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Life stressors and coping style are associated with immune measures in HIV-1 infection--a preliminary report.

OBJECTIVE: Life stressors and coping style have been associated with alterations in cellular immunity similar to those seen in HIV-1 infection. The interval between infection with HIV-1 and the development of AIDS is lengthy and highly variable. This pilot study investigated whether life stressors and coping style may account for a portion of this variation. METHOD: A sample of eleven asymptomatic HIV-1 seropositive homosexual male volunteers responding to a local advertisement was assessed on life stressors, coping style and cellular phenotypic and functional immune measures--T4 "helper" cell/T8 "suppressor" cell ratio, T4 cell count, total lymphocyte count, and natural killer cell cytotoxicity. RESULTS: Significant associations were observed for both major life stressor impact over the previous year and passive coping style use with the total lymphocyte count; higher life stressor impact and passive coping style use were associated with lower total lymphocyte counts. Similarly, a trend in the same direction was found for the relationship of these two measures with the count of T4 cells, which are directly infected and killed by HIV-1. CONCLUSIONS: It is well documented that decrements in T4 cell and total lymphocyte counts are powerful predictors of subsequent clinical progression to AIDS. These preliminary findings suggest that life stressors and coping style may also be predictors of the development of AIDS.

Acquired Immunodeficiency Syndrome↗

Undergoing cardiac catheterization: the effects of informational preparation and coping style on patient anxiety during the procedure.

OBJECTIVE: To examine the effects of coping styles and preparatory informational treatments on patient anxiety during cardiac catheterization. DESIGN: Prospective, experimental, random assignment, repeated measures design. SETTING: Canadian, university-affiliated, large urban hospital. SUBJECTS: 145 adult patients (107 men and 38 women) scheduled for their first cardiac catheterization. Age range was from 34 to 78 years. Mean educational level was 10.72 years. OUTCOME MEASURES: Subject's coping style, "monitoring" (information seeking) or "blunting" (information avoiding) was assessed by means of Miller's Behavioral Style Scale. Subjects' anxiety was assessed using three measures: (1) a self-report measure, the Subjective Units of Distress (SUDS) Scale; (2) a behavioral measure, the Cardiac Catheterization Adjustment (CA) Scale; and (3) physiologic measures, heart rate and systolic and diastolic blood pressure. INTERVENTION: After coping style assessment, monitors and blunters were randomly assigned to receive one of three preparatory informational treatments: (1) videotaped procedural modeling information, (2) videotaped procedural-sensory modeling information, and (3) procedural-sensory information booklet. RESULTS: Analysis of variance techniques applied to the anxiety data revealed the following: (1) significant changes in self-reported patient anxiety occurred as a function of occasion rather than preparatory informational treatment or coping style, (2) subjects receiving the three preparatory informational treatments demonstrated significantly different behavioral adjustments during cardiac catheterization, and (3) most subjects demonstrated heart rate and blood pressure readings in the normal range; however, significant changes in cardiovascular reactivity were found to be associated with contrast dye insertion. CONCLUSIONS: Subjects who received the videotaped modeling treatments demonstrated greater behavioral adjustment than patients who received the information booklet. Questions remain as to whether the procedural modeling treatment is more efficacious than the procedural-sensory modeling treatment. Increases in subjects' SUDS levels were found to be associated with changes in ideational content. Changes in blood pressure and heart rate were attributed to physiologic and psychologic factors. Coping style did not appear to significantly influence any of the measures of patient anxiety.

Adaptation, Psychological↗

Influence of coping style and precolonoscopy information on pain and anxiety of colonoscopy.

BACKGROUND: This study assessed the relationship between patient coping style, precolonoscopy information, and anxiety and pain associated with colonoscopy. METHODS: Eighty consecutive adult patients undergoing initial colonoscopy were classified into two groups on the basis of coping style: information seekers or information avoiders. All were given standardized information about colonoscopy. Half of each group was randomly assigned to receive additional sensory information describing what they could expect to feel. Self-report, physiologic, and behavioral indices of anxiety and pain were measured. RESULTS: Patients given information congruent with coping style experienced significantly less self-report anxiety immediately after the information intervention and spent less time in recovery. In contrast, patients given information not congruent with coping style maintained their pre-intervention anxiety level. Patients given information congruent with coping style scored lower on behavioral indices of pain, but there were no differences with respect to patient perception of pain or the dosage of sedative drugs. Most patients reported that the bowel preparation was the most distressing part of the colonoscopy. CONCLUSIONS: Assessment of coping style and provision of congruent information reduces anxiety, recovery time, and observed behavioral indices of pain of colonoscopy but has no effect on sedation dose or patient perception of pain.

Adaptation, Psychological↗

Complete dentures and oral health-related quality of life -- do coping styles matter?

UNLABELLED: Oral health-related quality of life (OHRQOL) in edentulous patients with complete dentures is often impaired. This paper investigates the effect of different coping styles on OHRQOL. PURPOSE: (a) To assess OHRQOL of edentulous patients with conventional complete dentures, and (b) to investigate if individual differences in these patients' styles of coping with stress affect their OHRQOL. MATERIALS AND METHODS: Data were collected from 249 fully edentulous patients with complete dentures (mean age: 66.0 years) who responded to a mailed survey (adjusted response rate: 48.8%). OHRQOL was measured with the 14-item short form of the oral health impact profile (OHIP). Ratings of coping strategies were obtained using the 28-item Brief COPE, an instrument measuring various styles of coping with stress. Linear regression analyses were used to explore the relationships between coping styles, background variables such as age, gender, income, and age of prosthesis, and the patients' OHRQOL. RESULTS: About 35% of the respondents reported impacts from their oral conditions on their overall OHRQOL (OHIP-14 total score) occasionally, fairly often, or often. Physical pain was even more prevalent, with 53.3% of the respondents reporting pain impacts. The linear regression model (P < 0.0001) explained 31.1% of the variation in the OHIP-14 total score. The coping variables instrumental support, behavioral disengagement, substance abuse, denial, and religion were significant negative predictors of OHRQOL. Only emotional support was a significant positive predictor of OHRQOL. CONCLUSION: Wearing conventional complete dentures has a significant impact on OHRQOL. This impact is moderated by the styles a patient uses to cope with stress. Using emotional support has a positive effect on OHRQOL, while other coping styles, namely instrumental support, behavioral disengagement, substance abuse, denial, and religion are significant negative predictors of OHRQOL.

Adaptation, Psychological↗

Cortisol response to various stressful situations: relationship to personality variables and coping styles.

Studies on personality traits and coping styles as determinants of interindividual differences in neuroendocrine responses to stress have not yet yielded conclusive results. In a previous investigation, strong hints to distinct interindividual differences in the susceptibility of the HPA axis of 12 male volunteers aged 27 +/- 5 years exposed to five different stress situations were found. In the present report, psychometric variables (personality traits and coping styles) assessed in the same subjects before the study were analyzed to test whether specific psychometric variables were related to the interindividual differences in the susceptibility of the HPA axis. The results revealed that interindividual differences in the frequency of cortisol responses to stress situations could not be predicted by any of the psychometric variables investigated. The question if psychological factors contribute to neuroendocrine stress response and to what degree warrants further interest. These preliminary findings suggest, however, that nonpsychological factors should be considered more seriously as determinants of interindividual differences in neuroendocrine stress responses in healthy subjects as well as in psychiatric patients.

Adaptation, Psychological↗

Effects of coping style and relaxation on cancer chemotherapy side effects and emotional responses.

This study was designed to determine (a) the relationship of coping style to cancer chemotherapy side effects and (b) whether coping style moderated the impact of a relaxation intervention on anxiety, depression, and nausea associated with chemotherapy. Forty-eight cancer patients were assigned randomly to receive either progressive muscle relaxation training before chemotherapy (experimental group) or standard care (control group). Spearman correlations indicated that a "blunting" or distraction-oriented coping style was associated with less anticipatory anxiety, less depression, and less nausea during and after chemotherapy. Spearman correlations also indicated that a "monitoring" or information-gathering coping style was associated with more anticipatory anxiety, and more nausea before and during chemotherapy. Although there was a significant effect of the relaxation intervention on posttreatment nausea, there were no other between-group differences. The results did suggest, however, that relaxation was effective in reducing anticipatory anxiety among "blunters," but not "monitors," perhaps because relaxation is a distraction strategy and therefore is consistent with a blunting coping style. The effects of coping and relaxation on pretreatment anxiety may have important implications, because anxiety is a key factor in classic conditioning models of anticipatory nausea and vomiting.

Adaptation, Psychological↗

Recovery from acute whiplash: the role of coping styles.

STUDY DESIGN: Prospective cohort study. Victims of car accidents who initiated compensation claim procedures at a Dutch insurance company and presented themselves with neck complaints were sent a questionnaire containing neck-related questions and questions regarding the coping styles used shortly after the accident. An additional two questionnaires were administered 6 and 12 months, respectively, after the accident. OBJECTIVES: To examine the association between the coping styles used and the development of late whiplash syndrome. SUMMARY OF BACKGROUND DATA: Previous research has indicated that neither personality traits nor psychopathologic symptoms can predict the outcome of whiplash. No studies have yet been conducted on the association between coping styles and the development of late whiplash syndrome. METHODS: The coping styles were determined using the Utrecht Coping List. The duration of neck complaints was measured from the time of the accident and from the time of filling in the first questionnaire. Survival analysis was used to study the association between the duration of neck complaints and the explanatory variables. RESULTS: Of the 363 eligible claimants, 278 (77%) responded to the questionnaire; 242 (67%) were included in the analysis. After 12 months, 40% of the male and 50% of the female participating claimants still had neck complaints. The duration of the neck complaints was associated with gender, palliative reaction, and the seeking social support coping style. CONCLUSION: The coping style during the first few weeks after the accident and the gender are related to the duration of neck complaints (Cox regression: palliative handling relative risk = 0.91, P = 0.002; seeking social support relative risk = 1.06, P = 0.042; and gender relative risk = 1.50, P = 0.036). Thereafter the intensity of somatic complaints plays a role. Paying attention to the coping style could contribute to the prevention of the development of late whiplash syndrome.

Accidents, Traffic↗

Coping style and distress in newly incarcerated male adolescents.

PURPOSE: To research relations between coping style and well-being in adolescent prisoners; previous research suggests that the stress of incarceration may be moderated by coping style in adult prisoners. METHODS: This research examined links between coping style and distress in 133 male adolescent prisoners on two occasions over a six-week period shortly after the commencement of their imprisonment. RESULTS: Anxiety and depression both declined over this period, with T1-T2 depression reduction negatively associated with T1 emotion-based coping and positively associated with T1 detachment. Emotion coping declined over the six weeks, whereas detachment coping increased. These changes were associated with improved depression and anxiety scores. CONCLUSIONS: Detachment and low emotional expression may assist incarcerated adolescents to adapt more positively to the initial period of imprisonment, and prisoners may adopt these more effective coping styles over time. These findings are explained in terms of adaptation to stressors specific to the prison environment.

Adaptation, Psychological↗

Religiosity, religious coping styles, and health service use: racial differences among elderly women.

This study explored racial differences in the effects of religiosity and religious coping styles on health service use. The sample (N = 274) consisted of a cross-section of women ages 55 and older living in publicly subsidized high-rise dwellings in Nashville, Tennessee (1999 to 2000) and included 159 White and 115 African American women. The results suggested the effects of religiosity on health service use are generally negative for both groups. However, the effects of religious coping styles on health service use differed by race. The self-directing coping style was associated with higher levels of use for White women, but with lower levels of use for African American women. The deferring coping style was associated with greater physician visits and inpatient days among White women, but with fewer inpatient days among African American women. The collaborative coping style was associated with higher inpatient days among African American women, but had no significant effect on use patterns for White women. Conducting assessments of religiosity and religious coping styles would enhance holistic nursing practice.

Adaptation, Psychological↗

Chronic and acute stressors among military personnel: do coping styles buffer their negative impact on health?

This study examined the moderating impact of positive and negative coping styles on the relationship of acute and chronic job stressors with self-reported health symptoms of 521 military personnel. The number of acute work-related events was associated with a high frequency of self-reported symptoms. Similarly, role ambiguity, overload, and lack of job stimulation were associated with increased symptoms. Only the negative coping styles (i.e., venting of negative emotions and denial/disengagement) were uniquely associated with symptoms. Only 5 of the 13 proposed Stressor x Coping interactions were significant, and they all involved the negative coping styles. That is, instead of alleviating the negative outcomes of work stressors, these coping styles were associated with high strain, regardless of the amount of stressor, and, in some cases, these coping styles exacerbated the negative effect of the stressor on the strain outcomes.

Acute Disease↗

Psychological state, quality of life, and coping style in patients with digestive cancer.

The purpose of this study was to assess the relationships between psychological characteristics such as anxiety and depression, quality of life (QOL) and coping style among patients with digestive cancer. The subjects were 85 in-patients who were scheduled to undergo initial surgery for gastrointestinal cancer. The following psychological tests were administered: Japanese versions of the Hospital Anxiety and Depression Scale, Zung's Self-Rating Depression Scale, the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 and the Coping Inventory for Stressful Situations. The first 3 tests were performed on three occasions: before surgery, before discharge and 6 months after discharge. The results showed that there was no change over the 3 test administration days for the average scores of anxiety and that the scores of depression increased from before surgery to before discharge and did not return to presurgery levels at 6 months after discharge. Changes in each subscale score of the EORTC QLQ C30 across the 3 days displayed two typical trends. Relationships between the abovementioned trends and individual coping styles showed that the higher the score of "emotion-oriented coping style," the greater the deterioration in QOL subscales. It was suggested that focusing on a patient's coping style, particularly emotion-oriented coping style, is important and that patients likely to adopt a more emotion-oriented coping style should receive special consideration.

Adaptation, Psychological↗

Divergent stress coping styles in juvenile brown trout (Salmo trutta).

Two distinct stress coping styles, proactive and reactive, have been stated in various animal studies. This divergence in coping has also been indicated in salmonid fish. Here, we test the hypothesis that divergent stress coping styles are identifiable in a sea-ranched brown trout population. To that end, we used a series of tests on individual juvenile brown trout, with each test including a common key aspect of the two different coping styles. Using a clustering method (SAS: PROC FASTCLUS), two groups that clearly differed both in blood chemistry (noradrenalin and adrenalin levels) following confinement and in behavior during hypoxia were identified.

Adaptation, Psychological↗

Cancer patients' coping styles and doctor-patient communication.

Monitoring and blunting styles have become relevant concepts regarding their potential impact on patients' and doctors' behaviors. The present study aimed at investigating the relation between cancer patients' coping styles and doctor-patient communication and global affect. Coping styles were assessed by means of the Threatening Medical Situations Inventory (TMSI). Since a shortened version of the TMSI was used, the validity of this instrument was also evaluated. First, it was examined whether the two factor structure of the original TMSI could be confirmed in our version. Then, the relation between coping style and patients' preferences for information and participation in decision-making was evaluated. Second, the relation between monitoring and blunting and patients' age, sex, education, quality of life and prognosis was investigated. Finally, the relation between patients' coping styles and communicative behaviors and global affect of both patients and physicians during the initial oncological consultation was examined. Patients (N = 123) visited their gynaecologist or medical oncologist for an initial discussion of possible treatment. Patients' coping styles, socio-demographics, preference for information and participation in decision-making, quality of life and prognosis were assessed by postal questionnaire prior to the visit to the outpatient clinic. The consultation was audiotaped and analysed according to Roter's Interaction Analysis System, to identify instrumental and affective communicative behaviors of both patients and physicians. The two factor structure of the TMSI could be confirmed. A monitoring style was related to a preference for detailed information (r = 0.23) and participation in medical decision-making (r = 0.23). A monitoring style was also related to patient question-asking (r = 0.25) and patient dominance (r = 0.23). To conclude, the validity of the shortened TMSI is satisfactory. Also, cancer patients' coping styles are not related to other personal and disease characteristics. Further, a monitoring style seems to have an impact on patients' question-asking and dominance during the oncological consultation.

Adaptation, Psychological↗

Coping styles among adolescent competitive athletes.

The use of approach and avoidance coping styles and task-focused and emotion-focused coping strategies in competitive sport was explored. Four hundred twenty-one adolescent males from New South Wales, Australia, who were currently competing in team sports indicated their usual responses to each of 8 acute stressors commonly experienced in sport, using a 128-item inventory. The reliability coefficient (Cronbach's alpha) for each stressor ranged from .81 to .92. Twenty-six of the original 128 items on the inventory were retained, on the basis of factor analysis. Correlations between stressors indicated that coping styles were a function of type of stressor, providing support for the transactional model. Goodness of fit was high (.87). The present results partially support the construct of coping style among adolescent-aged sports competitors.

Adaptation, Psychological↗

Coping style and preterm labor.

Psychometric tests (State-Trait Anxiety Index and Utrechtse Coping Lijst) were administered to 23 primigravidae hospitalized for preterm labor and to 22 controls in order to investigate whether women with and without preterm labor present a different coping style or (in) effectiveness of this coping and whether the coping style predicts duration of hospitalization and gestational age at delivery. No significant differences in trait anxiety nor in coping style were found between women with and women without preterm labor. However, within the group of women with preterm labor, coping mechanisms are important predictors of course and outcome of the preterm contractions. Palliative coping and social support seeking are protective mechanisms while active coping has an adverse effect upon outcome: an older gestational age at the moment of delivery is for 44% predicted by a higher social support seeking and a lower active coping.

Adaptation, Psychological↗

Relationship of chronic stress, social support, and coping style to health among Namibian refugees.

This study investigates how social support and coping style affect the relationship between a traumatic chronic stressor and health status. A population of 88 Namibian refugees living in an equatorial region of Africa participated in the study. The central hypothesis was that social support and coping style moderate the relationship between length of stay in exile (a proxy measure of chronic stress) and health status (symptoms of generalized anxiety disorders, self-reported physical health status and length of stay in hospital). The results show that when social support is high the relationship between length of stay in exile and all three health outcomes is substantially reduced. When social support is low, the relation between stress and poor health outcomes is high. Coping style moderates the relationship between length of stay in exile and period of hospitalization but has no effect on level of anxiety or perceived health status. When both social support and coping style are simultaneously considered, the best results emerge.

Adaptation, Psychological↗

Coping styles and locus of control as predictors for psychological adjustment of adolescents with a chronic illness.

This study examines the way coping styles and locus of control contribute to the prediction of psychosocial adjustment in adolescents with a chronic illness. Psychosocial adjustment of 84 adolescents aged 13-16 years with a chronic illness was assessed with measures of social adjustment, global self-esteem and behavior problems. Linear regressions were performed with demographic factors (age and gender) and stress-processing factors (coping style and locus of control) as predictor variables. Results indicated that coping styles were related to most aspects of social adjustment. The coping styles 'seeking social support' and 'confrontation' were important predictors for positive social adjustment; the coping style 'depression' was a predictor for poor adjustment, viz, low social self-esteem and high social anxiety. Avoidance and locus of control were not strongly associated with psychosocial adjustment. Clinical implications of these findings were discussed in terms of preventive interventions for adolescents with a chronic illness.

Adaptation, Psychological↗

Assessment of cognitive coping styles: a closer look at situation-response inventories.

Cognitive coping style approaches establish two concepts central to the understanding of people's responses to a stressful situation: "attention" and "avoidance". Theoretical frameworks corresponding to these conceptions are Sensitization-Repression (Byrne, 1961), Monitoring-Blunting (Miller, 1980), and Vigilance-Cognitive Avoidance (Krohne, 1986). Such types of cognitive coping styles are usually measured by means of situation-response inventories. In the present article, we take a closer look at this kind of coping assessment by considering the scenarios, the coping options and response formats, the dimensionality of the constructs, and published data on the reliability and the validity of seven situation-response inventories. Three important points deserve to be highlighted: (a) it probably makes little sense to assess coping style using scenarios that diverge maximally with respect to controllability and predictability since coping is not assumed to show such complete cross-situational stability; (b) similarly named inventories rely on largely different operationalizations and can hardly be considered as measuring similar constructs; and (c) monitoring/vigilance and blunting/avoidance generally emerge as independent constructs, which argues against use of summary scores.

Adaptation, Psychological↗