabetes management among early adolescents.

Objective: To examine whether benefit finding was associated with better adjustment among adolescents with diabetes by buffering negative affective reactions to diabetes stress and by promoting positive affective reactions. Design: Early adolescents aged 10–14 with Type 1 diabetes (n = 252) described recent diabetes stressors, affective reactions, and perceived coping effectiveness. They also completed measures of benefit finding, depressive symptoms, and adherence. Metabolic control (i.e., HbA1c) was obtained from medical records. Main Outcome Measures: The main outcome measures were perceived coping effectiveness, depressive symptoms, adherence, and HbA1c. Results: Benefit finding was associated with lower depressive symptoms, higher perceived coping effectiveness and better adherence, and with higher positive as well as negative affective reactions to diabetes stress. Benefit finding interacted with negative affective reactions to predict depressive symptoms and HbA1c. Negative affective reactions to stress were associated with poorer adjustment among those with low benefit finding, but were unrelated or more weakly related to poor adjustment among those with high benefit finding. Positive affective reactions did not mediate associations between benefit finding and any outcome. Conclusions: Consistent with a stress-buffering process, benefit finding may be a resource that buffers the disruptive aspects of negative affective reactions to stress for adolescents' diabetes management. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Psychological problems of spinal cord injury patients: Emotional distress as a function of time and locus of control.

A scale assessing psychological problems was developed and administered to 136 male VA hospital spinal cord injury (SCI) patients (under 30 yrs of age). Results suggest that reaction to SCI was dominated by emotional distress and was best predicted by external locus of control and by recent injury. The scale was correlated with self-reports of anxiety, adjustment, affiliation, and sociability in a college population. Results do not support a simple stage theory of reaction to SCI but are consistent with other studies of coping patterns in SCI patients. (1 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital closeness, functional disability, and adjustment in late life.

Socioemotional selectivity theory (SST) posits that emotionally close relationships are increasingly valued as people perceive constraints on time. Based on SST, this study of 1,532 older married persons hypothesized that emotional dimensions of marriage would more strongly predict adjustment at higher levels of functional disability. High levels of marital closeness were negatively associated with depression and anxiety and positively associated with self-esteem. Consistent with predictions derived from SST, marital closeness moderated the negative psychological effects of high levels of functional disability on depression, anxiety, and self-esteem. Results are discussed in the context of SST and traditional stress-buffering models of social support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Stress, coping, and marital satisfaction in couples with a depressed wife.

Evaluated the relationships among psychological distress, perceived stress, marital satisfaction, and coping in 20 couples in which the pregnant wife suffered major depression, 20 couples in which the pregnant wife suffered minor depression, and 40 control couples in which the pregnant wife was nondepressed. Consistent with a systems conceptualization of depression, the depressed Ss and their husbands both reported greater dissatisfaction in their marriages and used more dysfunctional coping strategies than did the nondepressed control couples. Whereas both the minor and major depressed Ss differed from the nondepressed Ss with respect to psychological distress and perceived stress, only husbands of the minor depressed Ss differed significantly on these measures from husbands of the nondepressed Ss, reporting greater distress and a higher level of perceived stress. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perceived control, coping efficacy, and avoidance coping as mediators between spousal unsupportive behaviors and psychological distress.

This study examined whether avoidance, coping efficacy, and perceived control mediate the effects of spouses" unsupportive behaviors on patient psychological distress among 191 married individuals enrolled in cancer treatment. Results of the structural equation analyses suggested that avoidance and coping efficacy mediated the relationship between spouses" unsupportive behaviors and patient psychological distress. Perceived control of emotional aspects of the illness, including emotional responses and relationships with family and friends, and perceived control of the medical course of the cancer did not mediate the relationship between spouses" unsupportive behaviors and patient psychological distress. These findings suggest 2 mechanisms to explain why unsupportive responses from spouses may be associated with psychological distress among cancer patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping and Anxiety in Women Recalled for Additional Diagnostic Procedures Following an Abnormal Screening Mammogram.

This study characterized women's concurrent and subsequent levels of emotional distress associated with a questionable mammogram screening and relationships between women's coping and psychosocial adjustment. State anxiety was assessed in 98 women 1 day after receiving a mammogram screening (Time 1), after notification of a questionable screening result that necessitated additional testing (Time 2), and after being informed of their breast-cancer-free status (Time 3). Key findings include (a) women reported a significant increase in anxiety following notification of the need to return for follow-up testing; (b) significant and positive associations were found between anxiety and behavioral approach, behavioral avoidance, cognitive approach, and cognitive avoidance coping in cross-sectional analyses; and (c) cognitive avoidance coping was a strong predictor of final levels of state anxiety in women. Findings suggest that cognitive avoidance coping plays an important role in reducing anxiety in women recalled to clarify an initially ambiguous screening procedure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment to occupational stress: The relationship of perceived control to effectiveness of coping strategies.

A sample of 187 medical center nurses described 2 stressful occupational episodes varying in perceived controllability and provided information regarding the coping strategies used. Outcome measures assessed effectiveness of coping across 3 dimensions: perceived coping effectiveness, job affect, and psychological adjustment. Negative affectivity was measured to control for its tendency to inflate stress-adjustment relationships. Use of problem-solving strategies was related to perceived coping effectiveness only for high-control episodes. However, differential use of coping across levels of controllability was not related to job affect or psychological adjustment. Avoidant coping was strongly associated with negative affect at work. In contrast, problem-reappraisal and problem-solving strategies were related to positive affect at work. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life experiences, coping, and weight preoccupation in young adult women.

Relationships among stress, 3 different styles of coping (task-, emotion-, or avoidance-oriented) and weight preoccupation were examined in 206 female college students (aged 19–55 yrs). The relationships among these variables were examined using the Life Experiences Survey (I. G. Sarason et al, 1978), the Coping Inventory for Stressful Situations (N. S. Endler and J. D. A. Parker, 1999), and the Eating Disorder Inventory (D. M. Garner and M. P. Olmsted, 1984). A hierarchical regression analysis was used to examine whether coping styles and life stress would predict weight preoccupation in this nonclinical sample of university women. Results showed that emotion-oriented coping predicted weight preoccupation regardless of stress. These findings suggest that how one copes with stress is associated with weight preoccupation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term adjustment to physical disability: The role of social support, perceived control, and self-blame.

100 40–73 yr olds with spinal cord injuries were interviewed an average of 20 yrs after the disability occurred. Ss answered questions concerning perceived control, attributions of blame, and the nature of the social comparisons they made. Adjustment was measured by an index of psychological well-being, a life satisfaction index, and a depression scale. For all 3 outcome measures, Ss reported levels of well-being only slightly lower than population means of nondisabled persons of similar age. Controlling for health status and current income, it was found that persons who had high levels of social support, who were satisfied with their social contacts, and who felt they had high levels of perceived control reported high levels of well-being. Self-blame and the perceived avoidability of the cause of the disability correlated only moderately with the measures of adjustment, suggesting that there are important differences between coping successfully immediately after a traumatic event has occurred and coping successfully many years later. (20 ref) (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)     

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)     

An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury.

Study Design: Systematic review. Objective: To examine the evidence supporting the effectiveness of cognitive behavioral therapy (CBT) for improving psychosocial outcomes in individuals with spinal cord injury (SCI). Method: Electronic databases (MEDLINE, CINAHL, EMBASE, and PsycINFO) were searched for studies published between 1990 and October 2010. Randomized control trials (RCTs) and nonrandomized control trials (non-RCTs) utilizing a CBT intervention to improve psychosocial outcomes (depressive symptomatology, anxiety, coping, and adjustment to disability) in outpatient persons with SCI were included for review. Levels of evidence were assigned to each study using a modified Sackett scale. Effect size calculations for the interventions were provided where possible. Results: Nine studies met the inclusion criteria. The studies reviewed included two RCTs, six prospective controlled trials (PCTs) and one cohort study. All studies examined at least two groups. There is Level 1 and Level 2 evidence supporting the use of specialized CBT protocols in persons with SCI for improving outcomes related to depression, anxiety, adjustment, and coping. Conclusions: CBT holds promise as an effective approach for persons with SCI experiencing depression, anxiety, adjustment, and coping problems. As CBT may involve many different components, it is important in the future to determine which of these elements alone or in combination is most effective in treating the emotional consequences of SCI. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Parent-child relationships, partner relationships, and emotional adjustment: A birth-to-maturity prospective study.

This study examined whether detrimental childhood relationships with parents were related to partner relationship quality and emotional adjustment in adulthood. The authors tested a theoretical model in which (a) low-quality parent-child relationships were related to conflict and low-quality communication with parents in adolescence, (b) parent-adolescent conflict and low-quality communication were linked to low-quality partner relationships in young adulthood, and (c) low-quality partner relationships in young adulthood were predictive of low-quality partner relationships as well as depression, anxiety, and dissatisfaction with life at midlife. Multi-informant data were used from 212 Swedish individuals who were followed from birth into adulthood. Results demonstrated that, as hypothesized, negative parent-child bonds were indirectly related to low-quality partner relationships and dissatisfaction with life in adulthood (but not anxiety and depression) through conflictual parent-adolescent communication and low-quality partner relationships in young adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping with health problems: Developing a reliable and valid multidimensional measure.

Current conceptions relating psychological variables to health recognize the key role of coping processes as mediating variables between stress and illness, yet few reliable and valid instruments exist for the assessment of coping with physical health problems. A self-report instrument, the Coping With Health Injuries and Problems Scale (CHIP) was developed identifying 4 basic coping dimensions for responding to health problems: distraction, palliative, instrumental, and emotional preoccupation coping. The CHIP's factor structure, established with a large derivation sample of adults, is cross-validated in a heterogenous group of general medical patients and a homogeneous group of patients being treated for lower back pain. Preliminary construct validity data are presented by comparing the coping behaviors of patients with chronic and acute illnesses and by comparing CHIP scores with basic coping styles. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burden of illness, metabolic control, and complications in relation to depressive symptoms in IDDM patients

Relationships between demographic-, treatment-, and sickness-related factors, metabolic control (HbA1c), perceived burden of illness, and degree of depressive symptoms were examined in a group of 155 insulin-dependent diabetic patients, aged 35.3 +/- 8.9 years. The patients completed a questionnaire measuring depressive symptoms and three aspects of perceived burden of illness. No gender differences in HbA1c level or occurrence of late diabetic complications were found. Both men and women showed a modestly elevated degree of depression compared with norm groups. Self-reported burden of illness was strongly related to depression but was largely unrelated to objective disease-related measures. Level of depression was correlated neither with degree of metabolic control nor with the presence of such late diabetic complications as retinopathy and nephropathy. Some 44% of the variance in depression could be explained by worries about complications in those patients with the lowest HbA1c levels, by perceived restrictions in everyday life in patients with intermediate metabolic control, and by problems of glycaemic regulation in patients with poor metabolic control. Degree of depression was largely unrelated to disease severity, but was found to be related to the perceived daily burden of living with the disease, the specific worries and concerns associated with a depressed mood varying with degree of metabolic control.     

School climate support for behavioral and psychological adjustment: Testing the mediating effect of social competence.

The present study used an ecological framework to examine the relationships among adolescents’ perceptions of school climate, social competence, and behavioral and psychological adjustment in the middle school years. This study improved upon prior studies by using structural equation modeling to investigate the hypothesized mediating effect of social competence and to account for measurement error. The sample included 1,042 participating students from 23 middle schools. Results showed that school mastery goal structure, promotion of autonomy and discussion, and teacher emotional support were negatively related to the levels of adolescents’ deviant behaviors and depression, while performance goal structure was positively related to deviant behaviors and depression. Social competence was a mediator between perceived school climate variables and adolescent adjustment, with the exception of the relationship between mastery goal structure and adjustment variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Caretaking behaviors by adolescent children of mothers with and without a history of depression.

In a sample of 72 mothers with and without a history of depression and their adolescent children, maternal depression history, current maternal depressive symptoms, intrusive and withdrawn parental behavior, and adolescent caretaking behaviors were examined as predictors of adjustment in these youth. Two types of caretaking behaviors were examined: emotional (e.g., caring for a parent's emotional distress) and instrumental (e.g., looking after younger siblings). Although adolescents of mothers with and without a history of depression were comparable on levels of both types of caretaking, caretaking was associated with adolescents' reports of anxiety–depression and mothers' reports of social competence only for adolescents of mothers with a history of depression. Moreover, regression models showed that among children of mothers with a history of depression, emotional, but not instrumental, caretaking was related to adolescents' anxiety–depression symptoms and social competence after controlling for current parental depressive symptoms and stressful parenting behaviors. Theoretical and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)