Insecure attachment moderates women's adjustment to inflammatory bowel disease severity.

Objective: Insecure attachment was explored as a moderator of the relationship between disease severity and psychosocial variables in a study of adjustment in women with inflammatory bowel disease (IBD). Method: Participants were 218 women recruited through notices placed in the community, in gastroenterologists' offices, and through online postings to support groups and message boards specifically for people with Crohn's disease, colitis, or IBD in general. Participants completed a mail-in or online survey assessing severity and frequency of symptoms, attachment style (separated into anxious and avoidant subscales), perceived social support, negative affect, and efficacy of coping with IBD. Results: Anxious and avoidant attachment styles were correlated positively with disease severity and negative affect and negatively with perceived social support and coping efficacy. Hierarchical regressions indicated that disease severity was most strongly associated with negative affect for high avoidant attachment, as compared with moderate and low avoidant attachment. Disease activity was inversely related to perceived social support and coping efficacy for high and moderate, but not low, anxious attachment. Conclusion: Our study indicates that attachment moderates associations between disease severity in women with different kinds of IBD and psychological indicators of adjustment. Limitations and relationship to previous research on attachment and health are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adjustment to rape.

Investigated rape victims' reactions, causal attributions for the rape, coping behaviors after the rape, and psychological adjustment to the rape by administering a questionnaire to 58 females who had been raped within the past 2 yrs. All but 1 S were aged 16–42 yrs; this S was aged 76 yrs. Findings show that, as in previous research, high levels of behavioral and characterological self-blame for rape were found. Contrary to prior hypotheses, behavioral self-blame was not associated with good adjustment. Rather, both behavioral and characterological self-blame were associated with poor adjustment. Societal blame was the only causal attribution for rape that was unassociated with adjustment. Remaining at home and withdrawing from others were both associated with poor adjustment, and the use of stress reduction techniques was associated with good adjustment. Implications for theories of victimization and for clinical interventions with rape victims are discussed. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting the impact of child sexual abuse on women: The role of abuse severity, parental support, and coping strategies.

Female Navy recruits (N=5,226) completed surveys assessing history of childhood sexual abuse (CSA), childhood strategies for coping with CSA, childhood parental support, and current psychological adjustment. Both CSA and parental support independently predicted later adjustment. In analyses examining whether CSA victims' functioning was associated with CSA severity (indexed by 5 variables), parental support (indexed by 3 variables), and coping (constructive, self-destructive, and avoidant), the negative coping variables were the strongest predictors. A structural equation model revealed that the effect of abuse severity on later functioning was partially mediated by coping strategies. However, contrary to predictions, the model revealed that childhood parental support had little direct or indirect impact on adult adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute and chronic distress and posstraumatic stress disorder as a function of responsibility for serious motor vehicle accidents.

In this study on the effects of attributions of responsibility for traumatic events, stress, coping, and symptoms of posttraumatic stress disorder (PTSD) were measured, including intrusive thoughts among 130 victims of serious motor vehicle accidents (MVAs) 14-21 days and 3, 6, and 12 months after their accident. MVA victims and 43 control participants were categorized by accident and attribution of responsibility for their accidents (self-responsible, other-responsible, and control). Although initially all MVA victims reported higher levels of intrusive thoughts and were more likely to meet criteria for PTSD diagnoses, only other-responsible participants continued to demonstrate increased distress 6 and 12 months postaccident. Self-responsible participants used more self-blame coping than other-responsible participants, although within the self-responsible group, use of self-blame was associated with more distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations of SARS-related stressors and coping to Chinese college students' psychological adjustment during the 2003 Beijing SARS epidemic.

This study examined the main and interactive relations of stressors and coping related to severe acute respiratory syndrome (SARS) with Chinese college students' psychological adjustment (psychological symptoms, perceived general health, and life satisfaction) during the 2003 Beijing SARS epidemic. All the constructs were assessed by self-report in an anonymous survey during the final period of the outbreak. Results showed that the relations of stressors and coping to psychological adjustment varied by domain of adjustment. Regression analyses suggested that the number of stressors and use of avoidant coping strategies positively predicted psychological symptoms. Active coping positively predicted life satisfaction when controlling for stressors. Moreover, all types of coping served as a buffer against the negative impact of stressors on perceived general health. These findings hold implications for university counseling services during times of acute, large-scale stressors. In particular, effective screening procedures should be developed to identify students who experience a large number of stressors and thus are at high risk for developing mental health problems. Intervention efforts that target coping should be adapted to take account of the uncontrollability of stressors and clients' cultural preferences for certain coping strategies. A multidimensional battery of psychological adjustment should be used to monitor clients' psychological adjustment to stressors and evaluate the efficacy of intervention. (PsycINFO Database Record (c) 2011 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.     

Coping with illness: Interrelationships across family members and predictors of psychological adjustment.

This study examined coping in families in which there was a chronically ill parent. Husbands, wives, and one child (aged 7–18 yrs) from 75 families in which the husband had hemophilia participated. Coping styles and psychological adjustment were assessed, and patterns of coping among family members were examined. Avoidant coping was associated with poorer adjustment for all family members. In addition, the coping style of one family member was found to be related to the psychological adjustment of other family members. Avoidant coping by one spouse related to poorer psychological functioning in the other spouse, and avoidant coping by either parent related to greater child adjustment problems for girls and boys. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between coping and adjustment after spinal cord injury: A 5-year follow-up study.

Investigated the relationship between coping and adjustment (including psychological distress, acceptance of disability, vocational hours, and medical status) 5 to 6 yrs after spinal cord injury. 28 people who had provided coping data during acute rehabilitation (AR) completed various measures including the SCL-90 (Revised). Results indicate that coping strategies during AR were not associated with long-term adjustment. However, at 5-yr follow-up, cognitive restructuring was positively associated and wish-fulfilling fantasy was negatively associated with acceptance of disability. Self-blame was related to psychological distress during AR but not at 5-yr follow-up. These results suggest that the importance of specific coping strategies to adjustment changes over time and support the belief that coping is a dynamic process. (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)     

Self-esteem, social support, internalized homophobia, and coping strategies of HIV+ gay men.

The relationship was examined between self-esteem, social support, internalized homophobia, and coping strategies used by gay men (N?=?89) who were positive for human immunodeficiency virus (HIV) and between the use of coping strategies and mood state. Multiple regressions were conducted with avoidant (escape avoidance, accepting responsibility) and proactive (seeking social support, planful problem solving) coping serving as criterion variables. Greater homophobia and less self-esteem predicted avoidant coping, whereas less homophobia and less time since diagnosis predicted proactive coping. Greater time since diagnosis, less avoidant coping, less homophobia, and greater self-esteem predicted better mood state and accounted for 50% of the total variance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intergenerational Family Conflict and Coping Among Hmong American College Students.

Problem solving and social support, as different styles of coping with intergenerational family conflict, were examined among 86 Hmong American college students. Problem solving and social support were hypothesized to differentially moderate the effects of family conflict on psychological adjustment. Furthermore, the effects of attributions of blame on the adjustment of Hmong American college students were examined. Results indicate that social support buffered and problem solving enhanced the negative effects of family conflict on symptoms of distress but not on affect. Additionally, there were significant interaction effects between family conflict and self-blame on distress. Specifically, students who were more likely to blame themselves reported higher levels of distress. (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)     

Anosognosia and denial: Their relationship to coping and depression in acquired brain injury.

Objective: To evaluate relations among denial, anosognosia, coping strategies, and depression in persons with brain injury. Study Design: Correlational. Setting: A Midwest residential, post-acute brain injury rehabilitation center. Participants: Twenty-seven adults with brain injury. Measures: Clinician's Rating Scale for Evaluating Impaired Self-Awareness and Denial of Disability After Brain Injury, COPE, Beck Depression Inventory-I. Results: Denial and anosognosia were related and co-occurred. Use of process coping strategies was associated with greater use of problem-focused coping strategies. Higher levels of denial were associated with greater use of avoidant coping strategies, and greater use of these coping strategies was related to higher levels of depression. Conclusions: Individuals primarily in denial and individuals primarily anosognosic differ in the coping strategies they institute. Avoidant coping strategies are used more frequently by individuals in denial, and use of these strategies is associated with higher levels of clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Learning to Live With What You Can't Rise Above": Control Beliefs, Symptom Control, and Adjustment to Tinnitus.

The relations between 3 types of perceived control, symptom severity, and 2 adaptational outcomes, depressive symptoms and psychological well-being, were examined in a sample of 319 people with tinnitus. Consistent with previous studies of control and adjustment to chronic health conditions, general health and symptom control were associated with better psychological adjustment, and retrospective control was associated with worse psychological adjustment. Only symptom control emerged as a significant moderator in the symptom severity--adjustment relationship, such that stronger beliefs in one's ability to control symptoms were most strongly associated with better adjustment among those with more severe tinnitus symptoms. These findings were consistent with coping perspectives and cognitive adaptation theory and suggest that symptom-related perceptions of control may be an effective coping resource to nurture in chronic health contexts with severe symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Avoidant coping as a predictor of mortality in veterans with end-stage renal disease.

Objective: The aim of this study was to examine the role of active and avoidant coping strategies in predicting mortality in 61 veterans with end-stage renal disease. Design: Participants completed a self-report measure of coping strategies (The COPE; Carver, Scheier, & Weintraub, 1989) and were interviewed as part of a structured assessment to determine their appropriateness for renal transplant. On average, participants were then followed for 9 years via medical record review to determine mortality status. Main Outcome Measures: Mortality, as predicted by factor scores on active and avoidant coping factors estimated via confirmatory factor analysis of select COPE subscales. Results: A Cox regression revealed that a unit change in avoidant coping was associated with a 114% increase in odds of mortality, even after controlling for variance attributable to demographic variables. There was also a statistical trend indicating that this association might be mediated by poor attendance at medical appointments. Active coping did not predict mortality. Conclusion: Results demonstrate the importance of assessing coping style in this population; clinical implications of these findings and possible mechanisms of this effect are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attributions, vulnerability, and psychological adjustment: The case of breast cancer.

Hypothesized that psychological adjustment would be positively associated with breast cancer victims' perceptions of invulnerability to a recurrence of cancer and that victims' causal attributions for cancer (e.g., self-blame, birth control pills, sexually demanding husband) would influence adjustment to the extent that the attributions contributed to or detracted from perceived invulnerability. A path model was developed based on the proposed association between invulnerability and adjustment, and attributions were tested for whether they directly or indirectly influenced adjustment. Responses from intensive interviews of 42 breast cancer victims (aged 23–81 yrs) who had undergone mastectomies within 2 yrs prior to being interviewed were used to test the path model. Ss were also administered the Beck Depression Inventory and another measure to assess emotional response to breast cancer at Ss' present stage of adjustment. Results support the hypothesized positive association between perceived invulnerability and adjustment and show that the relationships between specific attributions and adjustment were mediated by vulnerability beliefs. Follow-up data may be useful in ascertaining the role played by cognitions in the biological progression of cancer. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Victim attributions and post-rape trauma.

This study assessed (a) the kinds of attributions victims make, (b) whether behavioral and characterological self-blame are associated with other variables as hypothesized (e.g., perception of future avoidability of being raped), and (c) whether behavioral self-blame is associated with better post-rape adjustment (R. Janoff-Bulman; see record 1981-01320-001). Attributions and adjustment were assessed in a sample of adult female rape victims seen at a hospital-based rape crisis program. Many victims blamed themselves but tended to place more blame on external factors. The pattern of relations between behavioral and characterological self-blame and other attributional measures did not support the hypothesized distinctions between them. Both kinds of self-blame were significantly associated with increased post-rape depression. Attributions strongly predicted adjustment, accounting for up to 67% of the variance in 3-day post-rape depression. The theoretical and clinical implications of these findings 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)     

Trauma reactivity, avoidant coping, and PTSD symptoms: A moderating relationship?

In the immediate aftermath of a traumatic event, many individuals experience physiological reactivity in response to reminders of the traumatic event that typically lessens over time. However, an overreliance on avoidant coping strategies may interfere with the natural recovery process, particularly for those who are highly reactive to trauma reminders. In the current investigation, we examined avoidant coping as a moderator of the association between heart rate reactivity to a trauma monologue measured shortly after a traumatic event and severity of posttraumatic stress disorder (PTSD) symptoms measured several months later. Fifty-five female survivors of assault completed PTSD diagnostic interviews and a self-report coping measure and participated in a trauma monologue procedure that included continuous heart rate measurement. These procedures were completed within 1 month of the assault and again 3 months postassault. After we controlled for the effect of initial symptom levels, the interaction of heart rate reactivity to the trauma monologue and avoidant coping measured at Time 1 was associated with PTSD symptom severity at Time 2. Individuals who are relatively highly reliant on avoidant coping strategies and relatively highly reactive to trauma reminders may be at greatest risk of maintaining or potentially increasing their PTSD symptoms within the first few months following the trauma. These findings may help inform early intervention efforts for survivors of traumatic events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)