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PubMed2000

Adolescents becoming smokers: the roles of stress and coping methods.

PURPOSE: To examine the relationship of stress and coping methods to smoking status (never-smoker, experimenter, and current smoker) among an inner-city, clinic-based, adolescent population, as well as to examine the prevalence of smoking and related behaviors in this population using a cross-sectional survey. METHODS: A self-administered questionnaire that included the Perceived Stress Scale (PSS), negative life events (LES), and a coping measures scale was used with 954 clinic patients aged 12-21 years. Demographic characteristics were compared using analysis of variance and Chi-square test. The Kruskal-Wallis analysis of variance was used to compare the values of each scale among smoking-status groups. Logistic regression analysis was used to determine the relationship of smoking status to PSS, LES, and coping methods. RESULTS: The overall prevalence of smoking in this population was 26%. The age of onset was 13.3 years for current smokers vs. 15.5 for experimenters (p<.01). Perceived stress and negative life events, adjusting for demographic variables, were highest among current smokers, less so in experimenters, and lowest in the never-smokers (p <.001). Stepwise logistic regression analysis showed that negative life events, perceived stress, greater use of the negative coping methods of anger and helplessness, and less use of the positive coping methods of parental support and cognitive coping were significantly and independently related to smoking status. CONCLUSIONS: One in four inner-city youth report smoking. Higher levels of stress and greater use of negative coping methods were found in current smokers than in experimenters and never-smokers.

Adaptation, Psychological↗

PubMed2001

Impact of the therapist-child dyad on children's pain and coping during medical procedures.

This study examined the effects of physical therapists' behaviors on the levels of distress and coping of 32 children (19 males, 11 females; age range 2.6 to 9.1 years) during a painful medical procedure. This is the second study to assess children throughout rehabilitation following selective posterior rhizotomy and the first to assess the impact of physical therapists' behaviors. Results of the Child-Adult Medical Procedure Interaction Scale-Revised confirmed the hypotheses that: (1) children exhibit more coping behaviors and fewer distress behaviors over time, and (2) positive relationships exist between coping-promoting behaviors in physical therapists and coping in children, and distress-promoting behaviors in physical therapists and distress in children. Prompts for children to use a coping strategy, reassuring comments, and non-procedural talk by therapists explained 67% of the variance in children's coping. Criticism, reassurance, checking child's status, praise, and empathic statements by therapists explained 65% of the variance in children's distress. Older children and children with higher IQ scores exhibited more coping behaviors.

Adaptation, Psychological↗

PubMed2001

Prodromes, coping strategies and course of illness in bipolar affective disorder--a naturalistic study.

BACKGROUND: Psychosocial interventions for bipolar patients often include teaching patients to recognize prodromal symptoms and tackle them early. This prospective study set out to investigate which bipolar prodromal symptoms were reported frequently and reliably over a period of 18 months. Furthermore, we have also investigated which types of coping strategies were related to good outcome. METHOD: Forty bipolar patients were interviewed for their bipolar prodromal symptoms and their coping strategies at recruitment and 18 months later. Patients were also assessed as to whether they had experienced relapses. RESULTS: Bipolar patients were able to report bipolar prodromal symptoms reliably. Mania prodromal symptoms tended to be behavioural symptoms. A quarter of patients reported difficulties in detecting depression prodromes, which tended to be more diverse and consisted of a mix of behavioural, cognitive and somatic symptoms. Significantly fewer patients who reported the use of behavioural coping strategies to curb excessive behaviour during the mania prodromal stage experienced a manic episode. Similarly, significantly fewer patients who reported the use of behavioural coping strategies experienced depression relapses. How well patients coped with mania prodromes predicted bipolar episodes significantly when the mood levels at baseline were controlled. Ratings of how well subjects coped with mania prodromal symptoms also predicted manic symptoms significantly at T2 when manic symptom at T1 was controlled. CONCLUSION: Our study suggests that bipolar patients are able to report prodromal symptoms reliably. It is advisable to teach patients to monitor their moods systematically and to promote good coping strategies.

Adaptation, Psychological↗

PubMed2002

The relation between coping, social support and psychological and somatic symptoms among torture survivors in Nepal.

BACKGROUND: Little is known about the relation between coping, social support, and psychological and somatic symptoms among survivors of torture living outside the West. METHOD: In a population-based dataset of 315 tortured Bhutanese refugees, univariate and multivariate relationships between coping and social support and symptoms were estimated. These relationships were verified in a second sample of 57 help-seeking Nepalese torture survivors. RESULTS: A relationship was observed between the total number of coping strategies used and anxiety and depression. Negative coping, in contrast to positive coping, was related to all symptom outcome measures. Received social support was stronger related to symptoms than perceived social support. The findings from the first sample were replicated in the second sample. CONCLUSION: We found hypothesized relationships between coping, social support, and psychological and somatic symptoms among survivors of torture living in Nepal. The findings from this study confirm the importance of understanding specific types of coping and social support to develop intervention programmes for torture survivors in Non-western settings.

Adaptation, Psychological↗

PubMed2005

A controlled trial of cognitively oriented psychotherapy for early psychosis (COPE) with four-year follow-up readmission data.

OBJECTIVES: Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and preventing or alleviating secondary morbidity in the wake of the first psychotic episode. The present study reports on the outcomes of a controlled trial comparing two conditions: COPE versus No-COPE. METHOD: Ninety-one people participated in the trial which was analysed by intention-to-treat, including 12 people who were assigned to COPE but refused to participate. Assessments were conducted at pre-treatment, mid-treatment and post-treatment. Hospital readmission data were obtained through a Psychiatric Case Register. The study was conducted in a front-line public mental health service, the Early Psychosis Prevention and Intervention Centre (EPPIC). Clients in both COPE and No-COPE were provided with full access to the complete range of EPPIC services. RESULTS: There were no significant differences between the two conditions on the nine primary outcome variables. Hospital readmissions were assessed for each client at yearly intervals up to 4 years following the completion of treatment and again there were no significant between-group differences. CONCLUSIONS: The study indicated that there was no significant advantage to COPE over and above routine care at EPPIC.

Adolescent↗

PubMed2000

The relationship of hardiness, coping strategies, and perceived stress to symptoms of illness.

We proposed a conceptual model based on research supporting the relationship between symptoms of illness and the determinants of hardiness, coping strategies, and perceived stress. In this model, hardiness, avoidance coping, and approach coping have paths to perceived stress, perceived stress has a path to symptoms of illness, and hardiness also has a path to symptoms of illness. We examined the goodness of fit of this model using path analysis and tested its stability, as well as the presence of gender effects, in corporate (N = 110) and university (N = 271) samples. The proposed model was a good fit for the data in the corporate sample, and no gender effects were found. The proposed model was not a good fir for the data in the university sample, therefore we added two paths that have received some support in the research: from approach coping to symptoms of illness and from avoidance coping to symptoms of illness. This model was a good fit for the data in the university sample, however, the path from approach coping to symptoms of illness had a critical ratio < 2.0, thus we removed this path and ran the model again. The final model was a good fit for the data, and no gender effects were found. Implications for the relationship of hardiness, coping strategies, and perceived stress to health are discussed.

Adaptation, Psychological↗

PubMed2000

The negative effect of decreasing the level of activity in coping with pain in rheumatoid arthritis: an increase in psychological distress and disease impact.

The objective of this study was to analyze the effect of coping with pain in rheumatoid arthritis (RA) on subsequent changes in psychological distress and disease impact. A sample of 109 randomly selected RA patients was asked to participate in a longitudinal study. Patients were measured at baseline and after 3 years. Both measurements were completed in 80 patients. At each assessment the following variables were assessed: disease activity, pain, physical and psychological distress, disease impact, and coping. The relation between coping with pain at baseline and subsequent changes in psychological distress and disease impact was analyzed using stepwise regression. Disease status variables assessed at baseline and after 3 years were entered in the regression analysis as control variables. Results show that cognitive coping with pain at baseline was not related to subsequent changes in psychological distress or disease impact. On the other hand, behavioral pain coping assessed at baseline was related to subsequent changes in psychological distress and disease impact. "Decreasing activity" was related to an increase in self-reported psychological distress and disease impact after controlling for disease status at both assessments. It was concluded that cognitive pain coping did not predict any subsequent changes in psychological distress or disease impact. "Decreasing activity" as a behavioral pain coping style has a negative effect on subsequent changes in psychological distress and disease impact.

Activities of Daily Living↗

PubMed1999

Coping and quality of life in patients with psoriasis.

The aim of the present study was to investigate the relationship between coping dimensions and overall quality of life, disability and health status in patients' with psoriasis. Psoriasis is one of several chronic diseases which requires self-management in order to ensure an enhanced quality of life. The sample comprised 334 patients who were treated consecutively at three dermatology departments in eastern Norway. A total number of 273 patients completed the questionnaire, yielding a response rate of 82% (20% in-patients and 80% out-patients). The following questionnaires were used: The Jalowiec Coping Scale, the Psoriasis Disability Index, the Quality of Life Scale, and the SF-36. Results showed that patients who used combined emotive coping strategies reported more disability, poorer mental health and worse overall quality of life. Furthermore, patients who more frequently used normalising/optimistic coping reported higher levels of mental health. However, the variance explained by coping effort was low to moderate. Coping explained the variance in mental health and overall quality of life to a greater extent than that in physical health. Knowledge about the relationships between coping and quality of life dimensions is important with regard to the establishment and implementation of appropriate psychosocial interventions for patients with psoriasis.

Activities of Daily Living↗

PubMed2001

Perceived stress and cellular immunity: when coping counts.

This cross-sectional study investigated whether active and avoidance coping methods were differentially related to immune function depending on stress level. Perceived stress and coping method were assessed in 173 healthy older adults and related to the number and percentage of CD3+, CD4+, and CD8+ T lymphocytes as well as the proliferative response of peripheral blood leukocytes to phytohemagluttinin (PHA) and concanavalin A (Con A). Both active and avoidance coping significantly interacted with perceived stress on proliferative responses to both mitogens. Higher levels of active coping were significantly related to a more vigorous proliferative response to PHA and Con A, particularly at high stress levels. At low stress levels, active coping was not significantly related to proliferative responses, whereas avoidance coping was significantly associated with a greater proliferative response to Con A. These results suggest that the relationships between certain coping methods and immune function depend on perceived stress level.

Adaptation, Psychological↗

PubMed2003

Coping, catastrophizing and chronic pain in breast cancer.

This cross-sectional study investigated the relationships between individual differences in coping and catastrophizing, and markers of adaptation to chronic pain associated with breast cancer. Sixty-eight breast cancer patients with chronic pain due to either cancer or cancer-treatment were administered self-report instruments that assess active and passive coping, catastrophizing, pain, disability, and mood disturbance. Regression analyses were performed to investigate the unique contribution of differences in coping and catastrophizing to the various markers of adaptation. Both active and passive coping explained unique variance in self-reported disability; active coping was associated with less disability while passive coping was associated with greater disability. Catastrophizing explained unique variance in anxiety and depression scores; higher levels of catastrophizing were associated with greater emotional distress. The results suggest that coping and catastrophizing may contribute to different outcomes in chronic pain in breast cancer patients and provides preliminary evidence that they may be important targets of psychological treatments.

Adaptation, Psychological↗

PubMed2004

Perceived stress mediates the effects of coping on the quality of life of HIV-positive women on highly active antiretroviral therapy.

This study examined the relationship between three HIV-specific coping strategies (cognitive coping strategies, denial, and religious coping) and quality of life (QoL) in 90 HIV+, predominately minority women on highly active antiretroviral therapy. Religious coping was unrelated to QoL; however, use of cognitive coping strategies was related to greater QoL, and denial was related to poorer QoL. Baron and Kenny's model of mediation was then used to test perceived stress as a mediator of the relationships between denial and cognitive coping strategies and QoL. These relationships were both mediated by perceived stress. Results suggest that utilization of certain coping strategies may lessen or heighten perceptions of life stressfulness, thereby influencing QoL in this understudied population.

Adaptation, Psychological↗

PubMed2004

Coping competence as predictor and moderator of depression among chronic disease patients.

This tested the utility of the "Coping Competence Questionnaire" (CCQ) in predicting depression among chronic disease patients. Coping competence is defined as a dispositional stress resistance factor based on helplessness and hopelessness theory. Predictive power and buffering effects of the CCQ were tested in three patient samples scheduled for Coronary Artery Bypass Surgery (N = 272), other heart surgeries (N = 109), or lung tumor surgery (N = 203). Coping competence, symptom stress, and depression were assessed before and 6-months following surgery. Hierarchical multiple regressions indicated moderator effects of coping competence in the relationship between symptom stress and depression, supporting the stress-buffer hypothesis. Symptom stress was strongly correlated with depression among patients who were low in coping competence only. Among patients high in coping competence, depression was low and unaffected by symptom stress. The results suggest that the 12-item coping competence scale may qualify as useful tool for the prediction of depression in chronic disease populations.

Adaptation, Psychological↗

PubMed1997

"You can try or you can just give up": the impact of perceived control and coping style on childhood homesickness.

Research on children's coping with homesickness during relatively uncontrollable separations has suggested that secondary control coping (i.e., adjusting oneself to fit objective conditions) is often preferred over primary control coping (i.e., modifying objective conditions to fit oneself). Related research suggests that negative affect is associated with (a) relinquishing control or using primary control to cope with uncontrollable stressors and (b) perceiving low control over stressors. The convergence of these factors was examined for the stressor of homesickness. Among 1,032 boys and girls spending 2 weeks at residential summer camps, the most frequent and effective way of coping with homesickness was to exert secondary control by engaging in a distracting physical activity. Contrary to speculation, the use of secondary control coping rose in adolescence. Congruent with empirical predictions, the most homesick children perceived low control over homesickness and separation, and coped by relinquishing control.

Adaptation, Psychological↗

PubMed1989

Coping by children undergoing stressful medical procedures: some conceptual, methodological, and therapeutic issues.

Because coping is postulated to change across persons, time, and stressors, the study of coping is inherently complex. These complexities are magnified in children's coping because a child's ability to effectively appraise a stressor and the coping resources that are available is dependent on the child's rapidly shifting developmental level. A small set of recent pediatric psychology studies describes children's active, informative-seeking coping versus avoidant or information-denying coping as an example of current trends in research on children's coping. Review of these studies highlights the need for tighter, more complete conceptualizations and improved methodologies. There are many therapeutic implications of this research, not the least of which is the problem of how (or even if) avoidant children should be prepared for medical procedures.

Adaptation, Psychological↗

PubMed1989

The influence of situation and coping on relapse crisis outcomes after smoking cessation.

Examines the influence of situational characteristics and coping on the outcome of a relapse crisis for 232 Ss followed for 1 month after a self-initiated smoking cessation attempt. Survival of a relapse crisis was most strongly related to the number of coping strategies used. All coping strategies were equally effective; furthermore, combining cognitive and behavioral coping strategies was not more effective than using multiple cognitive or multiple behavioral strategies. During the second half of the follow-up period (Weeks 3 and 4 postcessation), the presence of smokers resulted in a decreased likelihood of coping and an increased likelihood of smoking. In addition, active coping was marginally related to higher baseline levels of motivation to quit. When motivation and the presence of smokers were controlled, however, coping still significantly predicted outcome. Results are discussed with reference to previous relapse studies.

Adaptation, Psychological↗

PubMed1989

Pain coping strategies and depression in rheumatoid arthritis.

A study was conducted to examine the role of pain episodes and the role of active and passive pain coping strategies in predicting depression in 287 patients with rheumatoid arthritis (RA). The independent effects of pain and pain coping strategies, as well as the interaction effects between pain and pain coping strategies on depression, were evaluated cross-sectionally and prospectively over a 6-month interval. The cross-sectional findings revealed that pain, passive coping, and the interaction between pain and passive coping contributed independent variance, all accounting for higher depression. Of principal interest was the finding that the frequent use of passive pain coping strategies in the face of high pain contributed to the most severe level of depression over time. These results were obtained after controlling for the potentially confounding effects of prior depression, functional disability, and medication status. These data imply that there may be a potential benefit of developing techniques to reduce the use of passive pain coping strategies to deal with chronic arthritis pain in cognitive-behavioral pain management programs.

Adaptation, Psychological↗

PubMed1994

Relationships between adjustment to HIV and both social support and coping.

This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage.

Adaptation, Psychological↗

PubMed1984

Locus of control, cognitive appraisal, and coping in stressful episodes.

Evidence suggests that internals and externals differ in the nature and effectiveness of their coping behavior. This study investigated locus of control and coping processes in relation to specific stressful episodes reported by 171 female student nurses. Scores on each of three measures (General Coping, Direct Coping, and Suppression) that were derived from the "Ways of Coping" Questionnaire were analyzed to examine the role of appraisal (in terms of the extent to which the situation was perceived as amenable to control) and the perceived importance of the episode as mediators of the relation between locus of control and coping. The results showed significant interactions between locus of control and appraisal for each of the measures. Further examination of the interactions showed that the patterns of coping reported by internals were potentially more adaptive in relation to types of appraisal than those of externals. The perceived importance of the episode was significantly related, negatively, to suppression, but the interaction with locus of control was not significant.

Adaptation, Psychological↗