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PubMed2006

Quality of life and current coping in young adult survivors of childhood cancer: positive expectations about the further course of the disease were correlated with better quality of life.

OBJECTIVES: As a result of advances in the treatment of childhood cancer many patients who may previously have had a limited life expectancy, are now surviving into adulthood. More insight is needed into the long-term adjustment of young adult survivors of childhood cancer. The purpose of this study was to (1) assess health-related quality of life (HRQoL), and (2) to explore the role of cognitive coping in relation to HRQoL. METHODS: HRQoL of 353 Dutch young adult survivors of childhood cancer was compared with HRQoL of 507 peers. Linear regression analyses predicted survivors' HRQoL by cognitive coping, independent of the impact of demographics and medical variables. RESULTS: Survivors reported a lower HRQoL than their peers. Health status was the best predictor of the Physical Component Scale of the RAND-36; health status and cognitive coping contributed almost equally well to the Mental Component Scale. The explanatory value of cognitive coping could mainly be attributed to the use of predictive control strategies. CONCLUSIONS: Because current coping seemed to be an important predictor of HRQoL, interventions directed at the coping strategies of survivors should be useful. The strong association between predictive coping and HRQoL stresses the importance of focusing at having positive expectations about the further course of the disease.

Adaptation, Psychological↗

PubMed2006

Coping among older-adult, long-term cancer survivors.

This research focuses on the coping behavior of older adult, long-term cancer survivors. Specifically, it identifies the personal (including race and gender) and illness/treatment characteristics of survivors that are significantly associated with the use of specific coping styles: planning, acceptance, venting, denial and seeking social support. It also examines the mediating role that these forms of coping play in terms of psychological distress: anxiety, depression and cancer-related worries. Multivariate analysis of data from a random sample of 321 long-term survivors in a major cancer center tumor registry is used to address the above issues. The most prominent forms of coping used by long-term survivors were planning and acceptance; least used were venting and denial. Increased age was associated with lower use of all forms of coping, but cancer type was not. Denial as a form of coping was associated with higher anxiety, depression and cancer-related worries. While race was not found to be a significant predictor of coping style, it was a significant predictor of three dimensions of psychological distress, anxiety, depression and cancer-related worries, with African Americans exhibiting lower levels of distress than Whites. The relevance of these findings for health and social service practitioners is discussed.

Adaptation, Psychological↗

PubMed2006

Depressive symptoms after lung cancer surgery: Their relation to coping style and social support.

Lung cancer patients may experience greater emotional distress than patients with other cancers. Studies have shown social support to predict adjustment in other cancers, but findings among lung cancer patients have been equivocal. Coping style has been shown to predict distress among lung cancer patients, but has not been examined in the context of social support. We examined coping style and social support as predictors of depressive symptoms one week after surgery among 119 patients with non-small cell lung cancer. The Beck Depression Inventory was the primary outcome measure. Predictors included age, ECOG performance status, stage of disease, and measures of adaptive coping, less adaptive coping, Directive instrumental social support and Nondirective instrumental social support. Results indicated that 29% of lung cancer patients had scores above a standard cutoff for clinically significant depression. Results also showed that depressive symptoms were directly related to use of less adaptive coping methods and Directive instrumental social support, inversely related to age and use of adaptive coping methods, and unrelated to nondirective social support, stage of disease and performance status. Results extend previous findings by showing that adaptive coping methods are related to severity of distress, and that the benefits of social support may depend on the characteristics of that support.

Adaptation, Psychological↗

PubMed1989

Defensive coping and blood pressure reactivity in medical patients.

Two defensive coping styles, denial of illness and repressive coping, were studied in two groups of medical patients whose blood pressure (BP) was measured during a stress interview. Denial of illness was measured using the Levine Denial of Illness Scale (LDIS), and repressive coping was measured using a combination of the Marlowe-Crowne (MC) Social Desirability Scale and the SCL-90R anxiety subscale (ANX). Consistent with our prior research indicating that LDIS was associated with adaptive outcomes in the short run, high deniers manifested reduced systolic BP reactivity compared to low deniers. Although not related to repressive coping, systolic BP reactivity was correlated positively with MC and ANX separately. The results demonstrate that LDIS and MC measure different types of defensive coping. Current theories of the MC scale suggest two possible interpretations of the MC findings, one that focuses on avoidant coping and the second on attentional coping in high MC scorers.

Adaptation, Psychological↗

PubMed1985

Coping with a stressful medical procedure: further investigation with volunteer blood donors.

The coping strategies used by volunteer blood donors were studied in an attempt to replicate and extend the findings of Kaloupek et al. [(1984). J. Behav. Med. 7:35-60]. Specifically, coping was assessed by process, state, and trait measures that were then examined in terms of their relationships with subjective, physiological, and behavioral indices of anxiety. Ratings of anxiety made by the donors themselves and by attending nurses generally replicated the previous finding of lower distress associated with avoidant coping (e.g., distraction). Problem-focused coping was also associated with lower distress, including a lower heart rate for first-time donors. Other evidence suggests that for some individuals the expression of distress may be part of a coping strategy that is associated with reduced physiological responding. Discussion concerns links between coping and anxiety which may have relevance to stressful medical situations, including the possible need for anxiety reduction to allow successful application of avoidant coping.

Adaptation, Psychological↗

PubMed1992

The relationship of dispositional optimism, daily life stress, and domestic environment to coping methods used by cancer patients.

The relationship of dispositional optimism, daily life stress, and domestic environment to two types of coping methods was examined in a group of 94 cancer patients. As expected, dispositional optimism and domestic environment made significant contributions to the prediction of avoidance coping. Dispositional optimism contributed significantly to the prediction of active-behavioral coping. Specifically, a significant positive relationship was obtained between active-behavioral coping and optimism. A significant positive relationship also was found between avoidance coping and both daily stress and domestic environment. Avoidance coping was negatively related to dispositional optimism. In multivariate analyses, gender and disease-related variables did not make significant contributions to the prediction of coping method. Suggestions for future research were made.

Adaptation, Psychological↗

PubMed1986

The medical context of parental coping with childhood cancer.

This research assessed the extent to which contextual factors, especially the medical context, are related to the use of specific coping strategies by 74 parents of surviving children with cancer. Parents reported that they coped reasonably well by using information-seeking, problem-solving, help-seeking, maintaining emotional balance, relying on religion, being optimistic, denying, and accepting. More highly educated parents tended to use problem solving, optimism, and information seeking significantly more and denial significantly less than well-educated parents. However, gender and income were unrelated to coping. The use of specific coping strategies was not related to severity of the child's medical condition, stress level, or parents' own evaluations of their coping effectiveness. However, the quality of relations with the medical staff was strongly related to coping strategies. Use of passive coping strategies was positively related to good relations with the medical staff.

Adaptation, Psychological↗

PubMed1988

Responses to collective risk: appraisal and coping among workers exposed to occupational health hazards.

Appraisals of occupational health risks and coping alternatives were examined in a study of 670 steelworkers. Three forms of coping were considered: emotion focused, problem focused, and system oriented. Path analysis was used to test a model of coping as a function of primary appraisals of occupational exposures, secondary appraisals of coping options, reappraisal of health concerns, and background characteristics. Results show that each element in the proposed model contributes significantly to all three coping types. In addition, distinctive patterns of secondary appraisal were observed for each type of coping. Future use of the concept of system-oriented coping is suggested for investigating problems not easily solved by individual action.

Adaptation, Psychological↗

PubMed2000

[Coping with stress by the elderly: a comparison of young, middle-aged and elderly couples].

The aim of this study was to investigate age effects on differences and similarities of individual and dyadic coping in 242 couples. There exist only a few systematically designed studies for age effects on individual coping. The majority of the results show that functional and dysfunctional individual coping are maintained constant if age differences are focused on. In our study we found high stability in the functional and dysfunctional individual coping over the three groups. By contrast, there are no studies except one for age effects on dyadic coping in the literature. Our results show differences in the positive emotional common dyadic coping and the total score of the positive common dyadic coping, both with the lowest values in the older couples.

Adaptation, Psychological↗

PubMed2005

Stress-resilience, illness, and coping: a person-focused investigation of young women athletes.

Coping correlates of resilience, defined as resistance to illness in the face of exposure to high numbers of negative life events, were studied in a sample of 404 young women high school athletes. Negative life events and coping strategies were assessed preseason, and daily illness data were collected during the course of the season. Among athletes with high levels of exposure to negative life events, resilient (no illness time loss) and nonresilient (upper third of time loss distribution) groups were compared on 6 scales of the Ways of Coping Checklist. Coping profiles of the groups differed significantly, with resilient athletes favoring Problem-focused Coping and Seeking Social Support, and nonresilient athletes reporting greater use of Avoidance and Blaming Others. Correlations among Problem-focused Coping, Seeking Social Support, and Minimize Threat were higher in the resilient group. Results suggest that certain coping strategies may contribute to illness-resistance in the face of high life stress.

Adaptation, Psychological↗

PubMed2005

Coping with prostate cancer: a meta-analytic review.

The present meta-analytic review assessed the relations between coping categories and indices of adjustment in men with prostate cancer. Relevant methodological and statistical information was extracted from 33 target studies (n = 3,133 men with prostate cancer). Men with prostate cancer who used approach, problem-focused, and emotion-focused coping were healthier both psychologically and physically, although the effect sizes for problem-focused coping and emotion-focused coping were more modest. For approach coping these effect sizes were particularly strong for measures of self-esteem, positive affect, depression, and anxiety. Conversely, men with prostate cancer who used avoidance coping experienced heightened negative psychological adjustment and physical health, and particularly for measures of positive mood and physical functioning. The findings of this study suggest that active approaches to coping with prostate cancer are beneficial psychologically, physically, and are positively associated with a return to pre-cancer activities.

Adaptation, Psychological↗

PubMed1987

Coping behaviors among depressed and nondepressed medical inpatients.

Sixty medical inpatients completed a variety of psychological measures related to factors associated with depression. An analysis of self-reported depression and coping response indices revealed significant differences in coping strategies between depressed and nondepressed medical inpatients. Depressed patients more often reported avoidance strategies to cope with the stressors associated with hospitalization, while nondepressed patients were more likely to utilize active coping techniques. Since the coping and depression measures were assessed concurrently, the direction of influence cannot be determined. Still, these findings are consistent with the learned helplessness model of depression for medical inpatients and suggest specific psychological interventions for treating this population. Such treatment would attenuate the adverse effects of inpatient medical depression and thereby enhance the desired benefits of medical hospitalization. It is suggested that future research examine the effectiveness of coping in a prospective design to clarify the direction of the coping and depression relationship.

Adaptation, Psychological↗

PubMed1988

Association of type A behavior and its components to ways of coping with stress.

This preliminary study provides evidence suggesting that Type A behavior and its components influence how people cope with personally relevant stressful situations, and that the relationship between Type A scores and coping is different when examined separately among males and females. Among males, Type A behaviors were positively correlated to the use of problem-focused coping, and inversely related to seeking social support. Among females, Type A behaviors were positively correlated with problem-focused coping, cognitive restructuring coping, and self-denigration coping. Results were integrated into Glass' model of the role of individual differences in need for personal control in the coping process, and discussed in terms of their implications for understanding the biopsychosocial mechanisms through which some Type A behaviors might increase an individual's risk of coronary heart disease.

Adaptation, Psychological↗

PubMed1984

Stress and coping in the explanation of psychological adjustment among chronically ill adults.

This study evaluates the utility of a stress and coping paradigm for explaining individual differences in psychological adjustment to chronic illness. Using data from the first wave of a longitudinal study of 170 middle-aged and elderly adults faced with one of four chronic illnesses (hypertension, diabetes mellitus, cancer and rheumatoid arthritis), this paper examines the relationship between the stresses of chronic illness and coping, and the ability of coping to explain psychological adjustment. Results show coping strategy use tends to be minimally explained by medical diagnosis. Cognitive strategies, including information seeking, are related to positive affect while emotional strategies, particularly those involving avoidance, blame and emotional ventilation, are related to negative affect, lowered self-esteem and poorer adjustment to illness. While the findings suggest that a stress and coping model may be valuable in understanding adjustment among the chronically ill, the general modesty of coping effects and the failure of the stress buffering hypothesis to explain adjustment indicates a need for new research approaches and some modification of current theories of coping.

Adaptation, Psychological↗

PubMed1989

Coping with political violence in Northern Ireland.

Recent community based research, employing a self-assessed measure of psychological distress, has suggested that people in Northern Ireland may be coping relatively well with the stress of continuing political violence. This paper reports a first direct investigation of coping in Northern Ireland. Using two scales from the Folkman and Lazarus Ways of Coping Questionnaire--Distancing and seeking Social Support--an attempt was made to investigate the role of coping in relation to local levels of violence, the appraisal of violence, gender and trait neutoticism. The results indicated that trait neuroticism was not related to the appraisal of levels of violence, but that appraisal was related to both types of coping. In particular, those who perceived the violence to be more serious reported using less distancing, while they also reported seeking the most social support. In addition more women reported seeking social support compared to men. Finally those who lived in a high violence area were more likely to report using distancing than were those from a less violence prone area. These results were taken to support the contention that some form of denial may be the main form of coping in Northern Ireland, and that coping is related more to the appraisal of violence than to actual violence levels, while the appraisal of violence is in turn not related to trait neuroticism.

Adaptation, Psychological↗

PubMed1992

Methodological issues and research strategies in the study of coping with cancer.

We explore methodological issues and research strategies and applications in the study of coping with cancer. The major points are addressed within the context of the transactional, or process, model of stress and coping offered by Lazarus and Folkman. Three features of this model are discussed: (a) a focus on what individuals are actually doing and thinking in stressful transactions as opposed to what they usually do or would do; (b) an emphasis on assessing coping behavior in relation to a specific context and; (c) attention to the dynamic nature of coping behavior. We outline each of these three features and discuss its implications for research on coping with cancer; particular attention is given to specific measurement strategies and substantive research questions. We also consider the utility of research on coping with cancer for the design and implementation of coping interventions for individuals with cancer.

Adaptation, Psychological↗

PubMed1987

Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients.

This study describes the development of a self-report questionnaire, the Vanderbilt Pain Management Inventory, which assesses the frequency with which chronic pain patients use active or passive coping strategies when their pain reaches a moderate or greater level of intensity. Two internally reliable scales, Active Coping and Passive Coping, were derived using factor analytic techniques from a sample of 361 rheumatoid arthritis patients. The 2 scales showed an opposite pattern of relationships with criterion measures. While Active Coping was associated with reports of less pain, less depression, less functional impairment, and higher general self-efficacy, Passive Coping was correlated with reports of greater depression, greater pain and flare-up activity, greater functional impairment, and lower general self-efficacy. The relationship of these scales to previous theory and research on coping is presented. These scales appear useful for the assessment of coping strategies in clinical settings and in treatment outcome research on chronic pain.

Adaptation, Psychological↗

PubMed1991

Coping with chronic pain: a critical review of the literature.

A growing number of investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. This article reviews the empirical research which has examined the relationships among beliefs, coping, and adjustment to chronic pain. Although preliminary, some consistent findings are beginning to emerge. For example, patients who believe they can control their pain, who avoid catastrophizing about their condition, and who believe they are not severely disabled appear to function better than those who do not. Such beliefs may mediate some of the relationships between pain severity and adjustment. Although coping strategies appear to be associated with adjustment in chronic pain patients, methodological problems limit conclusions regarding the strength and nature of this association. Our recommendations for future research include the development of coping and belief measures which: (1) do not confound different dimensions (e.g., coping, beliefs, and adjustment) in the same measure; (2) assess specific (rather than composite) constructs; (3) are psychometrically sound; and (4) assess behavioral coping strategies more objectively. We also recommend a greater use of experimental research designs to examine causal relationships among appraisals, coping, and adjustment.

Adaptation, Psychological↗