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PubMed1997

Integration of coping and social support perspectives: implications for the study of adaptation to chronic diseases.

In this article, empirical studies dealing with the relationship between coping and social support are discussed in order to identify promising themes for research on adaptation to chronic diseases. Although only few studies deal with this issue explicitly, the review reveals that four ways to study the relationship between coping and social support can be distinguished: (a) seeking social support as a coping strategy; (b) social support as a coping resource; (c) social support as dependent on the way individual patients cope; and (d) coping by a social system. It is argued that all four ways of integrating coping and social support contribute to a better understanding of adaptation to chronic diseases. However, exploring the interrelatedness of both concepts by studying social support as a coping resource and social support as dependent on the patient's own coping behavior appear to be especially fruitful in the short term, as they: (a) provide a better insight in the social determinants of coping, and (b) may help to clarify the way social support affects health and well-being.

Adaptation, Psychological↗

PubMed1997

Pain coping and the pain experience during mammography: a preliminary study.

This study examined how pain coping efficacy and pain coping strategies were related to reports of pain during mammography. Subjects were 125 women over the age of 50 undergoing screening mammograms. Prior to their mammogram, all subjects completed the Coping Strategies Questionnaire (CSQ) to assess how they cope with day-to-day pain experiences. Ratings of pain during the mammogram were collected using a 6-point pain/discomfort scale, a 100-mm Visual Analog Scale, the adjective checklist of the McGill Pain Questionnaire, and the Brief Pain Inventory. Up to 93% of the women reported the mammogram examination was painful. On average, women rated the mammography pain in the low to moderate range. Considerable variability in pain ratings was found, however, with some women reporting severe pain and others reporting little or no pain. Correlational analyses were conducted to examine how coping efficacy (CSQ ratings of ability to decrease pain and ability to control pain) and coping strategies (CSQ pain coping strategy subscales) related to variations in pain report. There was a pattern for ratings of ability to decrease pain to be related to lower ratings of current mammography pain. Women who rated their ability to decrease pain as high reported lower average levels of mammography pain, lower ratings on the mammography pain/discomfort scale, and were much more likely to report having had lower levels of pain during their last mammogram. These findings suggest that women who rate their coping efficacy in decreasing day-to-day pain as low may be at higher risk for having a painful mammogram. Individual pain coping strategies were not generally correlated with pain ratings. Behavioral interventions (e.g., patient controlled breast compression) and cognitive therapy interventions (e.g., training in the use of calming self-statements or distraction techniques) designed to increase coping efficacy potentially could be useful in reducing pain in women who are at risk for pain during mammography.

Adaptation, Psychological↗

PubMed1998

The Pain Coping Questionnaire: preliminary validation.

A new measure of coping, the Pain Coping Questionnaire (PCQ), is presented and validated in two studies of children and adolescents. Factor analyses of data from healthy children and adolescents supported eight hypothesized subscales (information seeking, problem solving, seeking social support, positive self-statements, behavioral distraction, cognitive distraction, externalizing, internalizing/catastrophizing) and three higher-order scales (approach, problem-focused avoidance, emotion-focused avoidance). The subscales and higher-order scales were internally consistent. The pain coping scales were correlated in the expected directions with children's appraisals of pain controllability, self-rated coping effectiveness, emotional distress when in pain, and among high school students, pain thresholds and functional disability. The structure and internal consistency of the PCQ were replicated in a sample of children and adolescents experiencing recurrent pain (headache, arthritis), and their parents. Relations between child- and parent-ratings of children's coping were moderate (median r=0.34). Higher levels of emotion-focused avoidance were related to more emotional distress (both samples), less coping effectiveness (headache sample), and higher levels of pain (arthritis sample). Higher levels of approach coping were related to less disability (headache sample). Other relations between approach and distraction coping and the outcome variables were generally not significant. The PCQ is a promising instrument for assessing children's pain coping strategies. The items are simple and relatively few, making it useful for assessing coping across a wide age range. It can be administered to children as young as 8 years of age in approximately 15 min.

Adaptation, Psychological↗

PubMed1999

Some relationships between perceived control and women's reported coping strategies for menopausal hot flushes.

OBJECTIVES: This questionnaire study compared the patterns of reported coping strategies of women high and low in perceived control over hot flushes. METHOD: A volunteer sample of 38 women fully completed a postal questionnaire. Perceived control was measured by a standardised scale (Reynolds F. Maturitas 1997a;27:215-221) and respondents provided qualitative accounts of coping. RESULTS: Consonant with previous findings that higher perceived control is associated with lower distress, the data indicated that women high in self-rated perceived control tended to describe more numerous coping strategies to manage both the physical and socio-emotional discomfort of flush episodes. Preventive strategies were infrequently adopted in both groups. However, the links between distress, control and coping were complex and subject to several influences. Those feeling low in control tended to report rather more numerous flushes (although the differences did not quite reach significance). Also, qualitative analysis of coping strategies suggested that it is not always coping behaviour per se that differentiates more and less distressed women, but attitudes towards these behaviours. A coping strategy (such as wearing cotton fabrics) that seems satisfactory to one women may fundamentally challenge the body-image of another, increasing distress by making her feel drab and different from her pre-menopausal self. Also, women often make reference to situational influences on their coping choices. CONCLUSION: The data support further enquiries into the role of psychological interventions to enhance strategies for coping with hot flushes. Some relationships occur between perceived control and women's reported coping strategies for menopausal hot flushes.

Adaptation, Psychological↗

PubMed1998

Chronically ill children coping with repeated hospitalizations: their perceptions and suggested interventions.

This qualitative research study used grounded theory methodology to learn from chronically ill children who are repeatedly hospitalized how they cope and how they feel others can assist them to cope with their recurrent hospital experiences. Six hospitalized children, ages 10 to 13 years, with various chronic conditions participated in an audiotaped interview, completed a drawing and kept a journal. The subjects identified their perceived stressors of hospitalization; revealed their use of both cognitive and behavioral coping strategies; described how hospital personnel, family, and friends enhanced their coping; and illustrated the impact of the hospital environment on their coping process. From comparison of the data, it is theorized that chronically ill children who are repeatedly hospitalized become adept at identifying and implementing a repertoire of coping strategies, accessing family and friends as resources in the coping process, developing patterns of coping with their parents, and utilizing the hospital environment to promote coping. Their coping is enhanced by familiarity and knowledge and by the respect and patience of gentle, supportive, and competent health care professionals.

Adaptation, Psychological↗

PubMed2004

The role of anxiety level, coping styles, and cycle phase in menstrual distress.

Using three samples, researchers investigated the relation between various anxiety levels, coping strategy use, and menstrual cycle phase to menstrual distress. In Studies 1 and 2, women low in anxiety sensitivity used more acceptance coping strategies and women high in anxiety sensitivity reported using more maladaptive coping strategies. In Study 2, women with medium anxiety sensitivity reported similar coping strategies to women low in anxiety. Menstrual cycle phase did not differentially affect coping strategy use in women varying in anxiety sensitivity levels in Studies 1 and 2. In addition to depressed mood emerging as a significant predictor of premenstrual distress in these two studies for all participants, avoidance coping for women high in anxiety sensitivity and problem-focused coping for women low in anxiety sensitivity were also significant predictors of premenstrual distress. In Study 3, during the premenstrual phase, women with panic disorder, compared to controls, reported using more avoidance coping whereas controls reported used more active coping and seeking social support for emotional and instrumental reasons. Results are discussed within a continuity model from high anxiety sensitivity to anxiety disorder for maladaptive coping and menstrual distress.

Adaptation, Psychological↗

PubMed2003

Optimism, anxiety, and coping in parents of children hospitalized for spinal surgery.

Optimistic expectations about outcomes have significant implications for behaviors. Knowing the role that dispositional optimism plays in parents' anxiety and coping responses during their child's surgical experience is essential to aid professionals in bolstering parents' coping and providing support. Parental optimism, anxiety and coping, and whether optimism moderated (changed) the anxiety-coping relationship preoperatively and postoperatively were the factors evaluated in this study. Parents (N = 60) primarily white of middle and upper middle class, were administered the Life Orientation Test to assess optimism, Spielberger's State Anxiety Scale and the Ways of Coping Questionnaire. Parental anxiety decreased significantly from preoperative to postoperative levels but remained high, indicating that parents continue to be emotionally distressed during their child's recovery. Reappraising the situation more positively (positive reappraisal) was the most often used emotion-focused coping strategy and seeking social support was the most often used problem-focused coping strategy. The preoperative and postoperative anxiety-coping relationships also depended on parents' levels of optimism. The use of emotion-focused coping strategies was not effective for reducing anxiety in highly optimistic parents. Recommendations include continually assessing the parents' need for reassurance and support throughout the surgical experience. Professionals can bolster parental coping by stressing the benefits of surgery and encouraging parents to be actively involved in the child's care and progress.

Adaptation, Psychological↗

PubMed2002

Coping styles as correlates of health in high school students.

PURPOSE: To study a large, population-based sample of adolescents with the goal of expanding our knowledge base about the relationship of coping and health outcomes. METHOD: We examined 1769 nonclinical, high school students (48% girls, mean age 16 years, predominantly white) using one class period to establish a link between coping styles, health problems, and health risk behaviors. Instruments employed included the Coping Response Inventory - Youth form (abbreviated version) and the Juvenile Wellness and Health Survey. ANCOVAs were used to test the main effects of coping typology, gender, and their interaction on the five health domains. RESULTS: Findings were consistent with previous research and showed that approach coping correlated negatively with indicators of health problems and health risk behaviors, while avoidance coping correlated positively with these domains. The presence of both forms of coping mitigated the negative effects of avoidance coping. CONCLUSION: As early as mid-adolescence, habitual coping styles appear to be associated with significant health outcomes. In screening nonclinical samples the clinician can rely on habitual coping styles as indicators of potential health problems.

Adaptation, Psychological↗

PubMed2003

Mediating and moderating effects of stress perception and situation type on coping responses in women with disordered eating.

Effects of stress perception and situation type on coping behavior were assessed in undergraduate females. Women with high (n=28) and low (n=28) Eating Attitudes Test (EAT) scores listened to audiotaped scenes representing two different situation types and two levels of stress. As predicted, the High EAT group rated scenes as more stressful and endorsed more of the maladaptive emotion-oriented coping, compared to the low EAT condition. Importantly, analyses revealed that stress perception mediated the relationship between group membership and emotion-oriented coping. Scene type appeared to moderate the effect of group on emotion-oriented coping. However, stress perception was shown to mediate, or account for, the moderating effect of situation type; a relationship termed mediated moderation. So although the two groups appeared to differ in the effect of situation type on coping, this apparent interaction effect can be attributed to differences in their perception of stress. Finally, women with High EAT scores did not exhibit a deficit in the more productive task-oriented coping behaviors, nor did they exhibit an avoidant coping style. In sum, the maladaptive coping used by women with disordered eating may represent characteristic emotional responses to exaggerated perceptions of stress and a preoccupation with issues specific to body image and food, rather than deficits in productive coping skills or an avoidant coping style.

Journal Article↗

PubMed2006

Stress and coping with advanced cancer.

OBJECTIVE: For people with advanced cancer, the months preceding death can be very stressful. Moreover, cancer-related stressors can arise within multiple dimensions. However, little research has examined how people cope differentially with different types of stressors. The goal of this study was to examine patterns of coping across different dimensions of stress. METHOD: Fifty-two patients who were receiving palliative care for cancer were asked to indicate their most significant stressors within social, physical, and existential dimensions. A structured interview was then conducted to describe how the participants coped with these stressors. RESULTS: Overall, stressor severity ratings were correlated significantly across the three dimensions, although physical symptoms received the highest mean rating. Participants generally used a range of coping strategies to deal with their stressors, but there were clear differences across dimensions in the relative use of problem-focused versus emotion-focused strategies. Problem-focused coping was less frequent for existential issues, whereas emotion-focused strategies were used less frequently for physical stressors. Coping efforts were not clearly related to psychological distress. SIGNIFICANCE OF RESULTS: Although coping is an important research theme within psycho-oncology, it may be overly broad to ask, "How do people cope with cancer"? In fact, different cancer-related stressors are coped with in very different ways. There is not necessarily any particular pattern of coping that is best for relieving psychological distress.

Adaptation, Psychological↗

PubMed2001

Personality and coping with a common stressor: cardiac catheterization.

The association between coping and personality was examined in a sample of 204 cardiac catheterization patients who were asked to evaluate the use of specific coping strategies used to deal with their cardiac catheterization. Personality, as measured by the NEO Five-Factor Inventory (FFI), was moderately correlated with coping measures. In multivariate analyses, after considering confounding factors, Neuroticism was positively and Extraversion was negatively related to avoidance coping and Neuroticism was negatively associated with counting one's blessings as a coping strategy. Personality was not related to either problem solving or seeking social support coping strategies for individuals experiencing a cardiac catheterization. However, important covariates were associated with coping strategies. Not being married was negatively correlated with use of seeking social support and not having a confidant was negatively related with seeking social support and positively with avoidance. These results suggest that there are specific relationships between personality and coping, but these relationships are, for the most part, moderate in persons coping with a cardiac catheterization, and that coping processes are associated with individual differences in available social resources.

Adaptation, Psychological↗

PubMed2003

Quality of life and coping with schizophrenia symptoms.

The question addressed in this paper is whether different coping styles mediate the relationship between psychopathology and related distress and the quality of life (QOL) among patients with schizophrenia. In a cross-sectional design, 161 schizophrenia inpatients were comprehensively evaluated with standardized measures of QOL, psychopathology, psychological distress and coping styles. Correlations and regression analyses were performed to examine the relationship among parameters and to estimate the mediating effect of coping styles on QOL in the framework of a distress/protection model. Life quality correlated positively with task- and avoidance-oriented coping styles and slightly negatively with emotion-oriented coping. Emotion-oriented coping mediated the relationship between the severity of activation, anxiety/depression symptoms, and QOL, while avoidance-oriented (distraction) coping was mediated between QOL and paranoid symptoms. Coping styles accounted for 25% of the variance in subjective QOL scores compared with 15% for psychological distress, and only 3% for clinical variables. The ability to cope with symptoms and associated distress substantially contributes to QOL appraisal in schizophrenia. Thus, different coping strategies may reduce the negative influence of specific symptoms and related distress on the subjective QOL of schizophrenia patients.

Adaptation, Psychological↗

PubMed2002

Coping and its correlates among caregivers of patients with bipolar disorder: a preliminary study.

OBJECTIVES: In contrast to schizophrenia, coping patterns of caregivers of bipolar patients have not received much attention. Previous evidence suggests that demographic factors, illness variables, caregiver burden, appraisal, etc can significantly influence coping styles. This study thus attempted to examine coping and its correlates in caregivers of bipolar patients, in comparison with schizophrenia. METHOD: Structured assessments of dysfunction, burden, appraisal, social support available, and coping styles were carried out in caregivers of 38 bipolar patients and 20 patients with schizophrenia (ICD - 10 diagnoses). RESULTS: Caregivers used a wide variety of coping strategies, both problem and emotion-focused. In bipolar disorder, demographic parameters, illness duration, levels of dysfunction, burden and social support, and appraisal by caregivers demonstrated significant associations with coping styles of caregivers. Problem-focused coping strategies were more common in caregivers of bipolar patients and emotion-focused strategies in caregivers of schizophrenic patients. These differences appeared to be linked to differences in caregiver-burden and appraisal between the two groups. CONCLUSIONS: Appraisal by, and burden on caregivers play a major role in determining their style of coping. These factors largely accounted for the differences in coping observed between caregivers of patients of bipolar disorder and schizophrenia, in this study. Reducing burden on caregivers and enhancing their awareness of illness could lead to adoption of more adaptive coping styles by them.

Adaptation, Psychological↗

PubMed1985

If it changes it must be a process: study of emotion and coping during three stages of a college examination.

This natural experiment provides substantial evidence for the following major themes, which are based on a cognitively oriented, process-centered theory of stress and coping: First, a stressful encounter should be viewed as a dynamic, unfolding process, not as a static, unitary event. Emotion and coping (including the use of social support) were assessed at three stages of a midterm examination: the anticipation stage before the exam, the waiting stage after the exam and before grades were announced, and after grades were posted. For the group as a whole there were significant changes in emotions and coping (including the use of social support) across the three stages. Second, people experience seemingly contradictory emotions and states of mind during every stage of an encounter. In this study, for example, subjects experienced both threat emotions and challege emotions. The complexity of emotions and their cognitive appraisals reflects ambiguity regarding the multifaceted nature of the exam and its meanings, especially during the anticipation stage. Third, coping is a complex process. On the average, subjects used combinations of most of the available forms of problem-focused coping and emotion-focused coping at every stage of the exam. Different forms of coping were salient during the anticipation and waiting stages. Problem-focused coping and emphasizing the positive were more prominent during the former, and distancing more prominent during the latter. Finally, despite normatively shared emotional reactions at each stage, substantial individual differences remained. Using selected appraisal and coping variables, and taking grade point averages (GPA) into account, approximately 48% of the variances in threat and challenge emotions at the anticipation stage was explained. Controlling for variance due to the grade received, appraisal, and coping variables accounted for 28% of the variance in positive and negative emotions at the outcome stage. Including grade, 57% of the variance in positive emotions at outcome and 61% of the negative emotions at outcome were explained.

Adaptation, Psychological↗

PubMed1987

Personal and contextual determinants of coping strategies.

This study examined personal and contextual predictors of active and avoidance coping strategies in a community sample of over 400 adults and in a sample of over 400 persons entering psychiatric treatment for unipolar depression. Sociodemographic factors of education and income (except for active-cognitive coping), personality dispositions of self-confidence and an easy-going manner, and contextual factors of negative life events and family support each made a significant incremental contribution to predicting active and avoidance coping. Among both healthy adults and patients, active and avoidance coping were positively associated with negative life events. Individuals who had more personal and environmental resources were more likely to rely on active coping and less likely to use avoidance coping. Moreover, for both groups, most of the predictors continued to show significant relations with active and avoidance coping strategies even after the stable component in coping was controlled in a longitudinal design. A comprehensive framework to understand the determinants of coping can be of practical value in suggesting points for therapeutic interventions aimed at fostering more adaptive coping efforts.

Adaptation, Psychological↗

PubMed1989

Assessing coping strategies: a theoretically based approach.

We developed a multidimensional coping inventory to assess the different ways in which people respond to stress. Five scales (of four items each) measure conceptually distinct aspects of problem-focused coping (active coping, planning, suppression of competing activities, restraint coping, seeking of instrumental social support); five scales measure aspects of what might be viewed as emotional-focused coping (seeking of emotional social support, positive reinterpretation, acceptance, denial, turning to religion); and three scales measure coping responses that arguably are less useful (focus on and venting of emotions, behavioral disengagement, mental disengagement). Study 1 reports the development of scale items. Study 2 reports correlations between the various coping scales and several theoretically relevant personality measures in an effort to provide preliminary information about the inventory's convergent and discriminant validity. Study 3 uses the inventory to assess coping responses among a group of undergraduates who were attempting to cope with a specific stressful episode. This study also allowed an initial examination of associations between dispositional and situational coping tendencies.

Adaptation, Psychological↗

PubMed1994

Determinants of coping: the role of stable and situational factors.

A longitudinal study of 243 students was conducted to examine the stable and situational influences on coping. At Time 1, measures of coping in response to a recent event (initial coping) and coping resources were obtained. At Time 2 (4 weeks later), Ss described an event (coded for event type) they were currently experiencing. Situational appraisals were also assessed. At Time 3 (2 weeks later), Ss' coping responses to the event were assessed. There was evidence that stable factors did influence coping behavior. Coping resources accounted for a significant proportion of variance in each of the measures of coping (except cautiousness), as did initial coping. There was evidence that the latter effects were dependent on cross-situational consistency in event type and levels of stress. After controlling for the stable influences, situational factors (situation type and situational appraisals) influenced the type of coping used.

Adaptation, Psychological↗

PubMed1994

Assessment of coping with muscular dystrophy: a methodological evaluation.

There is no published research on coping with muscular dystrophy among adults. In the present study, two questionnaires, the Reaction to the Diagnosis of Cancer Questionnaire (RDCQ) and the Mental Adjustment to Cancer scale (MAC), were modified in order to measure coping with muscular dystrophy (MD). A total of 60 people (16-64 years) with diagnosed MD answered the questionnaires in two interviews including semi-structured questions. The replies to these questions were analysed by two independent judges on the basis of the RDCQ and MAC categories for coping. The purpose was twofold: to investigate if cancer-coping categories could be used for the classification of interview answers concerning coping with MD, and to gain knowledge about specific coping with MD. Analysis indicated that 82% of replies to semi-structured questions concerned with emotion/appraisal-focused coping with MD can be described by means of RDCQ and MAC categories. Eight new categories were developed to classify the remaining 18%: Anticipation, Creation of new life values, Minimization, Establishment of control over everyday life, Secretiveness, Fear, Social comparison and Coping with heredity. In addition, 997 replies were classified to represent problem-focused coping. The judges reached good agreement with respect to the proportions of replies in the respective coping categories. However, kappa (kappa) values were within the range of fair to good agreement.

Adaptation, Psychological↗