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Self-concept clarity and preferred coping styles.

This study examined the relation between self-concept clarity and (a) preferred general coping styles, (b) coping with a specific event, and (c) coping with a specific ongoing situation in 175 undergraduate students. The results of the regression analyses for general coping styles indicated that self-concept clarity made a reliable but weak positive contribution to active coping styles (e.g., planning and taking action) and a strong negative contribution to passive coping styles (e.g, denial). The unique negative contribution of self-concept clarity to passive coping was replicated with respect to coping with a specific event and to coping with a specific ongoing situation. However, the weaker positive contribution of self-concept clarity to active coping was not replicated with respect to coping with specific events or specific ongoing situations.

Adaptation, Psychological↗

Psychological coping style versus disease extent, tumour treatment and quality of life in successfully treated head and neck squamous cell carcinoma patients.

OBJECTIVES: To study self-reported coping style by the COPE questionnaire and the association to tumour node distant metastasis (TNM) stage, received treatment and health-related quality of life (HRQoL) in a population of successfully treated head and neck squamous cell carcinoma (HNSCC) patients. DESIGN: Disease free HNSCC patients were interviewed during a regular outpatient visit to the Department. SETTING: All patients <80 years who had been diagnosed with HNSCC, in Western Norway, in the period from 1992 to 1997 and who were disease free in the year 2000 were included. MAIN OUTCOME MEASURES: The HNSCC patients were studied by the European organization for research and treatment of cancer quality of life (QoL) questionnaire and by the COPE questionnaire from which coping styles profiles were extracted. Clinical and socio-demographic variables were also gathered. RESULTS: Level of problem focused coping style was associated with the T stage and whether or not the patient was given neck radiotherapy. An avoidance-focused coping style was generally associated with lowered HRQoL. Employment of emotional focused coping was associated with low HRQoL among the patients treated with surgery only, and associated with increased HRQoL among patients treated with radiation therapy only. The associations between HRQoL and coping style levels were stronger for HRQoL indexes reflecting cognitive/emotional function than for HRQoL indexes reflecting physical function. CONCLUSIONS: In former HNSCC patients, level of problem focused coping style was associated with the T stage and if given neck radiotherapy. Level of avoidance coping was inversely associated with the HRQoL, and level of emotional coping was associated with HRQoL in a complex manner.

Adaptation, Psychological↗

Internal vs. external determinants of coping responses to stressful life-events in the elderly.

Coping appears to function in the relationship between stressful life-events and health. Factors that may influence an individual's use of a particular coping strategy, however, are not well understood. Coping consistency within individuals and across situations was examined in a longitudinal study of 74 independently living elderly persons, as were the effects of the type of event experienced, appraisal of its degree of threat, and demographic variables on coping behaviour. Correlational analyses indicated that coping responses were more a function of event type than of an individual's consistent style. A number of distinct life-events were associated with particular types of coping responses. The degree of threat, one's expectation of the changeability of an event, and one's appraisal of possible courses of action were also correlated with specific coping behaviours. Age was negatively correlated with problem-focused coping and total number of coping responses. This study suggests that the type of stressful event an individual experiences may be a more important general determinant of one's coping response than is one's overriding propensity to cope in a particular way.

Adaptation, Psychological↗

[Variability of coping strategies in coronary artery bypass surgery patients].

The state-versus-trait discussion in coping research would become more meaningful if attention is paid to the variability both of coping patterns in individual patients as well as stability of single coping strategies over time. 35 patients undergoing coronary artery bypass surgery were interviewed three times about their coping and stress experience: after cardiac catheterization, on the day before surgery, and six days after surgery. Anxiety and depression were measured. A coping attitude of "positive passivity" was present at all three points of time. While the group means were stable, vast interindividual differences occurred. Also, there was a high degree of scatter in the stability of single coping items; emotion related coping modes were more stable than cognition and action related ones. The variability of the patients' coping patterns correlated positively with the amount of stress experienced and with preoperative depression. Different coping strategies are linked to a different degree with personality traits, emotional coping modes revealing the closest connection. The variability of individual coping efforts might be linked to a personality disposition characterized by a vulnerability for stress and depressive reactions.

Adaptation, Psychological↗

The role of neurocognitive abilities in coping with adolescent relapse to alcohol and drug use.

OBJECTIVE: Neurocognitive abilities are hypothesized to influence coping with temptations to relapse to alcohol and drug use. In particular, a moderator model was proposed whereby neurocognitive abilities moderate the influence of coping strategies on treatment outcome. METHOD: Participants (N = 79) were consecutive admissions to inpatient alcohol and drug treatment centers in the San Diego, California. area, (age range = 14 to 18 years; 41% female). Treatment programs were abstinence focused, with an average inpatient stay of 5 weeks. Participants met DSM-III-R lifetime criteria for alcohol abuse or dependence and abuse or dependence of at least one other substance. Follow-up assessments were conducted 1 and 2 years following discharge, including a battery of neuropsychological tests, coping questionnaire, and detailed assessment of alcohol and other drug involvement. RESULTS: The interaction between general intelligence and coping diversity significantly predicted alcohol and drug use 1 year later (F = 10.71, 1/72 df, p <.005, R2 change =.08), even when controlling for current use. Attention-coping and problem solving-coping interactions also significantly predicted outcome, but not above the intelligence-coping interaction. CONCLUSIONS: Teens with poor neurocognitive abilities used little or no alcohol and drugs if good coping skills were evidenced, but used more alcohol and drugs if their coping skills were poor. This association between coping skills and outcome did not exist for teens with better neurocognitive abilities. Clinically, teens with poorer neurocognitive skills may maximally benefit from coping skills training programs, and neuropsychological evaluations may be particularly helpful in addressing these individual needs in treatment.

Adaptation, Psychological↗

Relationship of stress, distress and inadequate coping behaviors to periodontal disease.

BACKGROUND: The association of stress, distress, and coping behaviors with periodontal disease was assessed. METHODS: A cross-sectional study of 1,426 subjects between the ages of 25 and 74 years in Erie County, New York, was carried out to assess these relationships. Subjects were asked to complete a set of 5 psychosocial questionnaires which measure psychological traits and attitudes including discrete life events and their impact; chronic stress or daily strains; distress; coping styles and strategies; and hassles and uplifts. Clinical assessment of supragingival plaque, gingival bleeding, subgingival calculus, probing depth, clinical attachment level (CAL) and radiographic alveolar crestal height (ACH) was performed, and 8 putative bacterial pathogens from the subgingival flora measured. RESULTS: Reliability of subjects' responses and internal consistencies of all the subscales on the instruments used were high, with Cronbach's alpha ranging from 0.88 for financial strain to 0.99 for job strain, uplifts, and hassles. Logistic regression analysis indicated that, of all the daily strains investigated, only financial strain was significantly associated with greater attachment and alveolar bone loss (odds ratio, OR = 1.70, 95% CI = 1.09 to 2.65 and OR = 1.68, 95% CI = 1.20 to 2.37, respectively) after adjusting for age, gender, and cigarette smoking. When coping behaviors were evaluated, it was found that those with more financial strain who were high emotion-focused copers (a form of inadequate coping) had a higher risk of having more severe attachment loss (OR = 2.24, 95% CI = 1.15 to 4.38) and alveolar bone loss (OR = 1.91, 95% CI = 1.15 to 3.17) than those with low levels of financial strain within the same coping group, after adjustment for age, gender, and cigarette smoking. Similar results were found among the low problem-focused copers for AL (OR = 2.21, 95% CI = 1.11 to 4.38) and ACH (OR = 2.12, 95% CI = 1.28 to 3.51). However, subjects with high levels of financial strain who reported high levels of problem-based coping (considered adequate or good coping) had no more periodontal disease than those with low levels of financial strain, suggesting that the effects of stress on periodontal disease can be moderated by adequate coping behaviors. CONCLUSIONS: We find that psychosocial measures of stress associated with financial strain and distress manifest as depression, are significant risk indicators for more severe periodontal disease in adults in an age-adjusted model in which gender (male), smoking, diabetes mellitus, B. forsythus, and P. gingivalis are also significant risk indicators. Of considerable interest is the fact that adequate coping behaviors as evidenced by high levels of problem-based coping, may reduce the stress-associated risk. Further studies also are needed to help establish the time course of stress, distress, and inadequate coping with respect to the onset and progression of periodontal disease, and the mechanisms that explain this association.

Adaptation, Psychological↗

Coping with stress: its influence on periodontal disease.

BACKGROUND: Various forms of stress behavior were documented and in patients with periodontitis their relationship with periodontal disease was investigated. METHODS: Eighty-nine patients with different forms of chronic periodontitis were included in this retrospective case-control study. They were all undergoing periodontal treatment at the Department of Dental Prosthetics, University of Graz, or a private dental practice. The control group consisted of 63 persons employed in health care at the Clinic of Graz. All participants completed a stress coping questionnaire of 114 items and 19 actional and intrapsychic stress coping modes. The questionnaire served as a psychodiagnostic survey aimed at collecting data on stress coping strategies. Clinical attachment loss (CAL) served as the clinical parameter. RESULTS: With the help of a factor analysis with a factorization and Varimax rotation, 5 factors were extracted from the 19 subtests. The reliability of the questionnaire was less than 0.70 only for subtests "escape" and "pharmaceutical drugs." Otherwise the internal consistency ranged between 0.74 and 0.92, and the retest reliability between 0.72 and 0.84. Subsequent assessment with the t test for independent random samples at the 5% level showed that patients differ significantly from controls in regard of factor 2 (active coping, P = 0.40) and 3 (distractive coping, P = 0.033), and that they differ very significantly from controls in regard of factor 4 (defensive coping, P = 0.000) and 5 (coping through aggression and pharmaceutical drugs, P = 0.007). In the statistical analysis of factors with regard to the severity of periodontal disease, the patients were divided into 2 groups (mild to moderate and severe). The t test for independent random samples showed significance for factor 4 (defensive coping) in that patients with a defensive coping style had greater attachment loss (pF4 = 0.04). CONCLUSIONS: The data corroborate the thesis that periodontitis patients with inadequate stress behavior strategies (defensive coping) are at greater risk for severe periodontal disease. However, further investigations are required to confirm the significance of inappropriate coping styles with respect to the advancement of periodontal disease.

Adaptation, Psychological↗

Coping styles of older adults with ostomies.

Various clinical studies throughout the years have shown that individuals with ostomies are a unique group facing adjustment demands. One of the most important challenges for an individual with an ostomy is coping with the physiological and psychological changes. The purpose of this study was to describe coping styles of older adults after undergoing ostomy surgery and to explore its helpfulness in dealing with the stressors related to having an ostomy. Lazarus and Folkman's theory on stress and coping was used as the framework to guide this study. A sample of 27 participants ranging from age 50 to 84 years was obtained from an ostomy association in southeastern Louisiana. Participants were asked to complete a demographic data form and the Revised Jalowiec Coping Scale. This revised scale measured eight coping styles related to Use and Effectiveness. Findings revealed significant differences existed among the means of the eight measures for both Use and Effectiveness at p < .01. Results demonstrated that the optimistic and self-reliant styles of coping were the most frequently used as effective styles for coping with an ostomy. This indicated a positive outlook and dependence on oneself rather than dependence on others when coping with the stressors of having an ostomy. There were no statistically significant differences related to gender or ostomy type. Also, aging did not appear to be a factor when considering coping styles of older adults with ostomies. The nursing role should include assessment of the individual preoperatively to identify fears, concerns, and stressors related to having an ostomy. Also, nurses can provide education on disease management, assist with identification of ineffective coping mechanisms, and promote effective coping skills and stress management techniques.

Adaptation, Psychological↗

Pain experience and pain coping strategies in children with juvenile idiopathic arthritis.

OBJECTIVE: To compare reactions to cold pressor pain and pain coping strategies of patients with juvenile idiopathic arthritis (JIA), healthy children, and their parents. METHODS: We studied 16 children with JIA and one of their parents and 14 healthy children and one of their parents. Patients with JIA were selected from the patient population by fulfilling criteria for inclusion in a "high pain" group (n = 7) of patients with modest clinical arthritis activity, but who presented daily reports of pain in connection with everyday activities, and a "low pain" group (n = 9) who presented significant clinical arthritis activity, but who had only a few complaints of pain related to everyday activities. Dependent variables included pain threshold, discomfort, intensity and tolerance to cold pressor pain, and pain coping strategies. RESULTS: Patients with JIA exhibited significantly lower mean pain tolerance than healthy children. Disease duration correlated with both experimental and clinical pain measures, and JIA patients used significantly more Behavioral Distraction than healthy children. Correlations were found between children's and parents' use of Approach and Distraction related coping strategies. Correlations were also found for the coping strategy of Catastrophizing in the JIA patient group. For experimental pain coping strategies, a significant correlation was found between the JIA patients' and their parents' use of Distraction. For the JIA patients Positive Self-statements and Behavioral Distraction were inversely correlated with the clinical pain measures. In both children and parents the experimental pain coping strategies of Catastrophizing and Distraction were associated with the experimental pain response measures, and low pain JIA patients tended to use more Distraction pain coping strategies than high pain patients. CONCLUSION: The results indicate that JIA patients may differ from healthy children with regard to their responses to experimental pain as well as to their use of pain coping strategies. Pain coping strategies of JIA patients were associated with pain coping strategies of their parents, and use of pain coping strategies was associated with both experimental and clinical pain experience.

Adaptation, Psychological↗

Coping capacity among women with abusive partners.

Coping capacity, although increasingly implicated as a mediating force in how individuals respond to personal threat, is an underrecognized factor in work with women of abusive partners. To explore the utility of coping capacity as a multivariable set to guide intervention with women of abusive partners, findings are reported comparing four groups of women: those whose partners do not engage in abuse, are abusive toward them, are sex offenders of children for whom the woman is a parent, or are offenders of children for whom the woman is not a parent. Three variable sets were included: vulnerability factors that may negatively influence appraisals of threat and ability to cope with abuse; coping responses that include cognitive, emotional, and behavioral reactions to the abuse; and coping resources expected to mediate effects of vulnerability factors and to influence the mobilization (of lack thereof) of coping responses. There were significant differences in coping capacity profiles across the four groups. These appeared to be a continuum of coping capacity, with women who were most directly threatened showing the lowest and women who were least directly threatened showing the highest levels of coping capacity. In order from the lowest to the highest levels of coping capacity were (1) battered women, (2) women whose partners are offenders against their children, (3) women whose partners are offenders against children of whom they are not the parent, and (4) control group women. The paper ends with a conceptual interpretation of the mediating functions of coping resources and implications for intervention and further study.

Adaptation, Psychological↗

Precision of a CAD/CAM technique for the production of zirconium dioxide copings.

PURPOSE: The precision of a computer-aided design/manufacturing (CAD/CAM) system to manufacture zirconium dioxide copings with a predetermined internal space was investigated. MATERIALS AND METHODS: Two master models were produced in acrylic resin. One was directly scanned by the Decim Reader. The Decim Producer then manufactured 10 copings from prefabricated zirconium dioxide blocks. Five copings were prepared, aiming for an internal space to the master of 45 microm. The other five copings were prepared for an internal space of 90 microm. The second test model was used to try in the copings produced. The obtained internal space of the ceramic copings was evaluated by separate measurements of the master models and inner surfaces of the copings. The master models were measured at predetermined points with an optical instrument. The zirconium dioxide copings were measured with a contact instrument at the corresponding sites measured in the masters. RESULTS: The first group of copings had a mean internal space to the scanned master of 41 microm and of 53 microm to the try-in master. In general, the internal space along the axial walls of the masters was smaller than that along the occlusal walls. The second group had a mean internal space of 82 microm to the scanned master and of 90 microm to the try-in master. CONCLUSION: The aimed-for internal space of the copings was achieved by the manufacturer. The CAD/CAM technique tested provided high precision in the manufacture of zirconium dioxide copings.

Computer-Aided Design↗

Coping styles of mothers with disabled children at rural community rehabilitation centres in Muar, Malaysia.

Chronic disability in children imposes great strains on a family. The responsibility of mothering disabled children may be detrimental to the well-being of mothers. This study aims to assess the different types of coping styles of mothers with disabled children and its influencing factors. It is a cross-sectional study using Coping Inventory Stressful Situation (CISS) scale to determine the mothers' coping styles. A sample of 81 mothers with disabled children attending two rural Community Rehabilitation Centres, were included in the study. Overall, the mothers were using a mixture of coping strategies. However, they scored more in the task-oriented (mean T score = 52.88) and emotion-oriented (mean T score = 50.52) coping styles, while the other subscales of coping styles, namely avoidance, distraction and social diversion were below average (mean T score < 50). Divorced mothers (p=0.04) and those with low educational level (p=0.00) were more inclined to use emotion-oriented coping strategies while mothers with younger children (< 5 years old) used more avoidance coping strategies (p=0.01). There were no significant difference of coping styles in association with the mothers' age, ethnicity, duration of marriage, number of siblings, child's birth order or gender. By understanding the mothers' coping styles, health care workers would be able to educate the mothers with effective coping strategies and consequently reduce their psychological distress.

Adaptation, Psychological↗

A description of the nature and dynamics of coping following coronary artery bypass surgery.

The purpose of this study was to explore the nature and dynamics of coping following coronary artery bypass surgery (CABS). The coping strategies of 129 subjects recovering from (CABS) were assessed at 1 and 6 weeks following surgery using the Revised Ways of Coping Checklist. The most frequently used coping strategy was seeks social support, followed, in descending order of frequency, by problem focused coping and the emotion-focused coping strategies of blamed self, wishful thinking, and avoidance. There was an overall decrease in coping between 1 and 6 weeks following CABS. Seeks social support, blamed self, and wishful thinking coping were used significantly less frequently at 6 weeks than at 1 week following CABS. The decreases in problem focused and avoidance coping, however, were not statistically significant. This study provides insight into the process of coping following CABS and supports the need for development of nursing strategies to promote coping in this population.

Adaptation, Psychological↗

An empirical assessment of stress-coping styles in military pilots.

Although aircraft pilots are generally regarded as having superior stress-coping skills, there has been relatively little empirical research on how pilots cope with stress. New stress-coping models and measures for understanding and assessing these previously elusive processes greatly facilitate the empirical study of stress-coping styles. This study employed a new measure of stress-coping style, rationally developed from an integrative model of coping, to study stress-coping in U.S. Army pilots. Results indicated that the pilots preferred problem-focused stress-coping strategies oriented towards direct action to master stressful situations. Also, the pilots tended to deemphasize emotion-focused forms of coping with stress. Differences in stress-coping between pilots and samples of aircrewmen and non-rated military personnel suggest that this coping style reflects differences in psychological functioning independent from the pilots' adaptation to the aviation and military environment.

Adaptation, Psychological↗

Pain coping mechanisms in fibromyalgia: relationship to pain and functional outcomes.

OBJECTIVE: To evaluate the factor structure of the Coping Strategies Questionnaire (CSQ) in patients with fibromyalgia (FM) and to compare the factors derived from this measure, along with the active and passive pain coping scales of the Pain Management Inventory (PMI) in predicting pain, depression, quality of well being (QWB), and pain behavior concurrently and over time. METHODS: One hundred twenty-two patients with FM were recruited from medical clinics, the community, and support groups. Eligible patients completed a battery of self-report measures of pain and psychosocial functioning at baseline assessment before random assignment to a clinical trial. A subset of 69 patients who completed the clinical trial were readministered the same battery 3 mo later. Data were analyzed within the baseline period, and from the baseline period to posttreatment to evaluate the predictive effects of coping strategies on clinical outcomes. RESULTS: Principal components analysis of the CSQ revealed Coping Attempts (CA) and Pain Control and Rational Thinking (PCRT) factors, which have been found in other patient populations with chronic pain. Hierarchical multiple regression analyses revealed that high active coping and low PCRT contributed to higher concurrent pain, while low active coping and high passive coping were related to greater concurrent depression and pain behavior, respectively. Controlling for baseline scores on criterion measures, longitudinal multiple regression analyses demonstrated that high active coping and low PCRT scores contributed to greater pain, greater depression, and lower QWB at posttreatment, while low PCRT alone predicted greater pain behavior. CONCLUSION: The results show the import of the pain coping construct in FM and highlight the negative contribution of low perceived control over pain and high active coping to a range of pain outcomes. The findings on low perceived control converge with data on other chronic pain populations, while the role of active coping appears to be detrimental in FM, in contrast to its positive effects in patients with rheumatoid arthritis.

Adaptation, Psychological↗

Cognitive coping strategies of children with chronic illness.

Children with chronic illness need to adapt to more stresses than do healthy children. Research highlights the problems of children with chronic illnesses but not how they cope in response to the stress created by these problems. Cognitive appraisal of a stressor and of response options is an important aspect of coping. Our cross-sectional study investigated whether children with chronic illness used cognitive strategies for coping as often as did healthy children. One hundred seventy five children from summer camps with juvenile arthritis, asthma, or diabetes were compared with 145 healthy school children. Spontaneous responses to common painful and stressful events were categorized into coping or catastrophizing ideation. Data on anxiety, disease severity, and other sociodemographic variables were obtained. Coping strategies were reported by 64% of children with chronic illness and 63% of healthy children and varied significantly with age (p < .05) in both groups. Children with different chronic illnesses performed similarly except for a trend among children with severe juvenile rheumatoid arthritis who had higher rates of coping. For the individual stressful events, the rate of coping varied from 46% to 86%. The highest rates of coping responses were found with the child's recent personal stressful event where adolescents with chronic illness were twice as likely to offer more complex coping responses. More children with chronic illness than healthy children offered coping strategies in response to venipuncture (p < .001) but not to dental injection. Children with chronic illness report coping as their predominant strategy for adapting to common painful and stressful events.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

Coping with disfigurement/dysfunction and length of hospital stay after head and neck cancer surgery.

The purpose of this study is to determine if an individual's use of coping strategies prior to sustaining facial disfigurement/dysfunction is predictive of coping effectiveness after head and neck cancer surgery. The specific aims of the study are as follows: (1) describe the relationship between demographic data, preoperative coping strategies, severity of disfigurement/dysfunction, postoperative healing progress, and length of postoperative hospital stay; (2) describe the relationship between demographic data, preoperative coping strategies, and postoperative coping behaviors; (3) determine the relationship between postoperative coping behaviors and length of hospital stay. The Stress-Coping Model of Scott, Oberst and Dropkin (1980) provides the theoretical framework for this study. The sample consisted of 117 adults who were about to undergo head and neck cancer surgery associated with disfigurement/dysfunction. Zero-order correlations were computed among the variables, including preoperative use of coping strategies, degree of postoperative disfigurement/dysfunction, postoperative coping behaviors, postoperative complications, and length of hospital stay. Multiple regression analyses were conducted on the major outcome variables: length of stay and postoperative coping behaviors. Gender (female), preoperative radiation therapy, preoperative chemotherapy and postoperative problems were found to significantly increase length of stay. The 16 predictors in this study contributed to 56% of the variance in length of stay. Fifteen predictors accounted for 25% of the variance in postoperative coping.

Activities of Daily Living↗

[Influence of dispositional coping strategies on physical complaints and life satisfaction in the elderly].

Well-being and mental and physical health in old age are influenced in a significant way by the fact that it is possible to cope successfully with ongoing hazards, threats and problems. In recent years coping research has shown increasing interest in coping processes in the elderly. Most of the studies are focused on age-related differences in coping processes and on the issue of change or stability of coping in old age. However, the goal of our study was to examine the impact of dispositional coping strategies, conceptualized as consistent personality characteristics, on physical complaints and life satisfaction among the elderly. We recurred on the model of coping modes by Krohne, which postulates two statistically independent person-specific coping dimensions named "vigilance" and "cognitive avoidance". Based on this model it is possible to identify the "classical" coping styles of "sensitization" (high vigilance and low cognitive avoidance) and "repression" (low vigilance and high cognitive avoidance). In our study, including 766 subjects older than 60 years, we found a higher frequency of "repressors" than of "sensitizers". Results show that dispositional coping strategies are significant moderator variables of both physical complaints and life satisfaction: Older people who prefer a cognitive-avoidant coping strategy ("repressors") are more satisfied with their life and have less complaints than "sensitizers".

Adaptation, Psychological↗