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PubMed2001

Coping with chronic pain: a comparison of two measures.

Cognitive-behavioral models of chronic pain hypothesize that how a person copes with pain influences how well he or she adjusts to the pain. Several measures have been developed to assess pain coping, but no studies have yet examined whether these measures are complementary or redundant. In the current study, two pain coping measures (the Chronic Pain Coping Inventory, CPCI, and the Coping Strategies Questionnaire, CSQ) were completed by a large number (N=564) of primarily male veterans referred to a chronic pain program. Regression analyses indicated that the CPCI scales did not contribute unique variance to the prediction of depression over and above the CSQ scales. The CSQ Catastrophizing scale was the single most powerful predictor of depression, although several other CSQ scales (Coping Self-Statements, Diverting Attention, and Increasing Behavioral Activities) also contributed. Both the CPCI and the CSQ contributed unique variance to the prediction of disability, although the CPCI scales appear to be more strongly related to disability than the CSQ scales. The CPCI Guarding scale was the single most powerful predictor of disability of all the coping responses assessed in this study. Other scales predicting disability were the CPCI Seeking Social Support, the CSQ Catastrophizing, and the CSQ Increasing Behavioral Activities. While both CSQ and CPCI contribute unique but modest variance to the prediction of pain severity, the CSQ Catastrophizing scale was the single most powerful predictor of pain severity. The findings of this study are consistent with cognitive-behavioral models of pain. Future research will need to determine whether changes in coping responses (catastrophizing and guarding, in particular) merely reflect, or actually influence, adjustment to chronic pain. In the meantime, clinicians would be wise to give these coping responses particular attention in chronic pain programs.

Adaptation, Psychological↗

PubMed2003

Comparison of fears and coping strategies reported by Nepalese school-age children and their parents.

This study explored the self-reported fears and coping strategies of Nepalese school-age children and their parents' perceptions of their children's fears and coping strategies. Seventy-nine healthy school-age children attending a private school in Nepal and 48 parents participated in the study. The scores on the Child Medical Fear Scale (CMFS) indicated that children had moderate levels of fear. On the Schoolagers' Coping Strategies Inventory (SCSI), children reported using coping strategies less frequently and found them less effective than those reported by their parents. No significant correlations were found between fear scores and coping strategies. Significant differences were found between level of fears reported by school-age children and parents. No significant difference was found between children's and parent's report of children's coping strategies. However, a significant difference was found between effectiveness of coping strategies reported by children and parents. Nurses need to gather information from children, as well as from parents, about fears and coping strategies. Nursing intervention should be culturally sensitive with an awareness of cultural influences impacting how children perceive fears and cope with their fears.

Adaptation, Psychological↗

PubMed2003

Coping as a mediator of psychosocial impediments to optimal management and control of asthma.

Adherence to asthma medication regimens by asthma patients is often poor and contributes to the continued and substantial burden of asthma in the community. There is evidence of increased rates of behavioural problems, anxiety and depression in people with moderate-to-severe asthma and these factors may interfere with adherence and contribute to poor asthma control. An alternative explanation is that the relationship between feelings of anxiety and depression, and adherence to the treatment regimen may be more accurately predicted from the coping styles used, rather than the experience of asthma itself. The objective of this paper was to review evidence for associations between coping strategies used by asthma patients, asthma management and health outcomes. The Medline and PsychInfo databases were searched for articles containing the terms "asthma" and "coping". Patients with asthma tended to use different strategies for coping with stress and illness compared to healthy participants and individuals with other chronic illnesses. Emotion-focussed coping strategies such as denial were commonly used by patients with poor medication adherence, those who attended emergency departments for asthma, were admitted to hospital for asthma, or suffered near-fatal asthma attacks. Interventions to improve coping strategies have been effective in reducing symptoms and psychological distress. The availability of coping resources to patients and/or their caregivers and the coping strategies that are used are likely to mediate the influence of psychosocial factors on the management of asthma. Further studies exploring the ways in which individuals cope with asthma will improve our understanding of the mechanisms linking psychological and social status to asthma morbidity and mortality.

Adaptation, Psychological↗

PubMed1998

Anxiety and coping in patients with chronic work-related muscular pain and patients with fibromyalgia.

The aims of this study were: (1) to compare two groups of patients with chronic pain conditions (work-related muscular pain, mainly low back pain, and fibromyalgia) in general coping and pain-specific coping; (2) to examine the relationship between general and pain-specific coping and, (3) to examine the influence of state-trait anxiety on general and pain-specific coping. The sample included 80 individuals (range=19-70 years; mean=47; SD=9.9), who were patients at two pain management clinics for examination of their physical and psychosocial health conditions and consideration on disability pension. The patients were asked to respond to theStrategies to Handle Stress Questionnaire, theCoping Strategies Questionnaireand theState-Trait Anxiety Inventory. Patients with fibromyalgia scored significantly higher on T-anxiety and adopted < > (p<0.01) and < > (p<0.05) less often and < > more often (p<0.01) than patients with work-related muscular pain in coping with stressful situations in general. No differences were revealed in pain-related coping between the groups. T-anxiety was positively correlated to pain-related < > (p<0.001) and negatively to abilities to control and reduce pain (p<0.05 andp<0.01, respectively). The correlation between general and pain-specific coping was weak to moderate. In conclusion, patients with fibromyalgia scored significantly higher on trait-anxiety and seem to interpret stressful situations as more threatening than patients with work-related muscular pain. Anxiety seems to be of central importance for coping with chronic pain. Anxiety-prone patients with fibromyalgia might benefit from psychological support in the process of coping with pain. Copyright 1998 The British Infection Society. All rights reserved.

Journal Article↗

PubMed2000

A comparison of depression and styles of coping in male and female GA members and controls.

Depression and maladaptive coping styles are important components of theories of pathological gambling and are frequently foci of treatment with individuals with gambling problems. The present study aimed to improve understanding and treatment of pathological gambling by comparing levels of depression and styles of coping in male and female members of Gamblers Anonymous (GA) to a group of non-pathological gambling controls matched according to gender, age, education, and income. Pathological gambling was measured by the South Oaks Gambling Scale, depression by the Beck Depression Inventory, and coping styles by the Problem-Focused Styles of Coping inventory. Results showed that GA members reported significantly higher levels of depression and more maladaptive styles of coping than controls. Pathological gamblers' greater use of maladaptive coping was evident even when variance attributable to depression was removed, suggesting that their coping deficits may be pervasive. Female subjects reported significantly greater levels of depression and maladaptive coping than their male counterparts. Implications for treating depression and coping styles in pathological gamblers are discussed.

Journal Article↗

PubMed1998

Coping with chronic pain: sources of intrinsic and contextual variability.

Univariate and multivariate analyses were used to investigate intrinsic and contextual sources of coping variability among 90 patients with chronic pain. Pain coping strategies were assessed by the subscales of the Coping Strategies Questionnaire. Intrinsic variables included demographic characteristics and dispositional optimism. Contextual variables included pain-related variables and pain control appraisals. In univariate analyses, ethnicity was a statistically significant intrinsic source of variability for the praying and hoping coping subscale; however, comparisons between pairs of ethnic groups were not statistically significant. A multivariate perspective of the data found three independent and salient patterns of correlation between the intrinsic and contextual variables and coping subscales. These patterns of correlation accounted for 96% of the total variance and were conceptualized as optimistic active coping, educated rational coping, and optimistic restricted coping. The findings raise the prospect that there are intrinsic and contextual explanations of coping variability for patients with chronic pain.

Adaptation, Psychological↗

PubMed2004

Coping strategies and quality of life of adolescents with inflammatory bowel disease.

OBJECTIVE: This study aims to compare generic coping styles adopted by adolescents suffering from inflammatory bowel disease (IBD) to styles used by their healthy peers, and to assess the association between coping styles and health-related quality of life (HRQoL). METHODS: A generic coping style instrument, a disease-related coping style instrument and a disease-specific HRQoL instrument were administered to 65 adolescents (12-18 years old) with IBD. Normative data from the generic instrument were available. Mean domain scores of IBD patients were compared to normative scores. Multivariate linear regression analyses were performed on models with HRQoL domains as dependent, and preselected demographic and disease-related characteristics and coping styles as independent variables. RESULTS: Adolescents with IBD use more avoidant coping styles than their healthy peers. HRQoL is associated with disease-related coping styles and with disease activity. More use of a predictive coping style (having positive expectations about the disease) and less use of a depressive reaction pattern are associated with better HRQoL in three out of six HRQoL domains. CONCLUSION: This study suggests an association between coping styles and HRQoL.

Adaptation, Psychological↗

PubMed2001

MACS-II: does coping enhance subjective control over psychotic symptoms?

OBJECTIVE: Associations between subjective experience of control and the use of self-initiated coping strategies were examined in patients with psychotic symptoms. METHOD: Twenty-three patients were interviewed to assess (i) the subjective experience of distress with and control over symptoms and (ii) the coping strategies used. RESULTS: There was a positive association between coping type and control (OR = 1.07, 95% CI: 1.03-1.12). Active coping strategies had the strongest association with experience of control (active problem-solving: OR = 1.41 95% CI: 1.18-1.68; active problem-avoiding: OR = 1.45 95% CI: 1.18-1.68). Symptomatic coping was negatively associated with control (OR = 0.40, 95% CI: 0.30-0.55), but was the most frequently used strategy. Depressive symptoms were associated with the highest number of coping strategies. CONCLUSION: Coping strategies differ in the degree and direction of associated subjective control, and symptoms differ in the degree with which coping is mobilized. Assessment of coping strategies may be useful as a prelude to psychological therapy.

Adaptation, Psychological↗

PubMed1985

Attributions, expectations, and coping with abortion.

We examined cognitive predictors of coping with a negative life event. Women undergoing first-trimester abortion were, before the procedure, surveyed regarding their attributions for their pregnancy, expectations for coping, the meaningfulness of the pregnancy, and the degree to which the pregnancy was intended. After the abortion and again at a follow-up visit, we assessed affective state, physical complaints, anticipated negative consequences, and depression. As predicted, women who blamed their pregnancy on their character coped less well than low self-character blamers, but contrary to predictions, self-behavior blame was unrelated to coping. Women who had high coping expectations before the abortion coped much better than those with low coping expectations. Women who found their pregnancy highly meaningful, however, coped worse immediately after the abortion than did women who found their pregnancy less meaningful. Intentionality of the pregnancy was related to depression three weeks after the abortion, and women accompanied by their partner to the abortion clinic coped less well immediately after the abortion than women unaccompanied by their partner.

Abortion, Induced↗

PubMed1986

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

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

Adaptation, Psychological↗

PubMed1991

Coping success and its relationship to psychological distress for older adults.

The role of coping success on psychosocial distress was investigated in 147 older adults who experienced a major health problem and 82 older adults who reported a major loss in the past 6 months. Home interviews provided data on satisfaction with coping efforts and negative changes associated with events. Significant predictors of coping success were identified and controlled for in subsequent analyses predicting mental health. Efficacy in coping with loss was associated with less psychological distress. Coping efficacy interacted with coping efforts in predicting distress for those with health downturns; efficacy in coping was associated with less distress only for those who were actively engaged in coping. Analyses of longitudinal data replicated the cross-sectional findings for coping with loss.

Activities of Daily Living↗

PubMed1986

Stress and coping in early adolescence: relationships to substance use in urban school samples.

Measures of stress and coping were obtained from two cohorts of urban adolescents during the seventh- to eighth-grade period and were related to indices of cigarette smoking and alcohol use. Predictions were derived from a stress coping model of substance use. Stress was indexed by measures of subjective stress, recent events, and major life events; coping was assessed by behavior-based and intention-based methods. Concurrent and prospective analyses were consistent with predictions, indicating that stress was positively related to substance use, and four coping mechanisms (behavioral coping, cognitive coping, adult social support, and relaxation) were inversely related to substance use. Two types of predicted interactions, Stress X Coping and Positive X Negative Events, were found. Measures indexing peer support, distraction coping, and aggressive coping were positively related to substance use, independent of other predictors. Implications for substance use theory and prevention research are discussed.

Adaptation, Psychological↗

PubMed2004

En las manos de Dios [in God's hands]: Religious and other forms of coping among Latinos with arthritis.

This study tested a theoretical model concerning religious, passive, and active coping; pain; and psychological adjustment among a sample of 200 Latinos with arthritis. Respondents reported using high levels of religious coping. A path analysis indicated that religious coping was correlated with active but not with passive coping. Religious coping was directly related to psychological well-being. Passive coping was associated with greater pain and worse adjustment. The effects of active coping on pain, depression, and psychological well-being were entirely indirect, mediated by acceptance of illness and self-efficacy. These findings warrant more research on the mechanisms that mediate the relationship between coping and health. This study contributes to a growing literature on religious coping among people with chronic illness, as well as contributing to a historically under-studied ethnic group.

Adaptation, Psychological↗

PubMed2005

Testing a model of pain appraisal and coping in children with chronic abdominal pain.

This prospective study of children with recurrent abdominal pain (N=133; ages 8--15 years) used path analysis to examine relations among dispositional pain beliefs and coping styles, cognitions and behavior related to a specific pain episode, and short- and long-term outcomes. Children believing they could not reduce or accept pain appraised their episode-specific coping ability as low and reported passive coping behavior. Dispositional passive coping had direct effects on both episode-specific passive coping and long-term symptoms and disability. Accommodative coping (acceptance and self-encouragement) was associated with reduced episode-specific distress, which itself predicted reduced depressive symptoms 3 months later. Results suggest that coping-skill interventions for children with chronic pain should target reductions in passive coping and consider the potential benefits of accommodative coping strategies.

Abdominal Pain↗

PubMed2006

The role of illness uncertainty on coping with fibromyalgia symptoms.

This study examined the role of illness uncertainty in pain coping among women with fibromyalgia (FM), a chronic pain condition of unknown origin. Fifty-one FM participants completed initial demographic and illness uncertainty questionnaires and underwent 10-12 weekly interviews regarding pain, coping difficulty, and coping efficacy. Main outcome measures included weekly levels of difficulty coping with FM symptoms and coping efficacy. Multilevel analyses indicated that pain elevations for those high in illness uncertainty predicted increases in coping difficulty. Furthermore, when participants had more difficulty coping, they reported lower levels of coping efficacy. Results were consistent with hypothesized effects. Illness uncertainty accompanied by episodic pain negatively influenced coping efficacy, an important resource in adaptation to FM.

Adaptation, Psychological↗

PubMed1999

Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem.

OBJECTIVE: To create inventories of stigmatizing situations faced by obese people and ways of coping with stigmatization, and to examine how stigma and coping are related to psychological distress in an obese patient population. DESIGN: Study 1: Items were generated by asking obese people to list stigmatizing situations they had encountered and their ways of coping. Study 2: Obese patients were surveyed about the frequency with which they encountered each form of stigmatization and employed each form of coping. Cross-sectional data on current psychological adjustment were obtained. SUBJECTS: Study 1: 63 obese patients (body mass index, BMI > 40 kg/m2); 38 obese non-patients, seven professionals who work with obese patients and 32 obese female authors from the print media. Study 2: 112 gastric bypass patients (BMI 33.9-80.9 kg/m2) and 34 less obese patients (BMI 27.1-57.2 kg/m2). MEASUREMENT: Study 1: Collection of stigmatizing situations and coping responses. Study 2: Frequency of stigmatizing experiences and coping responses, psychological symptoms, body image, and self esteem measures. RESULTS: Study 1 resulted in two objective questionnaires, consisting of 50 situations and 99 responses. Study 2 found that stigmatization is a common experience, and that obese subjects frequently engage in some effort to cope with stigma. More frequent exposure to stigmatization was associated with greater psychological distress, more attempts to cope, and more severe obesity. Certain coping strategies are associated with greater distress.

Adaptation, Psychological↗

PubMed2003

Coping with chronic disease from the perspective of children and adolescents--a conceptual framework and its implications for participation.

In medical and health psychology, efforts have increasingly been made to assess coping of children and adolescents with chronic conditions. In contrast to the study of coping in adults, approaches to define and assess adaptational processes in children pose a number of problems because coping and development are inherently connected with each other. Issues arising when applying theoretical concepts from developmental psychology to the area of coping in children and adolescents are highlighted. The most prominent approaches to conceptualize and assess coping with chronic disease in childhood and adolescence are illustrated. In future research, there is a need to focus the situational context and content of coping rather than to assess the effort employed and level of a particular coping strategy. Coping is not only a way of regulating emotions, but has an interpersonal meaning, depending on its interactional context. In the medical field, coping has a mediating function for participation and shared medical decision-making in health care processes.

Adaptation, Psychological↗

PubMed1999

Strategies for coping with labour: does antenatal education translate into practice?

There is little evidence to associate attendance at antenatal classes with a reduction in psychological distress or increased satisfaction with the experience of labour. There may be several reasons for this, including failure to implement coping strategies. A within-subjects research design explored the use in labour of coping strategies taught in antenatal classes and the role of practice. Women's views about using these strategies and their expectations of their midwives and birth companions were also identified. Following Ethics Committee approval and providing informed consent, 121 nulliparous women completed a questionnaire at their final antenatal class. This included questions on confidence and the amount of effort required to use coping strategies, the involvement hoped for from birth companions and midwives in using coping strategies in labour and satisfaction with the amount of practice of coping strategies. Within 72 hours of delivery, women were interviewed to obtain a narrative of the events of labour and their use of the coping strategies (sighing-out-slowly breathing, Laura Mitchell relaxation and postural change). A questionnaire obtained information on the involvement of the midwife and birth companion. Women used the three coping strategies to different extents. Midwives were not involved to the extent that women had hoped for antenatally. Birth companions achieved a level of involvement closer to women's hopes than that achieved by midwives. A significant proportion of women expressed dissatisfaction with the amount of practice of coping strategies during antenatal classes. The findings of this study of a group of well-prepared women raise questions about the correct components of antenatal classes and how midwives and birth companions can be involved optimally in this aspect of a woman's labour. Further research is required to determine how women can best be helped to cope with the experience of labour.

Adaptation, Psychological↗