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)     

Psychosocial factors in peptic ulcer and inflammatory bowel disease.

Over the past decade, while gastroenterologists' interest in mind-body interactions in organic disorders dwindled, stronger evidence has linked psychosocial factors with the incidence and recurrence of peptic ulcer and with the course of inflammatory bowel disease. Psychological-behavioral approaches to treatment continue to be disappointing. Psychosocial factors may affect ulcer by increasing duodenal acid load, altering local circulation or motility, intensifying Helicobacter pylori infection, stimulating corticosteroid secretion, and affecting health risk behaviors; possible mechanisms for inflammatory bowel disease include immune deregulation, gut permeability changes, and poor medication adherence. Both belong to the growing category of diseases thought to have an infectious component: for peptic ulcer the bacterium Helicobacter pylori, for inflammatory bowel disease an exaggerated immune response to gut bacteria. Peptic ulcer and inflammatory bowel disease, which present unique interactions among psychological, immunologic, endocrine, infectious, and behavioral factors, are splendid paradigms of the biopsychosocial model. (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)     

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)     

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)     

Impact of health beliefs, quality of life, and the physician-patient relationship on the treatment intentions of inflammatory bowel disease patients.

The research tested a model of treatment decision making in chronic illness that includes health beliefs, quality of life, and relationship with the physician (shared or not). Inflammatory bowel disease patients, (N=218) reported on their physician-patient relationship, general and disease-specific quality of life, and intentions to take a drug, for which perceived benefits and costs were manipulated. For more symptomatic patients, both costs and benefits predicted intentions; however, for less symptomatic patients, costs played a more important role. Physician recommendation predicted intention primarily among those who shared a decision-making relationship with their physician. Overall, the model accounted for 57.8% of the variance in medication-taking intention. Findings suggest that an integrative consideration of relationship factors, health beliefs, and health status may help explain treatment intentions among the chronically ill. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coping Strategies as Mediators of the Relations Among Perceived Control and Distress in Sexual Assault Survivors.

Two studies assessed whether coping strategies mediate the relations among 2 forms of perceived control (past and present control) and postassault distress among female sexual assault survivors. In Study 1, longitudinal data were gathered from 2 weeks to 1 year postassault (N=171). Past control (behavioral self-blame) was associated with more distress partly because it was associated with greater social withdrawal. Present control (control over the recovery process) was associated with less distress partly because it was associated with less social withdrawal and more cognitive restructuring. In Study 2, cross-sectional data were gathered from a community sample of nonrecent survivors of sexual assault (N=131). Coping strategies again mediated the relations among the measures of past and present control and distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Avoidant coping as predictor of mortality in veterans with end-stage renal disease": Response to Jewett, Newton, Smith, & Thombs (2010).

Responds to the comments by L. R. Jewett, E. G. Newton, S. Smith, and B. D. Thombs (see record 2010-14873-001) on the current authors' original article, "Avoidant coping as predictor of mortality in veterans with end-stage renal disease" (see record 2009-06704-009). In their commentary, Jewett et al note that oddities often encountered in very small datasets—such as the one used by Wolf and Mori—and, as a result, stronger evidence must be accrued from larger, more robust samples. In this response, Jewett et al acknowledge that theirs is a preliminary study of a small and highly select sample and recognize the limited generalizability of our results. Jewett et al maintain that they do not assert that there should be radical changes in clinical or research programs based on their study results, but instead, suggest that further follow-up would be valuable and that readily available and commonly used assessment and intervention procedures may be appropriate in ameliorating avoidant coping in the endstage renal disease (ESRD) population. At the same time, given the focus on mortality, the risk of doing nothing because the evidence is preliminary far outweighs the minimal costs associated with assessing and addressing avoidant coping, particularly since psychological assessment, including of coping behavior, is part of the standard of practice in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation of filial responsibility to the personal and social adjustment of Latino adolescents from immigrant families.

A multidimensional model of filial responsibility encompassing caregiving activities in the home and perceptions of fairness was examined in relation to multiple self- and teacher-reported indices of competence and distress in a sample of Latino adolescents from immigrant families (N = 129, mean age = 16.8, 64% girls). Whereas most research of Latino adolescents has focused on felt familial obligations and attitudes, this study found that reports of actual caregiving activities were associated with higher competence for the sample as a whole and fewer acting out problems among boys. Perceived fairness was associated with lower levels of distress and moderated the curvilinear association of caregiving with behavioral restraint. High levels of filial caregiving predicted high levels of restraint, but only when the balance of give-and-take at home was perceived as fair. These results are consistent with a model that views filial responsibilities as a source of both personal distress and competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological adjustment and the worker role: An analysis of occupational differences.

How does the place of worker role on his personal adjustment vary from nonmanual to manual type of employment? "301 Ss, all between the ages of 55 and 65, were divided into two occupational statuses, nonmanual and manual workers. The former status included 116 of the managerial, supervisory, professional-technical, and clerical-sales personnel of a Midwestern oil refinery, while the latter status contained 185 of that company's skilled, semiskilled, and unskilled laborers. Both groups were then treated as separate populations in an analysis of the worker role as it related to personal adjustment, social adjustment, and job satisfaction… . the personal adjustment of nonmanual employees was not significantly related with their work-role competency, while the personal adjustment of manual employees showed a significant correlation with the worker role variable… . It was therefore concluded that the degree to which personal adjustment is related with the worker role depends to some extent upon an employee's occupational status." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive adaptation, psychological adjustment, and disease progression among angioplasty patents: 4 years later.

The long-term effects of the Cognitive Adaptation Theory Index (CATI) on psychological and physical health outcomes among men (n=199) and women (n=99) treated for coronary artery disease with percutaneous transluminal coronary angioplasty were examined. The CATI reflects a positive view of the self, a positive view of one's future, and a sense of personal control over daily life. This index was created from questionnaires administered during hospitalization for the initial angioplasty. Four years later, the CATI predicted positive adjustment to disease, even when initial adjustment was taken into consideration. In addition, the CATI predicted a reduced likelihood of sustaining a subsequent cardiac event over 4 yrs. This association was more robust for men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship of ambivalent coping to depression symptoms and adjustment.

Objective: To assess the influence of mental distancing and venting emotions on depressive symptoms and health-related quality of life (HRQOL). Participants: Seventy-six individuals hospitalized with acute burn injuries. Design: Prospective longitudinal study. Measures: Beck Depression Inventory (A. T. Beck, E. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961), COPE (C. S. Carver, M. F. Scheier, & J. K. Weintraub, 1989), and Short Form--36 Health Survey (J. E. Ware, K. K. Snow, M. Kosinski, & B. Gandek, 1993). Results: Ambivalent coping at baseline (i.e., using both mental distancing and venting emotions, relative to using only 1 or neither) led to more symptoms of depression at follow-up, even when baseline symptoms were controlled. Ambivalent coping was related to postburn psychosocial HRQOL, and baseline symptoms of depression only slightly attenuated this relationship. Conclusions: Ambivalent coping appears to result from vacillation between motives. Decreasing inconsistent coping or reducing antithetical motivation may reduce depression and improve adjustment. (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)     

The role of gender and negative affectivity in stressor appraisal and coping selection.

Individual differences in stress may arise from many sources. This study investigated the role of gender and negative affectivity (NA) in stressor appraisal and coping selection. Differential exposure to stressors was controlled by requiring participants to rate the stressfulness of identical hypothetical scenarios. As predicted, women rated the scenarios as more stressful than men, and perceptions of stressfulness increased with participant NA. Women endorsed the use of emotion-focused coping strategies more than men, even when perceived stressfulness was controlled. NA predicted use of both emotion- and avoidance-focused coping, although only the latter association remained significant after controlling for stressor appraisals. Gender × NA interaction effects were not significant. Implications for the prediction and management of stress are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maladaptive perfectionism, hassles, coping, and psychological distress in university professors.

This study examined the roles of hassles, avoidant and problem-focused coping, and perceived social support as mediating the relationship between maladaptive perfectionism and psychological distress in a sample of university professors. Hassles and avoidant coping both partially mediated a strong association between maladaptive perfectionism and psychological distress. These results are discussed in terms of the need to better understand how coping styles and social support are associated with the negative impact of perfectionism on the lives of university professors. The implications of these findings for counseling practice are also explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Humor: The psychology of living buoyantly.

Reviews the book, Humor: The psychology of living buoyantly by Herbert M. Lefcourt (see record 2000-14400-000). Lefcourt traces the changing concerns of psychology, and the reason why the psychological study of humour has often been trivialized as an unlikely candidate for research support in the past. The author charts his own personal odyssey in the field, one in which he is drawn to the study of human strengths rather than human frailties. An early chapter sets us up for the remaining chapters by reminding us how we experience humour in everyday life. Verbatim anecdotes from students in previous seminars offer vignettes which allow the reader to grasp the situation vicariously and to see how and why the humour of the situation could have arisen. It is here that Lefcourt confides that his is a functionalist psychological perspective, and that he views humour as a characteristic that has been useful to our species. Here one comes to the crux of the argument for most readers. Is humour, then, a coping strategy, ultimately devised in our evolutionary ramblings, as a protective cushion against the jagged impact of stressful experiences? The middle part of this book explores this hypothesis in a variety of experimental settings, all designed to assess the moderating role of humour in the face of stress. This is a useful, even uplifting, book about the human search for emotional well-being. Its academic value in outlining the history and current thrust of work in the field of humour is obvious, but this reviewer appreciated its bold attempt to provide a more personal view of human adaptation to life's stressful requirements. Very simply, this is a book that resonates with one's understanding of life beyond the research laboratory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acculturation and adjustment among immigrant Chinese parents: Mediating role of parenting efficacy.

This study examined parenting efficacy beliefs as a mediator of the association between acculturation and adjustment. The sample consisted of 177 immigrant Chinese mothers and fathers with early adolescent children in Canada. Acculturation was assessed bidimensionally as Canadian and Chinese orientations. A latent psychological adjustment variable was composed of symptoms of depression, feelings of self-esteem, and life satisfaction. Results showed that relations between Canadian orientation and psychological adjustment were partially mediated by parenting efficacy. As expected, the more parents were oriented toward Canadian culture, the more efficacious they felt in their parenting, which in turn was associated with better psychological adjustment. In contrast, mediation of relations between Chinese orientation and psychological adjustment was not supported, as Chinese orientation was not associated with parenting efficacy and was positively associated with psychological adjustment for mothers only. Similar results were found when the meditational model was extended to evaluate parenting practices as an outcome (i.e., warmth, reasoning, and monitoring). That is, parenting efficacy mediated the relation between higher Canadian orientation and more positive parenting practices, whereas Chinese orientation was unrelated to parenting practices. Invariance testing suggested that the models were similar for mothers and fathers. Results support the theory that higher orientation to Canadian culture may advance feelings of parenting efficacy because parents have the cultural knowledge and skills to feel confident parenting in a new intercultural context. Further, they support the expectation that parenting efficacy beliefs, in turn, are important determinants of psychological adjustment and effective parenting for immigrant parents. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The role of public exposure in moral and nonmoral shame and guilt.

Although scholarly traditions assume that shame results more from the public exposure of a transgression or incompetence than guilt does, this distinction has little empirical support. Four studies, using either undergraduate participants' responses to hypothetical scenarios, their remembered experiences, or the coding of literary passages, reexamined this issue. Supporting traditional claims, public exposure of both moral (transgressions) and nonmoral (incompetence) experiences was associated more with shame than with guilt. Shame was also more strongly linked with nonmoral experiences of inferiority, suggesting 2 core features of shame: its links with public exposure and with negative self-evaluation. The distinctive features of guilt included remorse, self-blame, and the private feelings associated with a troubled conscience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting hopelessness and psychological distress: The role of perfectionism and coping.

This study investigated an integrative model involving the relationship between perfectionism (P. L. Hewitt & G. L. Flett, 1991) and coping (C. S. Carver, A F. Scheier. & J. K. Weintraub, 1989) to predict changes in hopelessness and general psychological distress among college students. Results indicated that changes in psychological well-being (4-5 weeks later) were predicted by socially prescribed perfectionism, and, as theorized, avoidance coping moderated the link between perfectionism and psychological well-being beyond initial levels of distress. Support was also found for the adaptive effects of cognitive reconstruction coping and other-oriented perfectionism, whereas, under certain conditions, self-oriented perfectionism was shown to be maladaptive. These findings offer support for the proposed model. Implications for intervention and suggestions for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)