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The effect of rehabilitation service use on coping patterns over time among older adults with age-related vision loss.

OBJECTIVE: To enhance our understanding of coping and rehabilitation in the context of adaptation to disability by examining how coping may change over a two-year time period, and how different vision rehabilitation services may affect coping over time. DESIGN: Longitudinal two-wave study (baseline and two-year follow-up). SETTING: Vision rehabilitation agency. SUBJECTS: Older adults with visual impairment. METHOD: In-person interviews using structured assessments of functional vision loss and functional disability, rehabilitation service use and coping strategies. RESULTS: Ninety-five people participated in both study waves. Findings showed change in patterns of coping over the two-year period of the study, as participants adjusted to living with age-related vision loss. Although instrumental coping was the only coping mode with evidence for average change (a decrease), affective and escape/distraction strategies showed individual variation in change over time. Rehabilitation use explained variance in coping at time 2 over and above impairment status and coping at time 1. Those who used a greater number of assistive aids between time points were likely to report more instrumental coping at time 2, and those who used counselling between time points were likely to report more affective coping at the two-year follow-up. Finally, those who used more optical aids were likely to report more escape/distraction coping at time 2, whereas those who saw a low vision specialist tended to report less of this type of coping over time. CONCLUSIONS: Findings suggest that rehabilitation interventions can affect coping patterns over time, and that direction and magnitude of such an effect may depend on the type of rehabilitation received.

Adaptation, Psychological↗

Appraisal and coping strategy use in victims of school bullying.

BACKGROUND: Transactional models of coping (Lazarus & Folkman, 1984) can contribute to our understanding of why some children cope effectively with bullying while others suffer negative outcomes. However, previous research has relied on coping measures that are not comparable with adult measures, restricting investigation of developmental trends. Additionally, previous research has not included appraisals when measuring coping using an established coping measure. AIMS: To examine the factor structure of a coping measure that is directly comparable with the adult literature; to examine the content of pupils' threat and challenge appraisals concerning bullying; and to examine the relationships between appraisals and coping strategy use within the victims of school bullying. SAMPLE: Participants were 459 children aged 9 - 14 years. METHOD: A self-report bullying questionnaire, incorporating Halstead et al.'s (1993) adolescent version of the Ways of Coping Checklist, was completed by participants. Also included were control, threat and challenge appraisal items. RESULTS: Confirmatory factor analysis confirmed that Halstead et al.'s four-factor model of coping is valid for a population of school bullying victims. Content validity of items used to measure threat and challenge appraisal was demonstrated. Ambiguity of challenge appraisal influenced the use of Wishful Thinking, Seeks Social Support and Problem Focused coping. Wishful Thinking was also influenced by control appraisal. Avoidance coping was not influenced by the appraisals measured. CONCLUSION: Halstead et al.'s Revised Ways of Coping Checklist can be used to measure coping amongst child and adolescent victims of bullying. Furthermore, including appraisal variables improves our understanding of individual differences between victims' coping strategy choices.

Adaptation, Psychological↗

[The comparison of the stress and coping methods of cancer patients and their caregivers].

PURPOSE: The purpose of this study was to identify the stress and the coping methods in the cancer patients and their caregivers. METHOD: The stress method was measured by VAS(Visual Analogue Scale). The coping methods was measured using the modified Ways of Coping Questionnaire. The phases of patient illness consisted of 1st(initial) stage, and 2nd(recurred) stage and 3rd(terminal) stage based on Lewandowski & Jones(1988) method. The data were collected by a survey of convenience sampling of 257 cancer patients and 196 of their caregivers from two hospitals in Seoul. The data were analyzed using paired t-test, unpaired t-test. RESULT: The stress level of cancer patients was lower than their caregivers. The cancer patients used emotion-focused coping mode than problem-focused coping mode. The caregivers problem-focused coping mode over emotion-focused coping mode. In the problem-focused coping mode, the caregivers significantly used two coping strategies that were 'positive cope', 'information seeking' more than patients. In emotion-focused coping mode, the caregivers significantly used one coping strategies that was 'wish' more than patients. The patients tended to used two coping strategies that were 'blame' and 'emotion expression' more than the caregivers. CONCLUSION: Further study needs to be done to positively identify these coping methods and develop interventions to assist patients and their caregivers.

English Abstract↗

Anxiety coping style and daily blood pressure variation of female nurses.

OBJECTIVE: To examine how the style of coping with anxiety influences ambulatory blood pressures measured in work and home environments for 63 women aged 34 +/- 8 years employed as nurses. METHODS: Awake ambulatory blood pressures measured at work (n = 38 readings) and at home (n =7 readings) were compared among nurses who had been classified as belonging to four anxiety-coping-style groups: low anxious repressive (n = 18 work, n = 16 home), high anxious defensive (n = 4 work, n = 4 home) true low anxious (n = 21 work, n = 20 home) and true high anxious (n = 19 work, n = 18 home). The four anxiety-coping-style groups were determined by cross-classifying the women upon the basis of their scores on the Marlowe-Crowne Social Desirability Scale (cutoff at 18) and the Taylor Manifest Anxiety Scale (cutoff at 14). RESULTS: Average systolic blood pressures at work and at home among nurses with a low anxious repressive coping style were significantly lower than were those of nurses with a high anxious defensive coping style (P < 0.05) and a true low anxious coping style ( P < 0.025). Nurses with a low anxious repressive coping style also had lower diastolic blood pressures at work than did those with a high anxious defensive coping style ( P < 0.05) and lower diastolic blood pressures at home than did those with a true anxious coping style ( P < 0.01). Finally, subjects with a high anxious defensive coping style had significantly higher systolic blood pressures at work and at home (P < 0.05) and higher diastolic blood pressures at work than did nurses with a true high anxious coping style. The effects of the style of coping on the variation of work and home blood pressures were independent of several covariates including weight, perceived stress, smoking, alcohol, postural variation, and number of children. The univariate scales of Social Desirability and Anxiety also had no effect on the variability of the blood pressure. CONCLUSION: Among employed women, the extent of the reponse of the blood pressure to stresses in the work and home environments could be infoluenced by the style of coping with anxiety. Furthermore, the effects of personality constructs such as the style of coping, which are defined by the interaction of psychologic dimensions, may reflect better the complexity of behavioral influences on the blood pressure than do the univariate psychometric measures of which they are composed.

Journal Article↗

Coping with AIDS. A longitudinal study.

The goals of this longitudinal, prospective study were to 1) examine coping strategies of HIV-positive (HIV+) and HIV-negative (HIV-) injecting drug users; 2) study the relationship of earlier social support to later coping in HIV+ men; and 3) examine the effects of earlier coping strategies on later psychosocial function. The authors studied 287 men given a structured questionnaire at two points in time. HIV+ subjects scored higher than HIV- subjects on measures of AIDS-related adaptive coping (social support) and AIDS-related maladaptive coping (aggression), but not on general coping. General coping was not specifically AIDS-related, but was correlated positively with adaptive coping and negatively with maladaptive coping. These results suggest that earlier general coping is related to the later avoidance of maladaptive coping, and they have specific implications for teaching preventive strategies. AIDS-related adaptive or maladaptive coping techniques may be used simultaneously, and coping behavior may change over time. Earlier social support is related positively to aspects of later coping in HIV+ men.

Acquired Immunodeficiency Syndrome↗

Coping with dietary relapse crises and their aftermath.

We examined dieters' attempts to cope with dietary relapse crises (Immediate coping) and their aftermath (Restorative coping). We analyzed posttreatment interviews with 57 obese subjects with Type-II diabetes, comparing coping in situations in which subjects lapsed with those in which they survived temptations to overeat. Performance of Immediate coping predicted survival but the particular type of coping made little difference. Eight types of Immediate cognitive coping were equally associated with survival: each was significantly more effective than no coping and equal to the aggregate of the other types. A similar pattern held for 5 types of Immediate behavioral coping, except that social support was no more effective than no coping and restraint was less effective than the other types. Restorative behavioral coping was elicited as a response to overeating, while Restorative cognitive coping seemed elicited by the negative thoughts and feelings that sometimes accompany lapses or temptations. Implications for treatment and future research on relapse crises and coping are discussed.

Adaptation, Psychological↗

Spirituality and coping with life stress among adult survivors of childhood sexual abuse.

OBJECTIVE: The purpose of this study was to explore the role of spiritual coping in adult survivors' responses to current life stressors. Although there has been research on general coping and adult survivors of childhood sexual abuse (CSA), there has been no work done on spiritual coping behaviour and survivors' current adjustment. METHOD: One hundred and one adult survivors of childhood sexual abuse volunteered to participate in this study. Survivors were recruited through advertisements placed in various community venues. Survivors completed questionnaires on abuse descriptors, the coping resources of social support and general cognitive appraisal, spiritual coping and current distress. Spiritual coping was assessed in relation to a current negative life event. RESULTS: In general, spiritual coping predicted the current distress of adult survivors beyond the contribution of demographics, severity of abuse, cognitive appraisal and support satisfaction. For example, self-directed (beta=.27), active surrender (beta=.32), and passive deferral (beta=-.35) significantly contributed to the prediction of anxious mood, [F(15, 60)=3.31, p<.0001], while only spiritual discontent (beta=.26) predicted depressive mood, [F(15, 60)=3.66, p<.0001] beyond the contribution of other factors. Negative forms of spiritual coping (e.g., spiritual discontent) tend to be related to greater distress, while more positive forms of spiritual coping (e.g., spiritual support) were related to less distress. For instance, spiritual discontent coping was related to greater depressive mood, while active surrender coping and religious forgiveness coping (i.e., seeking God's help to relinquish negative emotion) were associated with lower levels of depressive mood. CONCLUSIONS: The results highlight the importance of making a distinction between negative and positive forms of spiritual coping when investigating the role of spirituality in the current life functioning of adult survivors of childhood sexual abuse.

Adaptation, Psychological↗

Coping with chronic renal failure in Hong Kong.

The purpose of the study was to investigate the coping behaviours of Chinese patients with chronic renal failure. The study, based on Lazarus and Folkman (Stress, Appraisal and Coping, Springer, New York, 1984) model of coping, was conducted to identify the process by which 11 chronic renal failure patients cope with their disease. The identified themes are coping with fluctuating feelings and concerns, motivation to cope, interdependent relationships between patients and their family members and modes of coping strategies. The significance of the results indicates that coping is the consequence not only of situational demands but also of life goals. Meaning in life is an important motivator in the coping process. Besides problem-focused coping and emotion-focused coping, another important element is relationship-focused coping. The interdependent influences of families on patients and patients on families are also important factors. The role of family and cultural factors is discussed as it affects how patients with chronic renal failure cope with their illness.

Activities of Daily Living↗

Emotional distress and coping in the early stage of recovery following acute traumatic hand injury: a questionnaire survey.

BACKGROUND: Emotional distress is frequent in patients with acute traumatic hand injury during the first weeks after the accident. Knowledge of coping in relation to emotional distress could help to identify those who need support. OBJECTIVES: To describe the different kinds of coping used by patients in the early stage of recovery following an acute traumatic hand injury and to investigate differences in coping patterns in patients with and without symptoms of emotional distress. DESIGN: Questionnaire survey with a descriptive and comparative design. SETTING/PARTICIPANTS: A total of 112 patients with acute traumatic hand injury requiring inpatient treatment at the hand surgical clinic. Those with injuries caused by a suicide attempt or with known drug abuse were excluded. Method/main outcome measures: The patients answered a postal questionnaire at home 1-2 weeks after the accident. Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping was measured with the Jalowiec Coping Scale-40. RESULTS: Coping by "trying to keep the situation under control" and "trying to look at the problems objectively and see all sides" were most frequent. These strategies are typical for the confrontive coping style, which dominated in the actual illness-situation. Symptoms of emotional distress occurred in 32% of the patients. These patients used significantly more kinds of coping strategies and used confrontive and emotive coping strategies more often than the others. Coping by "hoping for improvement", "working tension off with physical activity", "trying to put the problem out of one's mind", "worrying", "getting nervous or angry" and "taking off by one self" were associated with emotional distress. Coping by "accepting the situation as it is" and "thinking that it is nothing to worry about" were more frequent in patients without emotional distress. CONCLUSIONS: Observations of the coping strategies associated with emotional distress in this study could help to identify patients in clinical practice that need nursing support. Coping associated with less emotional distress should be encouraged.

Activities of Daily Living↗

The social epidemiology of coping with infertility.

BACKGROUND: To analyse the cross-sectional association between coping responses with infertility and occupational social class. Infertility is evenly distributed across social classes in Denmark, and there is free access to high-quality assisted reproduction technology. METHODS: Data were based on a questionnaire in a consecutive sample of 1169 women and 1081 Danish men who were about to begin assisted reproduction treatment. The coping measure was developed from an adaptation of Lazarus and Folkman's Ways of Coping Questionnaire and based on results from interviews with infertile people. The measure was developed in four categories: active-avoidance coping; active-confronting coping; passive-avoidance coping; meaning-based coping. These subscales were later confirmed by factor analysis. Occupational social class was measured in a standardized way. RESULTS: Contrary to expectations, the logistic regression analyses showed that women from lower social classes V + VI and men from social classes III + IV used significantly more active-confronting coping. Women from lower social classes V + VI used significantly more meaning-based coping. Both men and women from social classes III - VI used significantly more passive-avoidance coping and significantly less active-avoidance coping. CONCLUSION: Due to the significant social differences in coping with infertility, the study suggested that elements of coping may be learned from one's social network and reference group.

Adaptation, Psychological↗

Stress, coping, and psychological health of vocational high school nursing students associated with a competitive entrance exam.

An important issue for the nursing education system in Taiwan is to reinforce nursing education to enhance competence levels for entry to nursing specialties. Consequently, to meet the prospective demands of technical manpower, not only do nursing students in college and vocational schools pursue further studies, but they also take competitive entrance exams. Using a descriptive cross-sectional design, the study examined the following among nursing students in vocational high schools: (1) perception and sources of entrance exam stress and use of coping behaviors; (2) the effect of difference in entrance exam stress levels on coping behaviors used, and (3) measurement of coping function to determine which coping behavior works best for buffering the impact of stress on psychological health during a preparatory stage of a college and university entrance exam. The subjects were 441 third-year nursing students of vocational high schools in northern Taiwan, recruited by convenience sampling. Three measurements were adopted: Stress perceived scale, Coping behavior inventory, and a Chinese health questionnaire. Results showed that the five main stressors of entrance exam stress, in descending order, were taking tests, the student's own aspirations, learning tasks, teacher's aspirations and parent's aspirations. Students generally used problem-focused coping strategies including optimistic action and social support to deal with the entrance exam stress, but use of emotion-focused coping strategies including avoidance and emotional disturbance was significantly increased as perceived level of stress rose. Two-way analyses of variance (2-way ANOVA) revealed that problem-focused coping had a positive main effect of alleviating psychological distress. A significant interaction was observed between stress perceived and problem-focused coping used for psychological health. Further examination of the interaction effect showed that problem-focused coping behaviors were potentially more adaptive in relation to psychological health at the lower and moderate stress levels (25 - 75%T) than that at the extreme stress level (> 75%T). Conversely, emotion-focused coping had a negative main effect or impairing psychological health. No interaction effect was found between stress perceived and emotion-focused coping used, suggesting that the relationship between emotion-focused coping and psychological distress was consistent across various stress levels.

Adaptation, Psychological↗

Coping behavior of Finnish adolescents: remarks on a cross-cultural comparison.

As part of a larger cross-cultural project, the present study analyses the coping styles of Finnish adolescents. A sample of 548 adolescents aged 15 to 17 years was investigated. Coping styles were defined by a matrix of 20 coping strategies applied across eight different developmental areas. Factor analysis revealed a three-dimensional structure of coping styles. The first dimension involves activities such as seeking support or taking advice (Active Coping), the second emphasizes the adolescent's appraisal of the situation and the search for a compromise (Internal Coping/Compromising) and the third includes defenses like denial and withdrawal (Withdrawal) and may be regarded as dysfunctional. The Finnish adolescents most frequently employed functional forms of coping like Active Coping and Internal Coping/Compromising: dysfunctional coping style such as Withdrawal was used less often. In addition, significant main effects for age and gender were found. Girls favored more Active Coping and support seeking behavior, as compared to boys. Both functional coping modes showed an increase with age. A comparison of coping styles across eight different problem areas revealed situation specific influences, too. The discussion compares the coping styles of Finnish adolescents with results of two parallel studies focussing on German and Israeli adolescents, using the same instrument. In spite of the considerable impact of environmental and historical conditions in the three countries, the similarities in coping behavior were impressive.

Adaptation, Psychological↗

Defining and quantifying coping strategies after stroke: a review.

The coping strategies that people use after a stroke may influence recovery. Coping measures are generally used to assess the mediating behaviour between a stressor (ie, disease or condition) and the physical or psychological outcome of an individual. This review evaluates measures that quantified coping strategies in studies on psychological adaptation to stroke. The main aspects of the coping measures reviewed were (a) conceptual basis; (b) coping domains assessed; (c) coping strategies used after a stroke; and (d) psychometric properties of coping measures used in studies assessing patients with stroke. Four databases (Medline, CINAHL, PsychINFO and Cochrane Systematic Reviews) were searched to identify studies that used a coping measure in stroke. 14 studies assessed coping strategies in patients after stroke. Ten different coping measures were used, and the studies reviewed had many limitations. Few studies provided definitions of "coping" and the psychometric properties of the coping measures were under-reported. The need for future studies to more clearly define the coping process and to present data on the reliability and validity of the measures used is emphasised.

Adaptation, Psychological↗

Positive coping up- and down-regulates in vitro cytokine productions from T cells dependent on stress levels.

BACKGROUND: Specific coping styles have been shown to modulate stress-induced immune alterations and influence actual health outcomes. This study examined the effects of stressors and coping styles on human T-cell subpopulations and in vitro cytokine production using a cross-sectional design. METHODS: Seventy-one men (18-60 years old) were asked to complete a self-administered questionnaire that evaluates quantitative workload, mental demand and coping styles. The numbers of T-cell subpopulations and concentrations of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) after stimulation with phytohemaglutinin were measured. RESULTS: Positive and negative coping were negatively related to IL-4 and the number of CD4+ cells, respectively. Interactions between positive coping and mental demand significantly affected the number of CD8+ cells, IFN-gamma, IL-4 and the IFN-gamma/IL-4 ratio. Among men reporting high mental demand, positive coping was related to increased IFN-gamma and IFN-gamma/IL-4. Among men reporting low mental demand, positive coping was related to a decreased number of CD8+ cells and lower concentrations of IFN-gamma and IL-4. Analyses adjusting for the numbers of CD3+ and CD8+ cells revealed that the interactive effects of positive coping and mental demand on cytokine levels were attributable to the changes in T-cell function rather than the number of T cells. No modulating effect of anxiety on the associations of stressors and coping with immune function was observed. Depressive symptoms slightly, though not significantly, modulated the association of negative coping and the number of CD4+ cells. CONCLUSIONS: From the perspective of immunology, optimal stress characteristics were determined by an individual's coping styles, with positive coping being associated with stress-induced changes in the number of CD8+ cells and in vitro cytokine production from T cells. Our findings suggest that it is important to consider the interactive effects of the complexity of work and the individual coping style in stress management.

Adaptation, Psychological↗

Emotion-related primary and secondary appraisals, adjustment and coping: associations in women awaiting breast disease diagnosis.

OBJECTIVE: Different emotions are to some extent associated with different ways of coping. Cognitive processes involved in determining emotional reactions may influence coping (perhaps through directing attention or generating salient information). This study explored possible appraisal-coping associations by examining whether a set of appraisal components identified in emotion theory were also associated with coping. DESIGN: The study examined concurrent associations between appraisal components, emotional adjustment, and coping in 148 women with suspected breast disease. METHOD: Questionnaire measures of primary and secondary appraisal components identified in emotion theory, anxiety, depression, and coping were sent to women during the waiting period between GP referral and attendance at a 'one-stop' breast-disease diagnosis clinic. RESULTS: Consistent with expectations, appraisal components were associated with both emotions and coping. Elevated anxiety was associated with appraisals of low emotion-focused coping potential; avoidance coping was associated with motivational incongruence, self-accountability, and pessimistic appraisal of emotion-focused coping potential; acceptance/resignation coping was associated with self-accountability and pessimistic appraisals of both future expectancy and emotion-focused coping potential. CONCLUSION: This study presents a theoretically driven approach to exploring associations between emotions and adjustment efforts. In keeping with expectations, a number of appraisal components identified in emotion theory were found to be associated with both emotion and coping.

Adaptation, Psychological↗

Coping mechanisms in patients presenting for in-vitro-fertilization.

OBJECTIVES: The purpose of this study was to assess the coping mechanisms in patients presenting for in-vitro fertilization (IVF). METHODS: We evaluated thirty consecutive couples presenting for in-vitro-fertilization. All couples were interviewed individually at first, and then together, using a semi-structured interview technique. Psychiatric diagnoses were made using the Diagnostic and Statistical Manual-IV (DSM-IV) criteria. Coping mechanisms used by the individuals were assessed using the Mechanisms of Coping Scale (MOCS). Other instruments used were Hamilton Depression Rating Scale (HAM-D-17), Hamilton Anxiety Rating Scale (HAM-A), Brief Psychiatric Rating Scale (BPRS), Self-Rating Symptom Scale (SRSS), and Eysenck Personality Inventory (EPI). RESULTS: The mean age of the sixty patients was 32.3 +/- 5.2 years. Fatalism was the commonest factor on the mechanisms of coping scale. Analysis of variance (ANOVA) across all factors of the MOCS for demographic factors showed that men used problem-solving mechanisms significantly more often than women (F = 3.0, df = 1, 58, p < 0.05). ANOVA across coping factors on stressors with post-hoc tests of significance revealed that individuals facing social stress used fatalism significantly more often than other coping mechanisms, while those facing career stress used problem-solving significantly more often than other coping mechanisms (F = 5.6, df = 1, 58, p < 0.05 and F = 3.04, df = 1, 58, p < 0.01 respectively). ANOVA across coping factors on HAM-D-17 scores revealed that individuals who used fatalism had significantly higher HAM-D-17 scores compared to those who did not (F = 4.4, df = 1, 58, p < 0.05). ANOVA across coping factors on HAM-A scores revealed that individuals who used escape-avoidance had significantly lower HAM-A scores than those who did not (F = 4.3, df = 1, 58, p < 0.05). ANOVA across coping factors on SRSS scores revealed that individuals who used passivity or fatalistic coping mechanisms had significantly higher scores on SRSS than who did not (F = 4.6, df = 1, 58, p < 0.05 and F = 3.5, df = 1, 58, p < 0.05). CONCLUSIONS: Differential patterns of coping were found among the sixty individuals presenting for IVF and were associated with a variety of factors including gender, education, stressors, and levels of depression, anxiety, and overall psychopathology. Efforts to recognize and recruit the coping mechanisms of infertile individuals are likely to enhance their ability to participate effectively in treatment.

Adaptation, Psychological↗

[A study on the grief and coping pattern of mothers who have a chronically ill child].

This study was done in order to identify symptoms of grief and patterns of coping in mothers of chronically ill children. Nurses, as health professionals, must understand helpful coping methods for mothers who have chronically ill children. Based on this knowledge, nurses can develop appropriate nursing intervention strategies, and so help the mothers to develop effective ways of coping and give support to mothers with chronically ill children in process of coping with this grief. The research questions guiding this research were: 1. what type of grief does the mother have at the time of child's diagnosis and at present? 2. what are the problems confronting the mother? 3. what are the coping patterns of the mother? 4. is there a difference according to child's diagnosis in the mother's grief and coping pattern? Ths subject for this study were obtained by taking a convenience sample of 120 mothers with a chronically ill child. Interviews took place in four medical school hospitals and one medical center in Seoul from March 19th to May 16th 1990. The tools used in this study were Mcfarlan's (1983), Grief contents, Folkman & Lazarus (1983), Ways of Coping and Hymovich's (1983) the Chronicity Impact and Coping Instrument. The findings were as follows; 1. Grief items had a maximum score of three points. The highest item scores at the time of diagnosis, were in order, heart broken, talkative, and could not do anything, at the present, 'talkative', 'heart broken' and 'busy myself with other things'. 2. The problems confronting the mothers were 'worry about ill child's future', 'her responsibilities in taking care of the ill child.' 3. Most of the mothers used similar ways of coping, that is 'problem focused coping', 'detachment', 'wishful thinking', 'seeking social support' and 'focusing on the positive and hardly any of them used 'tension reduction'. 4. There was a significant difference in coping methods according to the child's diagnosis, leukemia, cancer hemophillia and nephrotic syndrome. The most frequently used coping method was detachment, especially for the mother of the child with. 5. At the time of diagnosis there was a positive correlation between the level of grief and the coping method of detachment and seeking social support.

Adaptation, Psychological↗

Social support, threat, and coping responses and effectiveness in the functionally disabled.

A causal model based on Lazarus' (1966) cognitively oriented theory of psychological stress and coping was tested in a functionally disabled population to determine the effects of social support variables, threat appraisal, and coping responses on coping effectiveness. Social support variables (perceived availability of social support, perceived effectiveness of social support, and personal constraints to the use of social support) were hypothesized to effect coping responses both directly and through the variable of threat appraisal. Coping responses (use of social support, cognitive reappraisal, emotion-focused coping, and problem-focused coping) were hypothesized to directly effect coping effectiveness and to mediate the effect of all other variables. Data from 50 functionally disabled, wheel-chair-bound individuals discharged within 3 years from two rehabilitation facilities were analyzed using path analysis. The model fit the data and accounted for 61% of the variance in coping effectiveness. Findings indicated that perceived availability of social support, but not the use of social support, was significantly and positively related to coping effectiveness through the mediating variables of problem- and emotion-focused coping. In contrast to the relationship of marital status to coping effectiveness usually found in the literature, nonmarried subjects coped more effectively and perceived less threat.

Adaptation, Psychological↗