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PubMed1998

The relationships of cognitive coping and pain control beliefs to pain and adjustment among African-American and Caucasian women with rheumatoid arthritis.

OBJECTIVE: Ethnic groups may experience or report pain differently; thus, we compared ethnic differences on pain coping strategies and control beliefs, and the relationships of these variables to health status, among women with rheumatoid arthritis (RA). METHODS: Using a sample of 100 women (48 African-American, 52 Caucasian), we related pain coping strategies and control beliefs to pain severity, activity levels, and affective state, controlling for socioeconomics, behavioral impairment, and disease activity. RESULTS: Ethnic groups did not differ in pain severity or negative affect, but African-Americans were less physically active. African-Americans used more coping techniques involving diverting attention and praying/hoping; Caucasians used more coping techniques involving ignoring pain. The relationships of praying/hoping and reinterpreting pain to RA adjustment differed by ethnic group. In contrast, ignoring pain, coping statements, and stronger control beliefs predicted better health status, and diverting attention predicted more pain for all patients. CONCLUSION: There are ethnic differences in the use of coping strategies that should be acknowledged when helping RA patients cope with their disease, but control beliefs and several coping strategies predict pain and adjustment, regardless of ethnicity.

Adaptation, Psychological↗

PubMed2006

Coping and quality of life among women extensively treated for gynecologic cancer.

The current study examined the use of engagement and avoidant coping strategies among advanced-stage gynecologic cancer patients who were facing the long-term stressors of extensive chemotherapy and advanced disease. Patients were compared to a reference group of early-stage patients who had received more limited treatment. Compared to the reference group, extensively-treated women more frequently utilized both engagement and avoidant strategies including active coping, seeking social support, and mental disengagement. Use of engagement coping strategies such as active coping and seeking social support were not significantly related to quality of life or mood. However, avoidant coping strategies, including disengagement and cognitive avoidance, were strongly associated with poorer well-being and more distressed mood. Moreover, relationships between coping and quality of life differed between the extensively-treated patients and patients in the limited treatment reference group. The use of avoidance and seeking instrumental support were associated with poorer outcomes among extensively-treated patients but not among the limited treatment group. Results of the current study suggest that coping patterns and outcomes may be more pronounced among cancer patients contending with severe disease and extensive treatment and that avoidant coping strategies may be particularly detrimental with respect to these patients' mood and quality of life.

Adaptation, Psychological↗

PubMed1988

Coping and defending styles among Vietnam combat veterans seeking treatment for posttraumatic stress disorder and substance use disorder.

A review of the literature on coping processes in addiction disorders yields at least two notions: one, that substance abuse is associated with less efficient, avoidant ways of coping with problems in living; and two, that substance abusers with a background of traumatic and stressful experiences are readily distinguishable by even more avoidant coping styles. These notions were tested in the form of three hypotheses: (1) substance abusers in general employ more avoidant coping styles than do nonaddicted groups; (2) Vietnam combat veterans meeting DSM-III criteria for both substance use disorder and posttraumatic stress disorder (PTSD) evidence significantly more avoidant coping styles than do Vietnam combat veterans meeting criteria only for substance use disorder but not PTSD--particularly when dealing with internal states of anxiety; and (3) for those meeting both substance use disorder and PTSD criteria, black Vietnam combat veterans (who presumably have encountered more stress, as minority group members) evidence more avoidant coping styles than do white Vietnam combat veterans. These three hypotheses were tested with Peck's (1981) newly developed Individual Styles of Coping, measuring four stages in the coping process for five behavioral contexts. All three hypotheses were confirmed. Results were discussed as confirming recent changes in DSM-III-Revised (1987) criteria, emphasizing generalized avoidance manuevers as criterial, in part, for diagnosing PTSD (in addition to behaviors of specific avoidance of traumatic memories). Theoretical implications about a traumatogenic dimension for substance abuse among some Vietnam combat veterans were discussed, as well as ramifications for treatment programming.

Adult↗

PubMed1992

Coping processes as mediators of the relationship between hardiness and health.

Hardiness has been hypothesized to moderate the impact of stress on health by influencing coping responses, but little attention has been focused upon these associations. This study examined the relationship among hardiness, coping, and illness while attending to recent criticisms of the hardiness literature including the potential overlap with neuroticism, whether hardiness is a unitary construct, and the predominant use of male samples. Hardiness was found to be positively related to adaptive coping variables and negatively related to maladaptive coping variables. Problem-focused, support-seeking, and avoidant coping were found to mediate the hardiness-illness relationship. Although these hardiness-coping relationships were partially independent of the influence of neuroticism, the relationship of both coping and hardiness with self-reported illness appeared to result from the common influence of neuroticism. Consistent with previous research, the commitment and control components correlated most consistently with coping variables, and predicted hardiness effects were most consistently demonstrated for males.

Adaptation, Psychological↗

PubMed2003

[Coping strategies in laryngectomy patients].

BACKGROUND: Over the last few years, paradigms for judging the results of treatment of tumor patients have shifted. In addition to characteristics such as the complete excision of the tumor and the duration of patient survival, restoring the quality of life has become an equally important aim. There is still a lack of systematic (and sufficient) research on coping strategies as a means of dealing with malignant tumors of the head and neck. PATIENTS AND METHOD: In a cross-sectional study, 25 laryngectomees, whose voices had been successfully restored with a Provox voice prosthesis,were examined for their coping strategies and the effects of the illness on their lives. The standardized Trier Scales of Coping Strategies and a custom-made questionnaire, which helped to structure the anamnesis of disease specific functional restrictions and the state of rehabilitation, were used as the means of inquiry. RESULTS: A high percentage of patients were content despite objective and subjective restrictions. Voice replacement was mainly experienced as unproblematic,with psychosocial restraints more commonly being felt in connection with pain and difficulties ingesting food. A correlation between the patients' evaluation of physical,psychological and social experiences and the coping strategies applied could not be verified. The way laryngectomees deal with their illness does not differ from the strategies of patients suffering from malignant or chronic diseases of other organ systems. CONCLUSION: The Trier Scales of Coping Strategies is a suitable means for determining the coping strategies of laryngectomees who have been successfully rehabilitated with the help of voice prostheses. The patients examined here did not apply different coping strategies from groups of patients with other severe illnesses. Obviously, the limitations on communication do not constitute a determining factor in coping with the disease. This finding is useful when planning psychological and social rehabilitation, e.g. by psychosomatic interventions.

Adaptation, Psychological↗

PubMed2006

Coping and adjustment in children with cancer: a meta-analytic study.

The current meta-analysis assessed the efficacy of coping strategies on psychological and physical adjustment in children with cancer (n = 1230). Coping strategies were operationalized in accordance with two coping taxonomies; the first is based on the general orientation of the child's coping attempts (approach or avoidance), and the second is based upon coping efforts to regulate the stressor and/or feelings of distress attributed to it (problem-focused and emotion-focused). Approach, avoidance, and emotion-focused coping were unrelated to overall adjustment. A small-to-medium but negative association was found between problem-focused coping and adjustment, indicating more use of the strategies that compose this dimension are associated with poorer adjustment. However, homogeneity analyses also indicated significant variation for all of these effect sizes. Follow-up moderator analyses found coping-adjustment relations were both dependent upon time since diagnosis and the particular stressor the child was dealing with during treatment.

Adaptation, Psychological↗

PubMed1992

Chronic pain coping measures: individual vs. composite scores.

Differences in the use of coping strategies have been hypothesized to explain some of the variation in adaptation among chronic pain patients. Investigators often assess coping using composite indices of different coping strategies. Although the use of composite measures has advantages, it may obscure the importance of specific coping strategies as they relate to functioning. This study compared composite with individual coping scale scores in the prediction of adjustment among chronic pain patients. One hundred and forty-one patients completed the Coping Strategies Questionnaire (CSQ) and 2 measures of adjustment (Sickness Impact Profile (SIP) and the Beck Depression Inventory (BDI)). The scales and ratings of the CSQ were factor analyzed to create composite measures, and the ability of the composite scores and individual scales to predict adjustment was compared. The results indicated that the individual scales provided more information than the composite measures regarding the relationship between coping and adjustment to chronic pain. The results also suggested that individual scale scores may be more useful than composite scores in identifying the conditions under which coping efforts have their greatest effects on adjustment.

Adaptation, Psychological↗

PubMed2006

Coping and suicidality among homeless youth.

This study examined the impact of coping strategies employed by homeless youth upon suicidal ideation, suicide attempts on the streets, and feeling trapped/helpless. Coping strategies examined in the analysis included problem-focused and avoidant coping, along with several coping strategies identified in previous exploratory qualitative studies. Greater risk was associated with avoidant coping, social withdrawal, use of drugs and alcohol as coping, with "belief in a better future" linked to lowered risk levels. Gender interactions emerged with respect to avoidant coping and social withdrawal, both of which served as greater contributors to risk levels among females. Several approaches to coping including problem-focused strategies and strategies identified by youths in previous qualitative works emerged as not serving to ameliorate suicidality.

Adaptation, Psychological↗

PubMed2004

Does coping predict CO2-induced panic in patients with panic disorder?

Patients with panic disorder (PD) show maladaptive coping but the role of coping in the pathogenesis of panic is unclear. This study examined general coping and panic-specific coping as predictors of fear responding to CO2 inhalation. Subjective and physiological responses including panic attacks were assessed in 45 patients with PD and 45 matched nonclinical controls. Measures of coping were the primary predictors used in the analyses. Consistent with other reports, patients with PD reported increased emotion-focused coping and there was an association between emotion-focused coping and subjective reactivity. However, only panic-specific coping predicted panic attacks in response to the CO2 challenge.

Adaptation, Psychological↗

PubMed2004

Is coping style linked to emotional states in heart failure patients?

BACKGROUND: Negative emotional states such as anxiety and depression are associated with increased mortality and morbidity in cardiac patients. Clinicians who counsel patients with heart disease often focus on enhancing coping skills to reduce negative emotions. METHODS: To identify the relationship between 3 coping styles (active behavioral, active cognitive, and avoidance) and emotional states, we studied 84 advanced heart failure patients and used the Dealing with Illness-R Checklist to measure coping and the Profile of Mood States to measure emotional distress. RESULTS: Patients who reported greater use of active behavioral coping demonstrated less fatigue and more vigor than patients who reported lower use of that coping style. When demographic and clinical variables were taken into account, the avoidance coping style was associated with significantly higher anxiety, anger, depression, confusion, and fatigue in patients with advanced heart failure. CONCLUSIONS: Incorporating interventions that support active behavioral coping in lieu of avoidance coping may improve the emotional well-being of patients with heart failure.

Adaptation, Psychological↗

PubMed2003

The role of social support in well-being and coping with self-reported stressful events in adolescents.

OBJECTIVE: This study investigated the role that social support plays in well-being and in coping after a stressful event in a group of non-clinical adolescents. Furthermore, this study aimed at replicating the finding that adolescents who reported sexual abuse reported more symptoms and less adequate coping strategies than adolescents who reported another type of stressful event or no stressful episode. METHOD: Eight hundred and twenty adolescents between 12 and 18 years of age filled out questionnaires assessing social support (Social Support Questionnaire, Sarason, Shearin, Pierce, & Sarason, 1987), trauma-related symptoms (Trauma Symptom Checklist for Children, Briere, 1996), behavior problems (Youth Self-Report, Achenbach, 1991), and coping (How I Cope Under Pressure Scale, Ayers, Sandler, West, & Roosa, 1996). RESULTS: 42% of the adolescents reported a stressful experience, and 4.4% reported sexual abuse. Sexually abused adolescents reported more stress-related symptoms and used more avoidance and fewer support-seeking coping strategies than the other adolescents. The main-effect hypothesis of social support was sustained, but social support did not moderate the relation between a stressful event and coping. Yet, a trend was found suggesting that high support from the family was associated with less avoidance coping and more support-seeking in adolescents who reported a non-sexually abusive, stressful event. CONCLUSIONS: Our findings show that a highly perceived availability of social support is directly associated with fewer trauma-related symptoms, especially in adolescents who are non-sexually abused. For adolescents who reported a sexual or another type of stressful event, social support did not play a different role in coping.

Adaptation, Psychological↗

PubMed2005

Coping predicts depression and disability in heart transplant candidates.

OBJECTIVE: The aim of this study was to describe the coping strategies used by cardiac patients who are pursuing heart transplant and to determine which coping strategies are related to depression and self-reported disability. METHOD: This is a cross-sectional design with 50 cardiac patients (74% male) who were inpatients being evaluated for heart transplant at a large medical center. Coping styles were measured using the COPE Inventory (Carver CS, Scheier MF, Weintraub, JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 1989;56:267-83). Depression was assessed with the Structured Interview Guide for the Hamilton Depression Rating Scale (HAM-SIGH-D; Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56-62), and disability was assessed using the Sickness Impact Profile (SIP; Bergner M, Bobbitt R, Carter W, Gilson B. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981;19:787-805). RESULTS: Patients reported using a variety of adaptive coping strategies, but depression and disability were only significantly correlated with maladaptive coping strategies. Multiple regressions demonstrated that denial had the strongest association with depression, and focusing on and venting emotions had the strongest association with disability. CONCLUSIONS: Maladaptive coping styles, such as denial and focusing and venting of emotions, can serve as markers of emotional distress and disability that may identify patients who may benefit from psychologic and psychiatric interventions.

Adaptation, Psychological↗

PubMed2004

The range of coping strategies women use to manage pain and anxiety prior to and during first experience of labour.

OBJECTIVES: To investigate whether nulliparous women, during pregnancy, can identify their own pre-existing coping strategies for managing pain and anxiety and whether the range of coping strategies used in Labour by women who do not attend antenatal classes can be described. DESIGN: Qualitative semi-structured interviews. SETTING: Two large maternity units in a city in the North of England. PARTICIPANTS: Twenty-three nulliparous women were interviewed during their third trimester of pregnancy (prior to any antenatal class attendance) regarding strategies used to cope with previous experiences of pain and anxiety. A separate sample of 20 women, who had not attended any form of antenatal education, were interviewed within 72h of their first experience of labour regarding the coping strategies used to manage pain and anxiety during labour. FINDINGS: Template Analysis was used to code data from transcribed interviews. The findings indicate that as women approach their first experience of labour they can identify coping strategies that they have employed to manage pain and anxiety in their past. Equally women who have not attended antenatal classes use a wide range of strategies in labour. The range of identified coping strategies is described and comprises thoughts and behaviours with positive and negative consequences. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: It is possible to help nulliparous women to identify, in pregnancy, a range of strategies that they have previously employed to manage pain and anxiety. This range reflects the coping strategies that women may potentially use in labour to manage pain and anxiety. Women may benefit from assistance in pregnancy to develop strategies for labour that are based on knowledge of their own coping repertoire, which includes enhancing positive strategies and finding alternatives to negative strategies.

Adaptation, Psychological↗

PubMed2004

Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study.

This study tested the separate and combined effects of spouse-assisted pain coping skills training (SA-CST) and exercise training (ET) in a sample of patients having persistent osteoarthritic knee pain. Seventy-two married osteoarthritis (OA) patients with persistent knee pain and their spouses were randomly assigned to: SA-CST alone, SA-CST plus ET, ET alone, or standard care (SC). Patients in SA-CST alone, together with their spouses, attended 12 weekly, 2-h group sessions for training in pain coping and couples skills. Patients in SA-CST + ET received spouse-assisted coping skills training and attended 12-weeks supervised ET. Patients in the ET alone condition received just an exercise program. Data analyses revealed: (1) physical fitness and strength: the SA-CST + ET and ET alone groups had significant improvements in physical fitness compared to SA-CST alone and patients in SA-CST + ET and ET alone had significant improvements in leg flexion and extension compared to SA-CST alone and SC, (2) pain coping: patients in SA-CST + ET and SA-CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA-CST + ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC, and (3) self-efficacy: patients in SA-CST + ET reported significant improvements in self-efficacy and their spouses rated them as showing significant improvements in self-efficacy compared to ET alone or SC. Patients receiving SA-CST + ET who showed increased self-efficacy were more likely to have improvements in psychological disability. An intervention that combines spouse-assisted coping skills training and exercise training can improve physical fitness, strength, pain coping, and self-efficacy in patients suffering from pain due to osteoarthritis.

Adaptation, Psychological↗

PubMed2004

Laboratory pain perception and clinical pain in post-menopausal women and age-matched men with osteoarthritis: relationship to pain coping and hormonal status.

The present study examined relationships between pain coping, hormone replacement therapy, and laboratory and clinical pain reports in post-menopausal women and age-matched men with osteoarthritis. Assessment of nociceptive flexion reflex threshold was followed by an assessment of electrocutaneous pain threshold and tolerance. Participants rated their arthritis pain using the Arthritis Impact Measurement Scales. To assess pain coping, participants completed measures of emotion-focused coping, problem-focused coping, and pain catastrophizing. Results indicated that women were more likely than men to report using emotion-focused pain strategies, and that emotion-focused coping was associated with more arthritic pain and lower electrocutaneous pain tolerance. Correlations between coping measures and pain reports revealed that catastrophizing was associated with greater arthritis pain and lower pain threshold and tolerance levels. However, catastrophizing was not related to nociceptive flexion reflex threshold, suggesting that the observed relationship between catastrophizing and subjective pain does not rely on elevated nociceptive input. A comparison of men (n=58), post-menopausal women receiving hormone replacement therapy (n=32), and post-menopausal women not receiving hormone replacement therapy (n=42) revealed no significant group differences in arthritis pain, electrocutaneous pain threshold or tolerance, or nociceptive flexion reflex threshold. Thus, older adults with osteoarthritis do not exhibit the pattern of sex differences in response to experimental pain procedures observed in prior studies, possibly due to the development of disease-related changes in pain coping strategies. Accordingly, individual differences in clinical and experimental pain may be better predicted by pain coping than by sex or hormonal differences.

Adaptation, Psychological↗

PubMed2005

Coping with critical life events and lack of control--the exertion of control.

Coping strategies in relation to unfair treatment or conflicts at work are discussed. 'Covert coping' has been assessed by means of a short questionnaire. Its relationship with cardiovascular risk and sick leave has been examined in an epidemiological study (WOLF) of working men and women in Stockholm. The findings indicate that in men 'covert coping' is associated with elevated cardiovascular risk and prospective long-term sick leave. In women such a coping strategy is related to current sick leave, but not to cardiovascular risk or long-term sick leave. Openness of coping strategies is also discussed in relation to bouts of anger preceding myocardial infarction. Another epidemiological study (SHEEP, ONSET) has shown that severe bouts of anger are reported significantly more often than expected during the hour preceding myocardial infarction. This was not the case in subjects who reported 'open coping patterns', however. Openness of coping strategies is partly determined by the working climate--the higher the decision latitude, the less 'covert' the coping strategies. The results support the idea that dialogue in the work place may be health promoting.

Adaptation, Psychological↗

PubMed2005

Exploring the association of John Henry active coping and education on smoking behavior and nicotine dependence among Blacks in the USA.

Although smoking is used as a coping tool in response to stress and Blacks have been found to report smoking more in response to stress than Whites, little research exists that has examined ethno-culturally specific constructs of stress and coping as they relate to smoking behavior and nicotine dependence among Blacks in the USA. This study explored the association between the ethno-culturally interactively defined construct of John Henryism, as well as the individual contributions of John Henry active coping and education on smoking behavior and nicotine dependence in a relatively urban-Midwestern Black population. Self-identified Black patients (n = 146) who had previously received a clinical intervention for nicotine dependence were followed to assess smoking status and John Henry active coping. Results revealed that patients with low levels of education who had low levels of John Henry active coping reported higher nicotine dependence scores than any other education by John Henry active coping group. Furthermore, low levels of John Henry active coping were associated with the use of menthol cigarettes and lower-educational level was associated with smoking greater than 20 cigarettes per day. Further community-based studies examining this construct among Black smokers in various socio-cultural contexts are needed to clarify the association between John Henry active coping and socioeconomic status on smoking behavior and nicotine dependence among Blacks.

Adaptation, Psychological↗

PubMed2006

Do religious/spiritual coping strategies affect illness adjustment in patients with cancer? A systematic review of the literature.

The present paper systematically reviews studies examining the potential beneficial or harmful effects of religious/spiritual coping with cancer. Using religion and spirituality as resources in coping may be specifically prevalent in patients with cancer considering the potentially life-threatening nature of the illness. Religious/spiritual coping may also serve multiple functions in long-term adjustment to cancer such as maintaining self-esteem, providing a sense of meaning and purpose, giving emotional comfort and providing a sense of hope. Seventeen papers met the inclusion criteria of which seven found some evidence for the beneficial effect of religious coping, but one of these also found religious coping to be detrimental in a sub-sample of their population. A further three studies found religious coping to be harmful and seven found non-significant results. However, many studies suffered from serious methodological problems, especially in the manner in which religious coping was conceptualised and measured. The studies also failed to control for possible influential variables such as stage of illness and perceived social support. Due to this, any firm conclusions about the possible beneficial or harmful effects of religious coping with cancer is lacking. These problems are discussed and suggestions for future studies are made.

Adaptation, Psychological↗