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Biomedical subjects

S Folkman

Publications and source records attributed to S Folkman.

At least 19 recordsLinked to original sources
PubMed1992

Stress, coping, and high-risk sexual behavior.

We examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse) in 398 nonmonogamous gay and bisexual men from the AIDS Behavioral Research Project in San Francisco. Unprotected anal intercourse during the previous month, the amount of stress experienced during the previous month in each of 10 domains, six types of coping (self-controlling coping, escape-avoidance, distancing, planful problem-solving, seeking social support, and positive reappraisal), and spiritual beliefs and spiritual activities were assessed through self-report. There was no relation between stress and unprotected anal intercourse. However, there was a relation between coping and unprotected anal intercourse. Subjects who reported unprotected anal intercourse used sex more of the time to help cope with stressful situations than did subjects who did not report unprotected anal intercourse. Unprotected anal intercourse was negatively associated with seeking social support and spiritual activities and positively associated with self-controlling coping, which involves keeping one's feelings to oneself, and positive reappraisal. The findings suggest that social aspects of coping may be a key to understanding differences between those who engage in high-risk sexual behavior and those who do not.

Adaptation, Psychological↗
PubMed1991

Do house officers learn from their mistakes?

Mistakes are inevitable in medicine. To learn how medical mistakes relate to subsequent changes in practice, we surveyed 254 internal medicine house officers. One hundred fourteen house officers (45%) completed an anonymous questionnaire describing their most significant mistake and their response to it. Mistakes included errors in diagnosis (33%), prescribing (29%), evaluation (21%), and communication (5%) and procedural complications (11%). Patients had serious adverse outcomes in 90% of the cases, including death in 31% of cases. Only 54% of house officers discussed the mistake with their attending physicians, and only 24% told the patients or families. House officers who accepted responsibility for the mistake and discussed it were more likely to report constructive changes in practice. Residents were less likely to make constructive changes if they attributed the mistake to job overload. They were more likely to report defensive changes if they felt the institution was judgmental. Decreasing the work load and closer supervision may help prevent mistakes. To promote learning, faculty should encourage house officers to accept responsibility and to discuss their mistakes.

Analysis of Variance↗
PubMed1991

War-related stress. Addressing the stress of war and other traumatic events.

A task force on war-related stress was convened to develop strategies for prevention and treatment of psychological, psychosocial, and psychosomatic disorders associated with the Persian Gulf War and other extreme stressors facing communities in general. The task force focused on the return home, reunion, and reintegration of service personnel with their families and work. Although the Persian Gulf War was won with relative ease, negative psychological sequelae may develop in some individuals because of the stress of war, family disruption, financial difficulty, and changes in family routines. Typical stress reactions and modes of coping that are usually unsuccessful or destructive were outlined, and suggestions were made for monitoring these. In addition, guidelines for successful coping were developed. Special attention was given to children's reactions and needs. Recommendations were made for outreach and intervention on the policy, systems (e.g., schools, businesses, governmental agencies), family, and individual levels.

Adaptation, Psychological↗
PubMed1989

Psychoactive drugs, alcohol, and stress and coping processes in older adults.

Data are presented on a) the relationship between psychoactive substance use and personal characteristics, b) the relationship between psychoactive substance use and appraisal of and coping with stressful situations, and c) the use of psychoactive substances specifically to cope with stress among older people. Data were provided by 141 65-to-74-year-old retired Caucasians who were assessed repeatedly over 6 months. Compared to national samples, subjects were relatively heavy users of alcohol and average users of psychoactive drugs. Use of alcohol increased with income, and drug use was associated with several psychosocial characteristics as well as with psychological and somatic health. Psychoactive substance use did not relate to the ways subjects appraised and coped with stressful encounters. Further, only a small number of subjects used drugs or alcohol specifically to help them cope in these encounters. The findings about psychoactive drug users are compared with other findings about misusers of drugs, and the risks associated with each type of drug use are discussed.

Adaptation, Psychological↗
PubMed1988

The relationship between coping and emotion: implications for theory and research.

Historically, coping has been viewed as a response to emotion. Our purpose here is to evaluate this idea and offer a broader view based on cognitive and relational principles concerning the emotion process. We will explore the ways emotion and coping influence each other in what must ultimately be seen as a dynamic, mutually reciprocal relationship.

Adaptation, Psychological↗
PubMed1988

The impact of daily stress on health and mood: psychological and social resources as mediators.

This study examined daily stress processes among 75 married couples across 20 assessments during a 6-month period. The somatic and psychological effects of common everyday hassles were investigated. Overall, there was a significant relationship between daily stress and the occurrence of both concurrent and subsequent health problems such as flu, sore throat, headaches, and backaches. The relationship of daily stress to mood disturbance was more complex. The negative effects of stress on mood were limited to a single day, with the following day characterized by mood scores that were better than usual. Furthermore, striking individual differences were found in the extent to which daily stress was associated with health and mood across time. Participants with unsupportive social relationships and low self-esteem were more likely to experience an increase in psychological and somatic problems both on and following stressful days than were participants high in self-esteem and social support. These data suggest that persons with low psychosocial resources are vulnerable to illness and mood disturbance when their stress levels increase, even if they generally have little stress in their lives.

Adult↗
PubMed1988

Centrality and individual differences in the meaning of daily hassles.

In this study we introduce the concept of centrality in an attempt to assess individual differences in the meaning underlying daily hassles. Central hassles are defined as those which reflect important ongoing themes or problems in the person's life. The characteristics of central hassles, and their role in psychological and somatic health, were assessed in a sample of 150 community-residing men and women. The results indicate that central hassles vary in content from person to person and touch more on problems with personal needs and deficits in coping skills compared to noncentral hassles. The dimension of centrality was found to play a significant role in the prediction of psychological symptoms. Although the empirical case for the importance of centrality in the stress-illness relationship is inconclusive due to problems of confounding and a cross-sectional rather than longitudinal design, the ideas presented appear promising and provide a basis for further research on psychological vulnerability to stress.

Adult↗
PubMed1988

Coping as a mediator of emotion.

There is widespread conviction among health care professionals that coping affects emotion. Yet theory and research have traditionally emphasized the effects of emotion on coping. The present research addresses this imbalance by evaluating the extent to which coping mediated emotions during stressful encounters in two Caucasian, community-residing samples. Subjects' recently experienced stressful encounters, the ways they coped with the demands of those encounters, and the emotions they experienced during two stages of those encounters were assessed repeatedly. The extent to which eight forms of coping mediated each of four sets of emotions was evaluated with a series of hierarchical regression analyses (of residuals). Coping was associated with changes in all four sets of emotions, with some forms of coping associated with increases in positive emotions and other forms associated with increases in negative emotions.

Adaptation, Psychological↗
PubMed1987

Correlates of social support receipt.

Psychological correlates of social support receipt were examined in an investigation of stress and coping among 150 middle-aged community residents. Subjects were interviewed monthly for 6 months, each time concerning a specific stressful situation in the previous month. Social support received and methods of coping were assessed each time, as well as other variables. Factors hypothesized to be associated with support receipt were person predispositions, appraisal patterns with regard to specific stressful encounters, and coping strategies used. Each was most strongly associated with a particular type of social support. Person predispositions related most strongly to emotional support received, appraisal factors related most strongly to aid, and coping strategies related most to informational support received. Furthermore, of the three sets of variables, the individual's ways of coping appeared to be most strongly associated with all types of social support received. Two implications are explored. First, we suggest that the three types of social support studied represent different constructs with different antecedents and consequences. Second, we argue that coping behavior provides interpersonal cues regarding what is wanted or needed in a stressful situation and that the members of the social environment respond accordingly.

Adaptation, Psychological↗
PubMed1987

Age differences in stress and coping processes.

The dramatic increase in the numbers of people who are living into old age has been accompanied by a growing interest among psychologists and health care professionals in their sources of stress and how they cope with them. Despite this interest, little is known about normative stress and coping patterns and the ways in which these patterns differ in older and younger people. This study, which draws on stress and coping theory, compares younger and older community-dwelling adults in daily hassles and eight kinds of coping. Two interpretations of age differences are evaluated: a developmental interpretation, which says that there are inherent, stage-related changes in the ways people cope as they age, and a contextual interpretation, which says that age differences in coping result from changes in what people must cope with. The findings indicate that there are clear age differences in hassles and coping. Overall, the findings tend to support the developmental interpretation, although the contextual interpretation also applies.

Activities of Daily Living↗
PubMed1987

Stress processes and the misuse of drugs in older adults.

There is increasing concern about the misuse of drugs among the elderly. We assessed misuse, including drug usage, drug interactions across pharmacologic classes, and multiple drugs in the same pharmacologic class, in a community sample of 65 to 74-year-olds, and evaluated its relation to stress and coping processes and psychological and somatic health. Assessments were made repeatedly over a 6-month period. Results indicated that misuse was multidimensional and widespread. Misusers did not differ from nonmisusers on antecedent psychosocial variables, nor did they report more hassles or cope differently than nonmisusers. However, misusers and nonmisusers differed on their subjective experience of stressful encounters; misusers experienced their hassles as more intense, and they experienced more threat emotions and more dissatisfaction with their coping than did nonmisusers. Misuse was also associated with long-term psychological satisfaction, psychological symptoms, and somatic health.

Adaptation, Psychological↗
PubMed1987

Effect of photoperiod on LH, FSH, prolactin and melatonin patterns in ovariectomized prepubertal heifers.

Angus and Angus crossbred prepubertal heifers were ovariectomized and randomly assigned to either increasing light simulating the photoperiod of the vernal equinox to the summer solstice (I) or decreasing light simulating the photoperiod of the autumnal equinox to the winter solstice (D) for 43 degrees N latitude. Three blood samples were taken each week for 14 weeks, the first at 11:00 h and two others 2 days later, 1 h before lights on (dark), 1 h before lights off (light). At the end of 14 weeks 4 heifers from each treatment group were cannulated and samples were taken for 12 h at 15-min intervals, 6 h in the light and 6 h in the dark. All sera were assayed for LH, FSH and prolactin. In addition, the samples taken at 15-min intervals were assayed for melatonin. In samples taken weekly at 11:00 h circulating concentrations of LH and prolactin were higher among animals in Group I, while FSH concentrations were not different between Groups D and I. In samples collected weekly in the light or the dark, LH and prolactin concentrations were higher in Group I animals. However, prolactin concentrations were higher and LH concentrations tended to be higher in samples taken in the dark. FSH concentrations were not different between either D or I or dark and light. In samples taken at 15-min intervals the prolactin baseline was higher and pulse amplitude tended to be higher for Group I animals. Neither LH nor FSH pulse characteristics differed between I and D; however, LH baseline and LH pulse amplitude were higher in the dark. Melatonin pulse amplitude was higher among animals in Group D and higher in serum collected in the dark. These results suggest that photoperiod alters circulating concentrations of LH and prolactin and alters pulsatile release of LH, prolactin and melatonin in the prepubertal heifer.

Animals↗
PubMed1986

Appraisal, coping, health status, and psychological symptoms.

In this study we examined the relation between personality factors (mastery and interpersonal trust), primary appraisal (the stakes a person has in a stressful encounter), secondary appraisal (options for coping), eight forms of problem- and emotion-focused coping, and somatic health status and psychological symptoms in a sample of 150 community-residing adults. Appraisal and coping processes should be characterized by a moderate degree of stability across stressful encounters for them to have an effect on somatic health status and psychological symptoms. These processes were assessed in five different stressful situations that subjects experienced in their day-to-day lives. Certain processes (e.g., secondary appraisal) were highly variable, whereas others (e.g., emotion-focused forms of coping) were moderately stable. We entered mastery and interpersonal trust, and primary appraisal and coping variables (aggregated over five occasions), into regression analyses of somatic health status and psychological symptoms. The variables did not explain a significant amount of the variance in somatic health status, but they did explain a significant amount of the variance in psychological symptoms. The pattern of relations indicated that certain variables were positively associated and others negatively associated with symptoms.

Adaptation, Psychological↗
PubMed1986

Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes.

Despite the importance that is attributed to coping as a factor in psychological and somatic health outcomes, little is known about actual coping processes, the variables that influence them, and their relation to the outcomes of the stressful encounters people experience in their day-to-day lives. This study uses an intraindividual analysis of the interrelations among primary appraisal (what was at stake in the encounter), secondary appraisal (coping options), eight forms of problem- and emotion-focused coping, and encounter outcomes in a sample of community-residing adults. Coping was strongly related to cognitive appraisal; the forms of coping that were used varied depending on what was at stake and the options for coping. Coping was also differentially related to satisfactory and unsatisfactory encounter outcomes. The findings clarify the functional relations among appraisal and coping variables and the outcomes of stressful encounters.

Adaptation, Psychological↗