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PubMed1997

Fantasies, coping behavior, and psychopathology.

This study assessed whether consistent relationships exist between the content of self-reported coping behaviors, sustaining fantasies, and ordinary daydreams. A second goal was the identification of coping behaviors associated with psychopathology and an exploration of connections between coping behaviors, fantasies, and daydreams correlated with pathology. College students (N = 119) completed the Tanck and Robbins Coping Behaviors Scale, the Sustaining Fantasy Questionnaire, and 12 Imaginal Processes Inventory scales. Pearson correlations indicated strong support for similar content between coping behaviors and the two types of fantasy. Previously reported relationships between coping behaviors and psychopathology were replicated. Significant intercorrelations were found between sustaining fantasies, daydreams, and coping behaviors that, separately, were found to be significantly associated with psychopathology.

Adaptation, Psychological↗

PubMed1999

Psychological and neuropsychological predictors of coping patterns by patients with multiple sclerosis.

To determine the relative contribution of psychological and neuropsychological (NP) variables to the prediction of patterns of coping with disease-related stressors and satisfaction with their coping efforts, 56 patients with multiple sclerosis (MS) were administered the Ways of Coping Checklist, the Symptom Checklist-90-Revised, and a battery of NP tests chosen for their sensitivity to MS. Higher levels of psychological distress were associated with greater use of emotion-focused coping strategies and reduced perceived effectiveness of the coping strategies employed. Psychological distress was not related to the use of problem-focused strategies and NP variables did not predict coping style or effectiveness. MS patients who display heightened psychological distress may be good candidates for psychotherapeutic interventions aimed at improving perceived coping effectiveness.

Adaptation, Psychological↗

PubMedDate not supplied

Gender differences in psychological adaptation and coping in parents of pediatric cancer patients.

This study investigated differences in psychological distress and coping styles between fathers and mothers of pediatric cancer patients, over a 1-year time period. Also examined were (dis)similarities in couples in distress and coping, and the relationship between (dis)similarities in coping and psychological functioning of both members of a couple. Parents (n = 124, 62 couples) were assessed at diagnosis, at 6 and 12 months. Fathers and mothers experienced higher levels of psychiatric symptomatology and psychological distress at diagnosis than men and women of a normgroup. Distress declined significantly with time. Although parents did not report more symptoms than the normgroup 12 months post-diagnosis, they still were psychologically out of balance. Contrary to findings in the general population, no differences were found between fathers and mothers in psychiatric symptoms or psychological distress on any of the measurements. Only a few gender differences in coping were found. Fathers used more active-problem focusing at diagnosis and a less palliative reaction pattern at 12 months than did mothers. Mothers used more social-support seeking on all measurements. A tendency for similarity in the use of the coping styles within couples was found. Discrepancies in coping in couples were positively related to distress in fathers at diagnosis. However, 12 months later, the more discrepant the couples were in their coping preferences the more distress the mothers indicated.

Adaptation, Psychological↗

PubMedDate not supplied

A structural model of the relationships among stage of disease, age, coping, and psychological adjustment in women with breast cancer.

The present study used structural equation modeling to examine the relationships among disease stage (i.e. Stage II versus Stage IV), age, coping style, and psychological adjustment in 100 women diagnosed with breast cancer. Five separate models were examined: a full model, a mediational model, a demographic-disease model, a coping style model, and a regression model The analyses revealed that the present data best fit the mediational model in which age and stage of disease were not directly associated with psychological adjustment but, instead, were mediated by coping style (chi 2(25) = 45.776, AASR = 0.05, CFI = 0.94). The mediational model accounted for 56% of the variance in psychological adjustment. In particular, the model showed that younger women and women with an earlier disease stage used greater levels of the coping strategy characterized as a fighting spirit and lower levels of the coping strategies characterized as hopelessness/helplessness, anxious preoccupation, and fatalism which, in turn, were related to better psychological adjustment. Overall, these findings may offer an explanation for the conflicting findings regarding the relationship between age, stage of disease, and psychological adjustment to breast cancer by illustrating that coping strategies may be an essential mediating factor; in turn, a mediating model of psychological adaptation may offer useful information for clinicians as they implement interventions designed to improve patients coping efforts.

Adaptation, Psychological↗

PubMed1981

The CPI subscales as predictors of parental coping with childhood leukemia.

Determined the role of the standard CPI subscales, the Summed Coping Scale, and the current Adjustment Rating Scale in prediction of parental coping with leukemia, with 30 mothers and 25 fathers of children with Leukemia. None of the standard CPI subscales was found to be a significant predictor of coping, as measured by a situation-specific instrument, the Family Coping Scale. The Summed Coping Scale and the CARS were significant as predictors for fathers, but not for mothers. It is suggested that coping with the specific situation may be a better predictor of later coping in a similar situation than more global assessments.

Adaptation, Psychological↗

PubMed1991

Coping strategies and psychological symptoms in a Japanese sample.

The role of coping strategies as moderators in the relationship between hassles and psychological/physical well-being was investigated in a Japanese sample (N = 107). Multiple regression analyses revealed that active-behavioral coping contributed to a negative prediction of depression after partialing out hassles' levels. Emotion-focused coping and avoidance provided significant predictions of physical symptoms, whereas problem-focused coping significantly contributed a negative prediction. The results indicated that active-behavioral and problem-focused coping were moderators, while emotion-focused coping and avoidance were enhancers in the stress-symptoms relationship. The role of coping strategies as moderators did not appear to be influenced by the Japanese cultural environment.

Adaptation, Psychological↗

PubMed1992

Coping with arthritis. Current status and critique.

Our understanding of the complex role of coping in the psychological adjustment to arthritis has improved over the past decade. Studies have consistently demonstrated a relationship between certain coping strategies and psychological outcomes. However, unresolved problems in the methodology and theory concerning these studies cloud the picture, limiting the conclusions that can be drawn. There are general problems with the ways in which coping has been conceptualized and measured by researchers evaluating stress and coping, and there are problems more specific to the ways coping concepts and measures have been used to study patients with arthritis. A complete understanding of the relationship between coping and mental health in this population would have important theoretical and clinical implications. Such studies would serve as a model for investigations of stress and coping in patients with other illnesses, and would point to effective psychosocial interventions for improving the quality of life for this population.

Adaptation, Psychological↗

PubMed2006

Influence of coping skills on health-related quality of life in patients with systemic lupus erythematosus.

OBJECTIVE: To identify coping strategies used by patients with systemic lupus erythematosus (SLE), and to assess the influence of main clinical and coping variables on health-related quality of life (HRQOL). METHODS: We administered the Coping Orientation to Problems Experienced and the Short Form 36 questionnaire to a group of 144 patients with SLE and a group of 129 healthy controls. At the time of the psychological assessment, all patients underwent a complete clinical and laboratory evaluation. RESULTS: SLE patients had higher scores in acceptance (P < 0.001) and turning to religion (P = 0.05) and lower scores in planning (P = 0.001), suppression of competing activities (P = 0.010), restraint coping (P = 0.031), focusing on and venting of emotion (P = 0.009), and strategies focused on problem (P = 0.012) compared with controls. By means of linear regression analysis, HRQOL in SLE patients seemed to be influenced positively by restraint coping and positive reinterpretation and growth, and negatively by focusing on and venting of emotion, behavioral disengagement, and mental disengagement. When clinical variables were added to the multivariate analysis for coping strategies, more significant regression models that included joint pain were obtained. CONCLUSION: In facing stressful situations, patients with SLE tend to use coping skills that are generally adopted for events perceived as nonmodifiable. Strategies that show a passive attitude and joint pain seem to impair these patients' HRQOL.

Adaptation, Psychological↗

PubMed2006

Negative stress-coping strategies among novices in surgery correlate with poor virtual laparoscopic performance.

BACKGROUND: This study explored the impact of habitual stress-coping strategies on the laparoscopic performance of novices in surgery using a virtual reality simulator. METHODS: The SVF78 stress-coping questionnaire was administered to 12 medical students in their final year of medical school (camera holders) and to 12 inexperienced surgical residents (postgraduate years 1-3). The questionnaire included devaluation during stressful situations, distractions from stressful situations, control over stressful reactions and negative coping strategies such as stress avoidance and need for social support. Assessment of laparoscopic dexterity was based on the results of performance on a virtual reality simulator. The variables of time taken to complete the task, errors and economy of motion were analysed, with a higher score indicating poor performance. Pearson and non-parametric Spearman correlations were used to compare the subjects' results on the SVF78 with those on the LapSim. RESULTS: Time taken to complete the task correlated with high values in distractive stress-coping strategies (P = 0.002) and high values in negative stress-coping strategies (P = 0.042). CONCLUSION: Ineffective stress-coping strategies correlate with poor virtual laparoscopic performance. The need for effective intraoperative stress-coping strategies is evident.

Adaptation, Psychological↗

PubMed2002

An exploration of the pretreatment coping strategies of patients with carcinoma of the head and neck.

BACKGROUND: Patients with head and neck carcinoma (HNC) often face exhaustive and debilitating treatment as well as physical and functional residual effects, such as disfigurement, compromised speech, dry mouth, and difficulties swallowing. Understanding how patients cope with these challenges is important in comprehensive care of patients with HNC. METHODS: Seventy-nine patients with HNC were assessed for quality of life (QOL) and coping strategy. Measures included the Functional Assessment of Cancer Therapy-Head and Neck, the Performance Status Scale for Head and Neck Cancer Patients, and the Ways of Coping-Cancer Version. Coping strategies were summarized and related to patient demographics and QOL. RESULTS: The results suggested that patients with HNC used a wide range of coping strategies, with social support seeking behaviors representing the greatest proportion of total coping effort (25%). The use of avoidant coping strategies (both cognitive and behavioral escape) was associated with poorer overall QOL. CONCLUSIONS: Although further examination of these issues in larger groups of patients with HNC is warranted, the current findings suggest the adaptability of this group of patients and the potential benefit of social support-based assistance or intervention.

Adaptation, Psychological↗

PubMed2006

Impact of coping skills intervention with family caregivers of hospice patients with cancer: a randomized clinical trial.

BACKGROUND: Family caregivers for cancer patients experience high levels of stress and burden and diminished quality of life (QOL). Interventions to improve coping skills of caregivers have been shown to be effective with other populations, but their impact has not been assessed in the difficult context of hospice care. The purpose of this study was to determine whether hospice plus a coping skill training intervention improved family caregivers' QOL, burden, coping, and mastery, compared with hospice plus emotional support, and usual hospice care. METHODS: A three group randomized controlled trial was conducted including baseline, 16 day, and 30 day assessments conducted from March 1999 to May 2003. The sample consisted of 354 family caregivers of community dwelling hospice patients with advanced cancer. Patient/caregiver dyads were randomly divided into three groups, including a control group (n = 109) who received standard hospice care, a group (n = 109) who received standard hospice care plus three supportive visits, and a group (n = 111) who received standard care plus three visits to teach a coping skills intervention. Primary outcomes included caregiver QOL, caregiver burden due to patient symptoms, caregiver burden due to tasks, and caregiver mastery. RESULTS: At the 30-day follow-up, the coping skills intervention led to significantly greater improvement in caregiver QOL (estimate = -0.16, standard error [SE] = 0.07, P = 0.03), burden of patient symptoms (estimate = 0.28, SE = 0.07, P < 0.001), and caregiving task burden (estimate = -0.01, SE = 0.01, P = 0.038) than did the other two conditions. None of the groups showed significant change in overall caregiving mastery, caregiver mastery specific to caregiving tasks, problem-focused or emotion-focused coping. CONCLUSIONS: The coping skills intervention was effective in improving caregiver QOL, reducing burden related to patients' symptoms, and caregiving tasks compared with hospice care alone or hospice plus emotional support. Structured caregiver skill-training interventions for caregivers are promising even in the difficult environment of end-of-life care and for families already receiving benefits of hospice care.

Adaptation, Psychological↗

PubMedDate not supplied

Quality of life and coping strategies of clients with COPD.

A descriptive correlational design was used to study quality of life and coping in 39 clients with severe chronic obstructive pulmonary disease (COPD). Quality of life was measured by using the Sickness Impact Profile (SIP) and Cantril's Ladder; coping strategies were measured with Jalowiec's Coping Scale Revised (JCS). SIP and Cantril's Ladder scores revealed that the subjects experienced a high quality of life. Total coping scores were low, however, implying that patients used the JCS coping strategies only minimally and did not find them particularly helpful. A moderately strong relationship was found between the objective and subjective measures of quality of life. Coping strategies and quality of life were found not to be significantly related. Findings suggest that the caregivers of those with severe COPD should consider the client's perception of quality of life and use of coping strategies. Further research is needed to determine the factors that affect quality of life for these persons.

Adaptation, Psychological↗

PubMed2003

Dispositional and contextual perspectives on coping: toward an integrative framework.

The clinical disciplines have witnessed a rapidly growing literature on the conceptualization and measurement of coping and on the role of coping in confronting stressful life circumstances and maintaining adaptive functioning. This literature has spawned a diversity of concepts and contrasting perspectives on the determinants and effects of coping. To address this complexity, we comment on dispositional and contextual perspectives on the coping process, describe the domains of coping styles and coping skills, and review some measures of these constructs. Next, we present a conceptual framework that integrates key aspects of these constructs and use the framework to guide a selective review of the linkages between personal and social resources, coping skills, and adaptive functioning. We then consider applications of the framework to clinical practice.

Adaptation, Psychological↗

PubMed2006

Coping, symptoms, and functioning outcomes of patients with posttraumatic stress disorder.

This study examines the association between approach coping and better functioning outcomes and the reciprocal relationships between coping and posttraumatic stress disorder (PTSD) symptoms in patients diagnosed with PTSD. Posttraumatic stress disorder patients receiving services in five VA health care systems were randomly selected and surveyed at baseline and followed 10 months later. Analyses of longitudinal data using structural equation modeling techniques showed that more approach coping predicted better family and social functioning. Cognitive avoidance coping predicted more PTSD symptoms, and more PTSD symptoms predicted more approach coping and more behavioral avoidance coping. Approach coping may enable patients with chronic PTSD to establish and maintain better relationships with family and friends, despite continuing PTSD.

Adaptation, Psychological↗

PubMed2004

The role of social comparison in coping with rheumatoid arthritis: an interview study.

OBJECTIVE: This study aimed to explore the effects of participants' perceptions of support, ways of coping and feelings of control, on their accounts of well-being. METHODS: Semi-structured interviews were conducted with 10 patients with rheumatoid arthritis (RA) and explored the dynamics of participants' accounts of coping with their everyday lives. RESULTS: Four categories of coping mechanisms were evident in all participants' accounts: support during the medical consultation, nurse support, social support, and comparative strategies. This paper focuses on just one of the themes that emerged from our analysis. Further insight into coping mechanisms was provided by the prevalence of comparative coping strategies. A comparison with previous disease states was used by every participant. This comparison enhanced their sense of control and fostered a sense of well-being. Social comparison was used by seven participants to show themselves how fortunate they were in relation to others with RA. CONCLUSION: Comparative coping has been identified as an important strategy adopted by these participants that could be explored in further intervention-based studies of coping.

Journal Article↗

PubMed2001

Improving cognitive development of low-birth-weight premature infants with the COPE program: a pilot study of the benefit of early NICU intervention with mothers.

The purpose of this pilot study was to evaluate the effectiveness of a parent-focused intervention program (COPE) on infant cognitive development and maternal coping. A randomized clinical trial was conducted with 42 mothers of low-birth-weight (LBW) premature infants hospitalized in a neonatal intensive care unit (NICU), with follow-up at 3 months' and 6 months' corrected ages. COPE mothers received the four-phase educational-behavioral program that began 2-4 days postbirth and continued through 1 week following discharge from the NICU. Comparison mothers received audiotaped information during the same four time frames. Results indicated that COPE infants had significantly higher mental development scores at a 3 months' corrected age (M = 100.3) than did the comparison infants (M = 93.9), and this difference widened at 6 months' corrected age, with COPE infants scoring 14 points higher. COPE mothers were significantly less stressed by the NICU sights and sounds and had significantly stronger beliefs about what behaviors and characteristics to expect from their premature infants. Findings from this study support the need for further testing of early NICU interventions with parents to determine their effectiveness on parental coping and infant developmental outcomes.

Adaptation, Psychological↗

PubMed1987

The health of conjugally bereaved older widows: the role of appraisal, coping and resources.

Relationships between bereavement, coping, resources, and health dysfunction were investigated in 100 older women (M age = 71.3 years) widowed from 1 to 12 months prior to the interview. Differences in coping for those who appraised their bereavement as either (a) harmful loss, but without major accompanying losses, (b) harmful loss with other anticipated threats, or (c) a challenge were hypothesized. Data collection included use of the Ways of Coping Checklist, Sickness Impact Profile, and appraisal of bereavement and resources. The appraisal groups differed significantly in overall problem-focused coping, wishful thinking, help seeking/avoidance, self blame, and growth-oriented coping. There was no difference in use of emotion-focused coping and ways to minimize threat and seek social support. Social support, strong religious beliefs, practice of rituals, belief in control over bereavement, and good prior mental health were related to less psychosocial and/or physical dysfunction. Greater numbers of resources, but not greater numbers of coping strategies, also were related to less psychosocial and/or physical dysfunction.

Adaptation, Psychological↗

PubMed1994

A comparative analysis of coping behaviors in persons with multiple sclerosis or a spinal cord injury.

Coping behaviors in individuals with multiple sclerosis (MS) or a spinal cord injury (SCI) were compared. Data were collected on 433 subjects with MS and 257 with SCI. Coping and illness uncertainty were measured by the Ways of Coping Checklist (revised) and the Mishel Uncertainty in Illness Scale. Results of the multivariate analysis of covariance indicated that there was no significant difference between the groups for the use of emotion-focused coping (EFC) or problem-focused coping (PFC). However, there was a significant difference in coping depending on illness uncertainty and the appraisal of life with a disability. Subjects used more EFC at high uncertainty and more PFC at no uncertainty compared to the other levels. When situations were appraised as dangerous, EFC was used more often, and when situations were appraised as an opportunity, PFC was used. The construct of vulnerability emerged as an important antecedent variable. When vulnerability was not included in the analysis, a spurious difference in EFC was found between the groups. Multiple regression results indicated that, for both groups, the choice of coping strategies had no significant effect in explaining emotional well-being while controlling for selected sociodemographic and disability-related variables.

Adaptation, Psychological↗