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PubMed2002

Coping with Prader-Willi syndrome.

Weight- and behavior-control issues are major concerns for parents of a child with Prader-Willi syndrome. However, limited information is available on how families implement the necessary dietary restrictions and the effects of the strategies. This study identified the advice a group of families received regarding weight management, the nutrition concerns they faced and how they coped with these concerns, and the effectiveness of their coping strategies. A 2-step survey methodology was used. Survey 1 identified the strategies parents used to cope with the feeding issues typically presented by children with Prader-Willi syndrome. Survey 2 evaluated the frequency with which these coping strategies were used and their effectiveness. Respondents also provided information on why strategies were not effective. Surveys were mailed to 496 parents/guardians of children (aged 25 years or younger) with Prader-Willi syndrome. A total of 293 (64%) responded. Advice given to families centered on general weight management and dietary guidance. Difficulties centered around coping with food-related behaviors. Coping strategies varied; what worked for 1 family did not necessarly work for another. Participants indicated a desire to share experiences and a need for specific strategies to cope with feeding-behavior difficulties. A few basic behavior-management strategies, including successful use of incentives, responding to misbehavior, rewarding compliance with an exercise program, and modifying the behavior management when indicated, are briefly reviewed.

Adaptation, Psychological↗

PubMedDate not supplied

Coping strategies of panic and control subjects undergoing lactate infusion during magnetic resonance imaging confinement.

The psychological reactions and coping strategies used in response to a behavioral contingency (confinement in a magnetic resonance imaging [MRI] scanner) during a biological challenge (sodium lactate infusion) were systematically studied in 13 subjects with panic disorder (PD) and 11 control subjects using the Claustrophobia Questionnaire (CQ) and the Revised Ways of Coping Checklist (RWCCL). All participants were able to successfully complete the experimental procedure. Findings suggest between-group coping strategy differences in response to general stressors, but relative convergence of coping strategies in response to the experimental procedure, with relatively greater emphasis on problem-focused coping approaches. These observations suggest that PD patients are able to engage in effective coping strategies in response to stressful but highly structured experimental situations. An overall pre-post MR scanning reduction in the fear of restriction but not suffocation was observed for the combined sample, primarily reflecting changes in the control group. Among PD subjects, higher levels of suffocation fears were maintained despite emergence of more problem-focused coping in the experimental situation.

Adaptation, Psychological↗

PubMedDate not supplied

Alexithymia: relationship with ego defense and coping styles.

There is controversy in the literature as to whether alexithymia reflects a deficit in the cognitive processing of emotions or a defensive coping style. Previous studies with clinical populations reported a strong association between alexithymia and a maladaptive (immature) ego defense style. The present study was designed to examine this relationship in nonclinical populations, and also to explore the relationships between alexithymia and three general styles for coping with stressful situations. Sample 1, 287 nonclinical adults, completed the Twenty-Item Toronto Alexithymia Scale (TAS-20) and the Defense Style Questionnaire (DSQ). Sample 2, 83 undergraduate students who had been categorized previously into alexithymic and nonalexithymic subgroups, completed the DSQ and the Coping Inventory for Stressful Situations (CISS). In sample 1, the TAS-20 and its three factors were associated most strongly with an immature defense style, weakly with a neurotic defense style, and negatively with a mature defense style. In sample 2, alexithymic students scored significantly higher than nonalexithymic students on the immature and neurotic defense factors of the DSQ and significantly lower on the mature defense factor. Alexithymic students also scored significantly higher on the emotion-oriented coping scale and the distraction component of the avoidance-oriented coping scale of the CISS and significantly lower on the task-oriented coping scale. The results fail to support the view that alexithymia is an adaptive defense or coping style.

Adaptation, Psychological↗

PubMed1997

Anxiety, depression and coping methods of hospitalized patients with myocardial infarction in Taiwan.

The purpose of this study was to determine the relationship among anxiety, depression, and coping methods reported by myocardial infarction (MI) patients in Taiwan. Forty post-MI patients were interviewed in the general cardiovascular unit. A subset of patients (n = 15) had high levels of anxiety and depression, however, most patients displayed low levels of anxiety and depression. A significant, moderately positive relationship was found between anxiety and the use of coping styles. An association between depression and coping styles was not found. The optimistic coping style of the Jalowiec Coping Scale was the most often used and most helpful coping method described by subjects. Emotional reactions and coping methods were related to age, social class, and actual or perceived severity of MI. Results of this study lend further support for the need to evaluate the presence, intensity and influencing factors of anxiety and depression in the recovery phase of MI.

Adaptation, Psychological↗

PubMed2000

Coping strategies in twins with chronic fatigue and chronic fatigue syndrome.

OBJECTIVES: Individuals with chronic fatigue and chronic fatigue syndrome (CFS) face debilitating symptoms as well as stressful life situations that may result from their condition. The goal of this study was to examine the coping strategies used by fatigue-discordant twin pairs. METHODS: We utilized a co-twin design to assess how twin pairs discordant for chronic fatigue and CFS cope with stress. All twin pairs were administered the Revised Ways of Coping Checklist. RESULTS: Overall, the pattern of coping strategies was similar for fatigued and non-fatigued twins. However, twins with chronic fatigue or CFS utilized more avoidance strategies than their non-fatigued counterparts; those with chronic fatigue also used more avoidance relative to problem-focused coping than their co-twins. CONCLUSIONS: These results suggest that while fatigue-discordant twins generally exhibit similar behavior patterns in order to cope with stress, there may be an association between fatigue and avoidance coping. Future research should focus on the role of avoidance and its relationship to fatiguing illnesses.

Adaptation, Psychological↗

PubMed2004

Do health causal attributions and coping strategies act as moderators of quality of life in peritoneal dialysis patients?

OBJECTIVE: The present study aimed at testing the relationships between health causal attribution and coping mechanisms with quality of life (QOL) in patients who have end-stage renal disease (ESRD) undergoing a peritoneal dialysis (PD) treatment. It was hypothesized that QOL should be negatively associated with the severity of the disease. Problem-focused coping, internal health-related locus of control (HRLOC) and medical power HRLOC were hypothesized as positive moderators preserving a better QOL, after controlling for the severity of the disease. METHODS: A total of 47 PD patients completed the Kidney Disease Quality of Life (KD-QOL) scale encompassing the Medical Outcomes Study Short-Form (MOS SF-36) self-administered questionnaire, the Multidimensional Health Locus of Control scale and the Ways of Coping Check-List (WCCL) scale. RESULTS: Low scores for all QOL scores were found except for pain dimension, as compared with scores available from a general French population. Globally, QOL was not related to the severity of the disease. Univariate analysis showed that the physical component score (PCS) of QOL was positively associated with internal HRLOC (r=.35; P<.05), and negatively with medical power HRLOC (r=-.36; P<.05). Multivariate analysis adjusting for age confirmed these results. Mental component score (MCS) was negatively associated with the use of emotion-focused coping and seeking social support (r=-.45; P=.001 and r=-.30; P<.05, respectively), the first association persisting in multivariate analysis. Neither PCS nor MCS was linked to the use of problem-focused coping. CONCLUSION: These results suggest that physical QOL is all the more preserved when patients are more convinced that their behaviour can influence their health condition and that psychological QOL is all the more impaired when health condition is perceived as less controllable, requiring emotion-focused coping (avoidance strategies). Health causal attributions and coping act respectively as moderators of physical and psychological components of QOL.

Adaptation, Psychological↗

PubMed2003

Coping strategies in patients with interstitial cystitis: relationships with quality of life and depression.

PURPOSE: Previous research has demonstrated that interstitial cystitis patients experience depressive symptoms and decrements to quality of life. However, to our knowledge the extent to which patients may be able to influence quality of life and depressive symptoms through coping strategies has not been investigated in this population. In a number of other chronic conditions specific coping strategies have been associated with the degree of impairment beyond disease severity. Therefore, the association of coping strategies with depressive symptoms, quality of life and self-reports of pain was assessed in patients with interstitial cystitis. MATERIALS AND METHODS: A total of 64 females with interstitial cystitis were recruited from a urology clinic at a tertiary medical center. Questionnaires assessing depression, quality of life, coping and symptom severity were completed and returned at a clinic appointment. Depression was also measured through a standardized semi-structured interview (Hamilton Rating Scale for Depression). All analyses controlled for age. RESULTS: Patients coping by greater catastrophizing reported greater impairments in various domains, including depressive symptoms, general mental health, social functioning, vitality and pain. Greater venting was associated with greater depressive symptoms and poorer mental health. Seeking instrumental social support was associated with fewer depressive symptoms. CONCLUSIONS: These findings suggest that maladaptive coping strategies are associated with higher levels of depressive symptoms and quality of life decrements in patients with this condition. Psychosocial interventions aimed at increasing adaptive coping may positively impact the female experience with interstitial cystitis.

Adaptation, Psychological↗

PubMed1997

Assessment of coping strategies of child abusing mothers.

OBJECTIVE: Mothers who had physically abused their children were assessed to determine whether these mothers had a general coping skills deficit. METHOD: Abusing mothers (n = 17) were compared to nonabusing mothers of conduct problem children (n = 16). Coping was measured by several methods, each designed to address the insufficiencies of the others. RESULTS: In comparison to the nonabusing mothers, independent ratings indicated that abusing mothers exhibited a pattern of coping characterized by greater use of emotion-focused coping strategies and less use of effective problem-focused strategies. Finally, using self report ratings of coping, abusing mothers perceived their coping to be more ineffective than the nonabusing mothers. CONCLUSIONS: The possibility that the observed coping skills deficit may be indicative of a deficit in emotional responding to stress was discussed and suggestions were given for therapeutic interventions with child abusing mothers.

Adaptation, Psychological↗

PubMed1999

Coping strategies and social support as mediators of consequences in child sexual abuse victims.

OBJECTIVE: The main objective of this study was to evaluate the mediator role of coping strategies and social support on the adaptation of children following CSA. Empirical studies indicate that short-term consequences of child sexual abuse (CSA) are multiple and varied (Kendall-Tackett, Williams, & Finkelhor, 1993; Wolfe & Birt, 1995). While abuse-related characteristics were first studied to explain the variability of CSA outcome, more recently, the influence of other variables such as coping strategies and social support have been considered. METHOD: Fifty sexually abused children aged between 7 and 12 participated in this study. The Child Behavior Checklist (Achenbach, 1991) and the Perceived Competence Scale for Children (Harter, 1985) were used to measure victims' adjustment. Coping strategies were evaluated by the Self-Report Coping Scale (Causey & Dubow, 1992) and the children completed the Perceived Social Support (Harter, 1985). A French version of the History of Victimization (Wolfe, Gentile, & Bourdeau, 1987) was used to gather abuse-related characteristics from medical records. RESULTS: Results indicate that sexually abused children exhibit internalizing and externalizing behavior problems following CSA. Coping strategies and social support exert direct effects on victims' adjustment instead of the mediator influences originally expected. Among abuse-related variables, only the perpetrator's identity is directly related to internalizing symptoms. CONCLUSIONS: The absence of mediational effects of coping and social support is discussed in light of the measures used and the cross-sectional nature of the study. Results highlight the importance of parental implication and the consideration of coping strategies in designing therapeutic interventions with this population.

Adaptation, Psychological↗

PubMed2001

Parallel circuits mediating distinct emotional coping reactions to different types of stress.

All animals, including humans, react with distinct emotional coping strategies to different types of stress. Active coping strategies (e.g. confrontation, fight, escape) are evoked if the stressor is controllable or escapable. Passive coping strategies (e.g. quiescence, immobility, decreased responsiveness to the environment) are usually elicited if the stressor is inescapable and help to facilitate recovery and healing. Neural substrates mediating active versus passive emotional coping have been identified within distinct, longitudinal neuronal columns of the midbrain periaqueductal gray (PAG) region. Active coping is evoked by activation of either the dorsolateral or lateral columns of the PAG; whereas passive coping is triggered by activation of the ventrolateral PAG. Recent anatomical studies indicate that each PAG column receives a distinctive set of ascending (spinal and medullary) and descending (prefrontal cortical and hypothalamic) afferents. Consistent with the anatomy, functional studies using immediate early gene expression (c-fos) as a marker of neuronal activation have revealed that the preferential activation of a specific PAG column reflects (i) the type of emotional coping reaction triggered, and (ii) whether a physical or psychological stressor was used.

Adaptation, Psychological↗

PubMed1999

Coping styles in animals: current status in behavior and stress-physiology.

This paper summarizes the current views on coping styles as a useful concept in understanding individual adaptive capacity and vulnerability to stress-related disease. Studies in feral populations indicate the existence of a proactive and a reactive coping style. These coping styles seem to play a role in the population ecology of the species. Despite domestication, genetic selection and inbreeding, the same coping styles can, to some extent, also be observed in laboratory and farm animals. Coping styles are characterized by consistent behavioral and neuroendocrine characteristics, some of which seem to be causally linked to each other. Evidence is accumulating that the two coping styles might explain a differential vulnerability to stress mediated disease due to the differential adaptive value of the two coping styles and the accompanying neuroendocrine differentiation.

Adaptation, Psychological↗

PubMed2002

Beta-2 adrenergic receptor gene variations and coping styles in twins.

We tested the hypothesis that the beta-2 adrenergic receptor (beta-2 AR) gene locus, with known effects on blood pressure regulation, is also involved in psychological coping styles. 166 pairs of monozygotic (MZ) and dizygotic (DZ) twins and DZ twin parents were investigated. We found common genetic variance for the coping factor Emotional Coping and blood pressure. Using three microsatellites we found linkage between the beta-2 AR gene locus and the coping factor Active Coping. Using allele-specific PCR of all the single nucleotide polymorphisms (SNPs) in the gene causing amino acid substitutions we identified associations between the +491 G/A SNP and various coping factors. We conclude that the beta-2 AR gene is relevant to coping. These preliminary findings suggest a molecular genetic underpinning of the relationship between psychological and physiological phenotypes important to cardiovascular risk.

Adaptation, Psychological↗

PubMed1996

Good patients cope with their pain: postoperative analgesia and nurses' perceptions of their patients' pain.

Patients routinely receive less analgesia postoperatively than they need. Previous attempts to understand this have examined the nurses' attitudes to analgesia and their ability to assess accurately the intensity of their patients' pain. The present study examined three hypotheses derived from an alternative view that undermedication results from patients failing to disclose their difficulty in coping with pain because this would lead to disapproval by nurses: (i) that analgesic intake is related, not to pain intensity but to patients' feelings of being unable to cope with pain and to nurses' assessment of their inability to cope; (ii) that nurses specifically underestimate patients' ability to cope with their pain; and (iii) that poor coping with pain is seen by nurses as indicative of a 'bad' patient. Pain ratings were completed by 56 patients undergoing minor abdominal surgery; nurses completed similar scales to show their perception of patients' pain, as well as a specially devised scale which measured how negatively or positively they felt about their patients. Nurses were sensitive to the intensity of their patients' pain, but underestimated how well patients felt they coped with pain and how much they wanted analgesia. Patients who experienced the worst pain, or whom the nurses perceived as coping least well with their pain, were evaluated by the nurses as unpopular and demanding.

Adaptation, Psychological↗

PubMed1999

Validation of the Chronic Pain Coping Inventory.

The Chronic Pain Coping Inventory (CPCI; Jensen, M.P., Turner, J.A., Romano, J.M. and Strom, S.E., The Chronic Pain Coping Inventory: development and preliminary validation, Pain, 60 (1995) 203-216) is a recently developed questionnaire comprising eight main subscales that measure coping strategies that are frequently targeted for change in interdisciplinary pain treatment programs. Preliminary research, carried out by the developers of the CPCI, supports the reliability and validity of the scale. The purpose of the present study was to further examine the validity of the CPCI independently. In the present study, 210 patients were administered the CPCI, along with the Coping Strategies Questionnaire (CSQ; Rosenstiel, A.K. and Keefe, F.J., The use of coping strategies in low back pain patients: relationship to patient characteristics and current adjustment, Pain, 17 (1983) 33-44; Riley III, J.L. and Robinson, M.E., CSQ: five factors or fiction? Clin. J. Pain, 13 (1997) 156-162), and the Multidimensional Pain Inventory (MPI; Kerns, R.D., Turk, D.C. and Rudy, T.E.. The West Haven-Yale Multidimensional Pain Inventory (WHYMPI), Pain, 23 (1985) 345-356) as part of a pre-admission screening. Principal components analysis with oblique rotation was performed on the 64 main CPCI scale items. An eight-factor solution was identified as most appropriate. The original subscales were generally supported, however, some modifications to scoring of subscales were suggested. As a second step in the study, the relationship between the modified CPCI subscales and the CSQ subscales were examined and their relative ability to predict concurrent adjustment to pain (MPI subscales) was assessed. Results indicated that CPCI subscales tap coping constructs that are conceptually different than the CSQ subscales. Several CPCI subscales were also found to be significantly and uniquely related to measures of concurrent adjustment, even after taking CSQ subscales and demographic and pain-related variables into account. These results suggest the CPCI is a valuable tool, above and beyond established coping measures, in the clinical assessment and research of pain. Directions for future research are discussed.

Adaptation, Psychological↗

PubMed1999

Everyday life with osteoarthritis or rheumatoid arthritis: independent effects of disease and gender on daily pain, mood, and coping.

The effects of disease (form of arthritis) and gender on pain, mood, and pain coping strategies were examined in a prospective 30-day diary study of 71 patients with osteoarthritis (OA) and 76 with rheumatoid arthritis (RA). Diary instruments included joint pain ratings, POMS-B checklists for positive and negative mood, and the Daily Coping Inventory. Women's average daily pain was 72% greater than men's pain, and RA patients' average daily pain was 42% greater than OA patients' pain. Hierarchical Linear Models were estimated for (a) within-person associations between pain and next-day mood; coping and next-day pain; and coping and next-day mood; and (b) the independent effects of disease and gender on individual intercepts for pain, mood, and coping and on individual slopes for pain-coping-mood relations. Women, regardless of their disease, and RA patients, regardless of their gender, reported more daily pain. Women used more emotion-focused strategies each day than did men, regardless of their disease and even after controlling for their greater pain. Men were more likely than women to report an increase in negative mood the day after a more painful day. RA patients' pain worsened, but OA patients' pain improved, following a day with more emotion-focused coping. Implications for research and clinical practice are summarized.

Adaptation, Psychological↗

PubMed1997

A study of self-monitoring processes and coping behaviour in burns victims.

This is a quasi-experimental study to examine the manner in which burns victims cope with and self-monitor their presentation. Self-monitoring was measured by the Revised Self-monitoring Scale and coping with the Revised Ways of Coping Scale. Observations were made at weeks 2, 8 and 16 postburn. Conclusions were that self-monitoring does not change over time and the location of burns scars does not affect coping or self-monitoring. At 8 weeks postburn females have encountered more stresses and do more coping than males, and females use more emotion-focused coping than males as a whole. Recommendations are for increased patient education programmes on postburn information and predischarge counselling and for more staff education programmes on identification of major coping strategies and predischarge planning.

Adaptation, Psychological↗

PubMed1998

The relationship between stress-coping and vasomotor symptoms in postmenopausal women.

OBJECTIVE: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms. METHODS: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17 beta-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory. RESULTS: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group. CONCLUSIONS: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.

Adaptation, Psychological↗

PubMed1997

Coping strategies, personality, and voice quality in patients with vocal fold nodules and polyps.

Emotional state affects the physiological mechanism involved in phonation. Differences in acoustical parameters of the voice under stress have been attributed to the coping mechanism used, which is based on the individual's perception of the situation. This study examines the relationship between coping strategies, personality, and voice in female subjects, ranging in age from 19.3-55.7 years, diagnosed with vocal nodules or polyps. The differences between coping strategies and personality are examined and compared with another group with no history of voice pathology. The relationship of personality and coping strategies to voice quality variables is reported. Results show that patients use emotional coping strategies more and cognitive coping strategies less than the comparison group. Type of voice pathology was found to be related to dominance, and a number of coping and personality variables were found to correlate significantly with voice quality.

Adaptation, Psychological↗