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PubMed2001

Cognitively oriented psychotherapy for early psychosis (COPE): a 1-year follow-up.

OBJECTIVES: Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. DESIGN: A total of 80 people participated in the initial trial and completed assessments on a range of outcome measures. Post-treatment assessment results from a non-randomized controlled trial of COPE have been previously reported. The present paper describes the results obtained from 51 patients who attended a follow-up assessment 1 year subsequent to the end-of-treatment assessment. METHOD: The 51 patients formed three groups: (1) those who were offered and accepted COPE; (2) those who were offered COPE but refused it, and continued to receive other services from the Early Psychosis Prevention and Intervention Centre (EPPIC) (refusal subjects); and (3) those who were offered neither COPE nor any other continuing treatment from EPPIC (control subjects). RESULTS: At 1-year follow-up, there was only one significant difference and this was between the COPE and refusal groups on the Integration/Sealing Over (I/SO) measure (p = .008). End-of-treatment differences were mostly sustained over the 1-year follow-up period. When the complete sample of 80 was considered, there were no differences between the three groups in terms of hospital admissions, community episodes, or time taken to first in-patient re-admission. CONCLUSIONS: The study was weakened by the poor follow-up rates in the two control groups. This reduced power to detect differences between groups on the seven major measures. However, the relapse data gathered on the complete set of 80 patients were discouraging and suggest that the present formulation of COPE does not confer any advantage to those patients receiving the therapy over those not receiving the therapy.

Adolescent↗

PubMed1999

Coping effectiveness training for people with spinal cord injury: preliminary results of a controlled trial.

OBJECTIVES: To develop and evaluate a brief group-based psychological intervention for improving psychological adjustment and enhancing adaptive coping following spinal cord injury. The Coping Effectiveness Training (CET) programme is grounded on the cognitive theory of stress and coping of Lazarus & Folkman (1984), and represents an original adaptation of the theory to the needs of this client group. DESIGN: A controlled trial comparing patients receiving the CET intervention to matched controls in measures of psychological adjustment and coping was used. METHODS: Nineteen intervention group participants and 19 matched controls were selected from in-patients at a hospital-based spinal injury rehabilitation centre. Outcome measures of depression, anxiety and coping were collected before, immediately after and six weeks after the intervention. RESULTS: Intervention group participants showed significantly greater reductions in levels of depression (p < .01) and anxiety (p < .05) compared to matched controls immediately after the intervention and at six weeks follow-up. There was no evidence of a significantly greater change in the coping strategies used by the intervention group. Participants highlighted their interactions with other group members as the most helpful aspect of the intervention. CONCLUSIONS: This evidence suggests that the CET intervention facilitated a significant improvement, in psychological adjustment to spinal cord injury. It is proposed this may be understood in terms of changes in participants' appraisal of the implications of spinal cord injury and of the coping skills needed to continue living meaningful and satisfying lives.

Adaptation, Psychological↗

PubMed2004

Predicting the short-term course of fatigue symptoms: does adjustment of habitual coping strategies matter?

The present study investigated whether adjustment of coping strategies would predict the six-week course of fatigue symptoms in a primary care sample (N = 221) and whether the contribution of adjusting coping strategies would depend on the duration of fatigue at the time. It was hypothesized that the motivation to adjust coping strategies would be most present in people who are confronted with the possibility of their symptoms turning into a chronic condition, and not in people who have been fatigued for either a short period or a very long period. Moreover, it was hypothesized that adjustments in the employment of coping strategies are a better predictor of fatigue course than the continued use of particular coping strategies. Using a prospective design with a six-week follow-up, the results of a multisample LISREL analysis over four groups of participants differing in fatigue duration showed that adjustment of coping strategies is a significant predictor of the course of fatigue symptoms, and that a differential effect related to fatigue duration is present. Findings are discussed in the context of the role of coping in regulating psychosomatic symptoms.

Adaptation, Psychological↗

PubMed2005

The self-regulatory model in women with rheumatoid arthritis: relationships between illness representations, coping strategies, and illness outcome.

OBJECTIVES: The self-regulatory model proposes that an individual's cognitive representations of illness threat (illness representations) influence the selection and performance of strategies to cope with that illness (Leventhal, Meyer, & Nerenz, 1980). Also implicit in the model is the proposal that such coping strategies influence illness outcomes. These relationships represent a mediational model (Baron & Kenny, 1986). The aim of the present study is to test the hypothesis that coping strategies partially mediate the relationship between illness representations and illness outcome in women with rheumatoid arthritis. DESIGN AND METHODS: The study is an observational cross-sectional design. Self-report measures of illness representations, coping strategies, and illness outcome were collected from 125 women with rheumatoid arthritis attending rheumatology outpatient clinics. Clinical measures of disease activity and severity were obtained from hospital records. RESULTS: Avoidant and resigned coping were found to partially mediate the relationship between symptom identity and the illness outcome measures of disability and psychiatric morbidity. As in other studies, strong relationships were found between illness representations and illness outcome. CONCLUSIONS: The finding that avoidant and resigned coping partially mediated the relationships between the illness representation dimension of symptom identity and two of the illness outcome measures (disability and psychiatric morbidity) provided some support for the hypothesis. However, the hypothesis was not fully supported, as coping did not partially mediate the relationship between any of the other illness representations and illness outcomes.

Activities of Daily Living↗

PubMed1999

Differences in coping effectiveness and well-being among aging mothers and fathers of adults with mental retardation.

In this longitudinal study, we examined stress and coping processes among 133 married mothers (age 59 to 83) and fathers (age 56 to 84) of adults with mental retardation (age 19 to 53). There were no differences between mothers and fathers with respect to their frequency of use of emotion-focused coping, but mothers used significantly more problem-focused coping strategies than did their husbands. For mothers, greater use of problem-focused coping strategies and lower use of emotion-focused coping buffered the impacts of caregiving stress on their psychological well-being. However, for fathers, no buffering effects of coping were detected. The implications of gender differences in coping effects were examined in the context of the impact of lifelong caregiving.

Adult↗

PubMed2005

Perceptions of stress and coping strategies among adults with mild mental retardation: insight into psychological distress.

Stress, coping, perceptions of control, and psychological distress of 88 adults with mild mental retardation were assessed. Stressful interpersonal interactions and concerns over personal competencies occurred most frequently. Frequency and stress impact were positively associated with a composite score of psychological distress. Active coping was associated with less psychological distress than distraction or avoidant coping. Perceptions of control were positively related to active coping and negatively related to avoidant coping. Active coping was related to less psychological distress when used with perceptions of high control than with perceptions of low control. Decreasing opportunities for stress and increasing accurate perceptions of control and subsequently active coping may reduce psychological distress among people with mild mental retardation.

Adaptation, Psychological↗

PubMed2003

Coping ability at mid-life in relation to genetic and environmental influences at adolescence: a follow-up of Swedish twins from adolescence to mid-life.

From 1964 to 1971, twins and singleton controls were followed from 10 to 16 years of age in Swedish schools. It was a nationally representative sample of 323 twin pairs, and 1193 classmate controls. In 1991 a follow-up was made of this sample with the purpose of investigating genetic influences on experienced family and school environments, as well as coping ability at the age of 35. The follow-up also evaluated the relation between coping ability at mid-life and family environment, as well as coping ability and school environment at adolescence for males and females. Genetic influences on perceived family and school environments, as well as on self-reported coping ability, have been investigated by means of comparisons of MZ and DZ twin pairs. A stepwise linear regression analysis was performed to assess environmental influences on coping ability at mid-life. The findings indicated that coping ability at mid-life is influenced by both genetic and environmental factors. Different environmental factors were operating for males and females, however. The results demonstrate that early environmental factors and genetic disposition have a long-term effect on coping ability.

Adaptation, Psychological↗

PubMed2001

Evaluations of the quality of coping reported by prisoners who have self-harmed and those who have not.

Yufit and Bongar (1992) argued that a deficiency in coping skills is an important risk factor for suicidal behavior. Dear, Thomson, Hall, and Howells (1998) found that prisoners who had self-harmed in the past 3 days were less likely than a comparison group to have used problem-solving or active cognitive coping strategies to handle the most significant stressor of the past week, but it was not clear whether this represented a difference in the quality of coping responses used. In this study, three groups of blind raters (prisoners, prison officers, and forensic psychologists) rated the coping responses of the participants in Dear et al.'s study. The coping responses of self-harmers were judged less beneficial and more risky. Problem-solving strategies were most often cited as contributing to beneficial outcomes and the catharsis strategies employed by self-harmers were most often judged to be counterproductive. It remains unclear whether prisoners who self-harmed routinely employ poor quality coping strategies or if they simply used poor quality coping on this occasion.

Adaptation, Psychological↗

PubMed2004

The daily stress and coping process and alcohol use among college students.

OBJECTIVE: To examine whether students drink more alcohol on higher-stress days than on lower-stress days; whether daily coping strategies and affective states mediate the within-person relationship between stress and drinking; and whether the daily stress-drinking process varies as a function of previously identified between-person risk factors (sex, family history, coping motives, sensation seeking, neuroticism). METHOD: College students (N = 137) completed daily surveys for 28 consecutive days. RESULTS: With daily coping, affect and weekly trends in drinking controlled for, students consumed more alcohol on days that had events perceived as relatively more stressful. Students also drank more on days characterized by relatively lower problem-focused coping and relatively higher positive and negative affect. Contrary to predictions, the effect of stress on drinking was not fully mediated by coping and affect. Findings also revealed individual differences in several links in the daily stress coping-drinking process. CONCLUSIONS: The daily stress coping-drinking process is complex, and it appears that there are both positive and negative affective pathways underlying daily alcohol consumption.

Adaptation, Psychological↗

PubMed2004

Personality traits and drinking to cope as predictors of hazardous drinking among medical students.

OBJECTIVE: The purpose of this study was to describe the prevalence and development of drinking to cope and hazardous drinking among medical students and to examine whether various personality traits and drinking to cope predict hazardous drinking. METHOD: In a 6-year prospective study of a nationwide sample of medical students (N = 421) assessments were made by questionnaire at the beginning (T1) and at the end (T2) of each participant's tenure at medical school. A cohort of 272 medical students (56% women) from all medical schools in Norway participated at both T1 and T2. The questionnaires encompassed measures of personality characteristics (Basic Characteristic Inventory) and alcohol-use (hazardous drinking and drinking to cope). RESULTS: The levels of drinking to cope and hazardous drinking were not significantly different between T1 and T2, rising from 9.2% to 11.8% and from 17.7% to 19.2%, respectively. Hazardous drinking at T1 (odds ratio [OR] = 7.0; 95% confidence interval [CI]: 3.2-15.4) and level of control (personality trait) at T1 (OR = 0.7; 95% CI: 0.6-0.9) predicted hazardous drinking at T2 among all the students. Hazardous drinking (OR = 3.5; 95% CI: 1.4-9.0), control (OR = 0.7; 95% CI: 0.6-0.9) and drinking to cope at T1 (OR = 5.0; 95% CI: 1.0-24.1) independently predicted hazardous drinking at T2 among the men, whereas the only predictor among the women was hazardous drinking at T1 (OR = 42.1; 95% CI: 8.1-218.2). CONCLUSIONS: Drinking to cope should be targeted for preventive measures against hazardous drinking, particularly among men. The effects of personality and drinking to cope differ by gender and should be studied further.

Adaptation, Psychological↗

PubMed1992

[Development of a scale for workers' coping behavior: its reliability and validity].

The purpose of this study is to develop a scale for measuring coping with job stressors. Stress process and coping function provide the theoretical framework. Coping is conceptualized as situation-specific behavior. We measure episodic coping, that is, the strategies that individuals actually use in coping with a particular situation. First, a preliminary scale, was prepared. It contained 39 coping behaviors with job stressor which were based on an open-ended pilot study. Next, factor analysis was conducted in order to identify the structure of the scale. Subjects of this study were 649 male employees and 91 female employees of a in manufacturing firm and research and development institute. By occupation they were comprised of 383 professionals, 99 technicians, 96 clerks, 104 miscellaneous workers and 58 of unknown occupation. Seven items in the preliminary scale were omitted because of their psychometrical properties. Finally, factor analysis showed three factors in the scale: positive action and cognition (11 items), avoidant action and cognition (10 items), and symptom management (11 items). The coping scale showed high conceptual validity and reliability.

Adaptation, Psychological↗

PubMed2004

[Development of the Brief Scales for Coping Profile (BSCP) for workers: basic information about its reliability and validity].

Coping profile of workers greatly affects the process where job stressors develop health problems, but most of the previously proposed questionnaires for the coping profile are too long to be applied to the program of occupational mental health. In the present study, the authors report the process of developing a new self-rating questionnaire for assessing workers' coping profile which includes only 18 questions. Based on the results of a preparatory study, the 18 questions which provide 6 scales about coping strategies were proposed as the Brief Scales for Coping Profile (BSCP). A self-administered questionnaire including BSCP, Brief Scales for Job Stress (BSJS), and a depression scale (CES-D) was applied to 394 workers in a company, and 328 (83%) responded. Their age was 40.1 +/- 10.0 yr (mean +/- SD), 78% were men, 75% were married, and most of them were white collar workers. Six factors extracted through factor analysis of BSCP closely agreed with the expected 6 scales and also with the results of previous studies. They were named "active solution", "seeking help for solution", "changing a point of view", "changing mood", "emotional expression involving others", and "avoidance and suppression". The Cronbach's reliability coefficients for the scales were from 0.66 to 0.75, showing sufficiently high internal consistency. None of them related to gender or age. Multiple regression analysis revealed that 38% of the variance of the depression score was explained by "workload", "problems in personal relationships", and "reward from work" scores in BSJS, and also with "active solution" and "avoidance and suppression" scores in BSCP. Interaction analysis revealed that the coping profile modifies the relationship between job stressors and depressive symptoms; the "active solution" score was inversely associated with the depression score, particularly for the workers with high "problems in personal relationships" scores and low "reward from work" scores, while "avoidance and suppression" scores were positively associated with the depression score particularly for the workers with high "problems in personal relationships" scores. These results support part of the reliability and validity of BSCP, and also support the feasibility of BSCP as a tool for self-management and health education concerning job stress in the field of occupational mental health. The test-retest reliability and concurrent validity of BSCP should be confirmed in a future study. It also should be confirmed in future whether the coping profile relates with gender, age, job type, or other outcome of job stress in other populations.

Adaptation, Psychological↗

PubMed2002

Weight criticism during physical activity, coping skills, and reported physical activity in children.

OBJECTIVE: National health guidelines advocate increased physical activity in children and adolescents, but specific goals are not being achieved. Data are needed on variables that influence children's decision to be active or sedentary. METHODS: We tested the association of weight criticism during physical activity (WCA) with attitudes toward physical activity and reported physical activity levels in children. We also tested whether these associations were moderated by children's ability to cope with weight criticism. Subjects were 576 fifth- through eighth-graders who completed a questionnaire on physical activity patterns, weight criticism history, and coping skills. RESULTS: WCA was more common among girls than boys and among heavier children. In multiple regression analyses, WCA was associated with reduced sports enjoyment, perceived activity compared with peers, and mild-intensity leisure activity. These associations, however, were moderated by problem-focused coping skills such that the relationships were attenuated in children who were better able to cope with weight criticism. Avoidant coping skills also moderated the relationship between WCA and sports enjoyment. CONCLUSIONS: Children who are the targets of weight criticism by family and peers have negative attitudes toward sports and report reduced physical activity levels, although these relationships may be buffered by certain coping skills. Assessing WCA and related coping skills may be clinically useful for identifying barriers to physical activity in certain children (eg, the obese) and may be a potential target for interventions.

Adaptation, Psychological↗

PubMed2006

The role of coping and problem drinking in men's abuse of female partners: test of a path model.

This article examines the relationship of coping and problem drinking to men's abusive behavior towards female partners. While previous research has demonstrated a consistent association between problem drinking and male abuse of intimate partners, virtually no studies have assessed the role of coping in relation to men's violence. Furthermore, multivariate studies have not examined how these factors operate together to increase risk for abusive behavior. An ethnically diverse sample of 147 men in a court-mandated program for domestic violence offenders completed questionnaires at the first session. Path modeling was conducted to test the extent to which coping and problem drinking predicted both physical and psychological abuse. In addition, the relationships of problem drinking and physical abuse to injury of the men's female partners were examined. Results indicated that both the use of avoidance and problem-solving coping to deal with relationship problems were related indirectly to abusive behavior through problem drinking. Greater use of avoidance coping strategies was more likely among problem drinkers. By contrast, men who used higher levels of problem-solving coping were less likely to be problem drinkers. Avoidance, but not problem-solving coping also was directly and positively related to physical and psychological abuse. Men identified as problem drinkers were more likely to use both physical and psychological abuse. Finally, greater use of physical violence was strongly related to higher levels of injury among female partners, and served to mediate the relationship between problem drinking and injury. Results are discussed in terms of their contribution to the identification of risk and protective factors for men's violent behavior toward intimate female partners and implications for developing intervention strategies.

Adaptation, Psychological↗

PubMed2006

Association between coping with anger and feelings of depression among youths.

OBJECTIVES: I examined the association, among youths, between coping behavior when angry and depression. METHODS: Data were drawn from the Health Behavior in School-Aged Children in the United States survey (n=9938). Factor analyses and multivariate logistic regression analyses were used to determine the association between self-reported coping behavior when angry and depression. Gender-specific models were run. RESULTS: Factor analysis of 11 coping behaviors indicated a 4-factor solution: substance use, physical activity, emotional coping behavior, and aggressive behavior. Substance use, emotional coping, and aggressive behavior coping were associated with increased likelihood of depression, whereas physical activity was associated with decreased likelihood of depression. Male youths were more likely to engage in physical activity and were less likely to feel depressed. CONCLUSIONS: These data provide preliminary evidence of a link between specific coping behavior when angry and the likelihood of depression among youths. Whether these associations may be useful in identifying youths at risk for depression cannot be determined from these data alone but may be an important area for future study.

Adaptation, Psychological↗

PubMed1996

Reasons for living and coping abilities among older adults.

Older adults have successfully resisted inclinations to commit suicide; however, little research has focused on their ability to cope or their reasons for living. In the present study, seventy-nine (fifty-five women, twenty-two men, two unknown) older adults (M = 60.6 years) recruited from churches, retirement groups (n = 22), and relatives of college psychology students (n = 57), completed the Reasons for Living and the Cope inventories. Overall coping was significantly positively correlated with total reasons for living, r(78) = .19, p < .05, although the low correlation suggests that the constructs are moderately unique. Further, coping was positively correlated with two RFL subscales, Survival and Coping Beliefs, r(78) = .27, p < .01, and Child-Related Concerns, r(78) = .28, p < .01. Women were higher than men in total reasons for living, t(75) = 2.16, p < .05, but not significantly different in coping abilities. Older women may underrate their ability to cope. An implication is that suicide prevention strategies should target men and bolster their cognitive deterrents to suicide.

Adaptation, Psychological↗

PubMed2006

Compliance and coping potential of cancer patients treated in liaison-consultation psychiatry.

OBJECTIVE: To investigate the impact of psychiatric illness, aggression, and other covarying variables on the compliance and coping potential of cancer patients treated in liaison-consultation psychiatry. METHODS: The study involves 270 cancer patients who were admitted to the oncology ward for diagnosis and treatment. Each patient took part in a psychiatric consultation. We used the Transplant Evaluation Rating Scale (TERS), which provides a system for differentially recording the patient's compliance and coping potential (total score for the TERS items 3-10). Following standardization using the basic psychooncological documentation (PO-BADO), the demographic variables were recorded. We also identified the internal processes which each patient used to deal with the disease using criteria established by Kübler-Ross as well as the phases of cancer experience according to Fawzy. RESULTS: Twenty-three variables were checked for their relationship to the coping and compliance potential. For 13 of these, the Mann-Whitney U-test or Spearmann-Rank correlation calculated exceeded the required Bonferroni-adjusted significance level. The calculation of an ordinal regression model containing these significant single variables showed that the following variables are associated with a lower compliance and coping potential according to their estimate (Beta-value): aggression as the dominant form of dealing internally with cancer (Kübler-Ross), pre-existing DSM IV Axis 1 psychiatric disorders, carcinoma-induced psychiatric disorders, necessity of treatment with neuroleptics and male gender. Acceptance as the dominant form of dealing internally with cancer (Kübler-Ross) is strongly associated with a higher compliance and coping potential. CONCLUSION: The results show that the compliance and coping potential of oncological in-patients can be comprehensively described by the Transplant Evaluation Rating Scale. The instruments of measurement used in the study are also useful for describing risk factors associated with low levels of compliance and coping potential.

Adaptation, Psychological↗

PubMed2006

Older adults' coping with negative life events: common processes of managing health, interpersonal, and financial/work stressors.

This study examined how older adults cope with negative life events in health, interpersonal, and financial/work domains and whether common stress and coping processes hold across these three domains. On three occasions, older adults identified the most severe negative event they faced in the last year and described how they appraised and coped with that event, their ambient chronic stressors, and event and functioning outcomes. The stress and coping process was largely consistent across the three life domains. Individuals who appraised events as challenging and relied more on approach coping were more likely to report some benefit from those events. Individuals who experienced more chronic stressors and favored avoidance coping were more likely to be depressed and to have late-life drinking problems. Chronic stressors, as well as approach and avoidance coping, were predictably associated with overall outcomes in all three event domains. These findings provide a basis for preventive interventions that may help older adults' address the most prevalent stressors of aging more effectively.

Adaptation, Psychological↗