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PubMedDate not supplied

[Coping or adaptive processes in psychosomatic medicine].

In the last decade a new psychological concept was derived from the pre-scientific English term "coping" and introduced into what is known as illness-behaviour. Coping supplements the psychoanalytical defence theory by forming part of the adaption processes in illness and helping to overcome illness as a psychic crisis. The present paper is an attempt to provide a critical analyses of all literature available on the concept of coping. After various examples of a definition of the term, it was shown how coping differs from defence mechanisms, the connection between stress and coping was explained and a comprehensive illness model was presented. Then followed a discussion of the better known forms of coping to date and a brief presentation of fields of scientific research which could benefit from the coping concept.

Adaptation, Psychological↗

PubMed1984

Major coping behaviors of a hospitalized 3-year-old boy.

Heath used the active coping strategies of control, avoidance, and puppet play during the course of his postoperative recovery period. Regression, which existed in an earlier stage of development, was used to provide feelings of comfort, security, and control. The total number of coping behaviors utilized by Heath significantly increased from Phase 1 to Phases 2 and 3 of recovery (see Figure 1). This marked increase in coping behaviors during the latter two phases of recovery corresponded to the stabilization and improvement in Heath's physical condition. According to Josselyn (1955, p. 367), when an individual is ill energy that was once available for meeting the pressures of daily life is absorbed into the body as it struggles to master the illness. Barraclough (1937) states that when recovery begins and strength returns, the ill child will manifest a change in behavior which includes: increased interest in the environment; participation in ward activities; resumption of play; and return to the former carefree self. In Phase 1 of recovery, Heath was acutely ill. Since his energies had to be devoted to the inner processes of healing, Heath showed little interest in his environment. In the following two phases of recovery, Heath had more physical strength and energy which could be devoted to the process of active coping. Subsequently, the number of major coping behaviors utilized by Heath escalated. Through the repertoire of behaviors utilized in Heath's coping strategies during recovery from abdominal surgery, he was able to cope with his hospitalization. As a result, adaptation occurred which allowed the subject to achieve a degree of mastery of a stressful hospital experience.

Adaptation, Psychological↗

PubMed1981

How adolescents cope with the problems of early motherhood.

The purpose of this study was to measure the coping responses used by adolescent mothers (N = 64), to determine variables related to their choice of responses, and to examine the relationship between coping responses and emotional stress. Indepth interviews were used to measure the problems faced by adolescent mothers, their choice of coping response and the relationship between coping style and stress, support and personality characteristics (self-esteem and sense of control). The results showed that the adolescent mothers' major coping response was to ask others for assistance. This response was most common when the young mothers were faced with task-oriented problems. Interpersonal problems tended to elicit avoidance as a coping response, while conflicts with institutions elicited a range of responses. Direct action coping responses were related to higher self-esteem, more active support systems and lower levels of emotional stress. The results are interpreted to indicate the importance of support systems which help young mothers deal with their daily problems.

Adolescent↗

PubMedDate not supplied

[Styles of coping with stress and emotional reactions of patients after myocardial infarction].

The aim of the study is to answer the question: What are emotional responses in myocardial infarction patients who are characterized by specific coping styles? 101 males after first, uncomplicated myocardial infarction (MI) participated in this study. Coping styles were assessed by the Coping Inventory for Stressful Situations (CISS) by N.S. Endler and J.D.A. Parker. Emotional responses were assessed by the Profile of Mood States (PMS) by D. McNair, M. Lorra and L.F. Droppleman, and the Attitude Toward the Illness Scale developed by K. Wrześniewski. Patients characterized by the high Emotion Oriented Coping Style had a tendency to react to situations related to MI with strong negative emotions and unfavorable attitude toward the illness. Patients characterized by the high Task Oriented Coping Style had a tendency to react to situations related to MI with lower depression and favorable attitude toward the illness. High Emotion and Low Task Oriented Coping Styles, and Social Diversion Coping Style are unadapted for MI patients.

Adaptation, Psychological↗

PubMedDate not supplied

Rewards, costs, and coping of African American caregivers.

African American female caregivers who provided care to an elderly demented or confused relative (n = 83) were interviewed to explore the relationships between the caregiver's confrontive, emotive, and palliative coping and household income, relationship to the elder, perceived caregiving demands, quality of social support, rewards, costs, and care recipient's geographic area of residence. These seven variables accounted for significant variance in emotive coping, though not in confrontive and palliative coping. The caregiver's primary appraisal of perceived costs was key in the explanation of emotive coping; perceived rewards were important in accounting for palliative coping, and social support quality was salient in the explanation of confrontive coping. Perceived caregiving demands, caregiver household income, caregiver-care recipient relationship, and care recipient geographic area of residence were not significantly related to the three types of coping.

Adaptation, Psychological↗

PubMed1994

Coping and MCMI-II symptom scales.

The associations of the MCMI-II symptom scales with dispositional coping strategies were studied among 239 psychiatric outpatients. A similar core-pattern of emotion-focused coping was associated with all symptom scales except the bipolar scale. High scores on the MCMI-II symptom scales were associated with low use of adaptive emotion-focused coping (e.g., seeking social support) and high use of maladaptive emotion-focused coping (e.g., disengagement). Thought disorder, drug dependence, and delusional disorder also were associated with reduced use of problem-focused coping. The findings support the theoretical distinction between adaptive and maladaptive emotion-focused coping. The potential negative impacts of this coping pattern in terms of mental health and life adaptation are discussed.

Adaptation, Psychological↗

PubMed1994

Coping strategies of long-term cancer survivors.

Cancer survival is a stressful experience requiring coping for the maintenance of equilibrium. Lazarus' Theory of Stress and Coping was the framework for this descriptive study of the use and effectiveness of coping strategies as assessed by long-term survivors of cancer. The Jalowiec Coping Scale (JCS) and a subject information sheet (SIS) were mailed to 128 potential subjects, identified by the snowball technique, who survived cancer for > 5 years, were not currently receiving therapy, and were not in a terminal stage of disease. Fifty-nine subjects with a mean survival of 13.03 years correctly completed and returned the questionnaire and were included in data analysis. Respondents were predominantly white (88.1%), female (83.7%), married (72.8%), employed as professionals (57.8%), 41-65 years of age (59.3%), and diagnosed with breast cancer (50.8%). Subjects rated optimistic, supportive, and confrontive strategies as most often used and effective. Length of survival did not result in different choices of strategies. Statistically significant differences were found in coping styles between elderly and middle-aged survivors. Results of this study increase nurses' awareness of effective coping strategies and the importance of assessment of coping in long-term survivors of cancer. The importance of social support, spirituality, and helping others is emphasized.

Adaptation, Psychological↗

PubMed1993

[Coping with illness in myasthenia gravis].

Within the past few years, the introduction of immunosuppressants in the treatment of myasthenia gravis, has turned this severe, chronic and life-threatening disease into a moderate illness with good chances of control or even remission. Of 44 patients whose coping behavior and course of disease we investigated, only seven experienced a significant change in severity of the disease within nine months. This consistency in the course of the disease was also reflected in the forms of coping with the disease: in contrast to the situation two decades ago, today's myasthenia gravis patients are no longer caught up in the dilemma between passive dependency and active resistance, most of them adopting an attitude of calm acceptance. According to the Berne Forms of Coping (BEFO) which we applied, this attitude is expressed as a pattern of passive cooperation, acceptance, distraction and relativization. This coping pattern remained largely intact even in relation to the severity of the disease and the retrospectively assessed course of the disease. We present two cases to illustrate the influence of coping behavior on the course of the disease. Comparison with two other patient groups (rheumatoid arthritis and hip osteo-arthrosis) showed that there is no disease specificity of coping behavior. It can be assumed that there is a basic pattern in coping with chronic diseases, the manifestation of which is dependent on the severity and prognosis of the disease. If depressive reactions to the disease are excluded, the prevalence of longer-term pre-existent psychiatric disorders among MG patients corresponds to the average for the general population, although there is a relatively high incidence of anxiety disorders.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗

PubMedDate not supplied

Accuracy of replacing three tapered transfer impression copings in two elastomeric impression materials.

The accuracy of replacing three manufacturers' (Dental Imaging Associates, Implant Innovations Inc, and Steri-Oss) tapered transfer impression copings into impressions made with two different materials (Impregum F and Extrude) was evaluated. Five operators replaced these copings into the elastomeric impression materials. The angular deviations (replacement error) of the copings between the control (original) position and the replaced position in the impressions were evaluated. It was found that no one coping could be replaced into the impressions accurately and consistently by all five operators. However, there were significant differences in replacement accuracy between the three copings. Lower angular deviations were found for the Steri-Oss and Dental Imaging Associates copings when compared to the Implant Innovations coping. There was no significant difference in replacement accuracy between the two impression materials.

Analysis of Variance↗

PubMed1993

Coping with AIDS and AIDS-risk reduction efforts among gay men.

Because AIDS has been identified as a major source of stress among gay men, coping models may contribute to an understanding of factors related to changes in and failure to change sexual behavior. Gay men in Long Beach, California, were surveyed to determine whether appraisal and coping are factors in efforts to reduce transmission risk for the human immunodeficiency virus (HIV). Factor analysis of the appraisal and coping items yielded factor structures similar to those reported by earlier coping investigators and that were differentially associated with reported reductions in risk for HIV transmission and with reported intent to engage in high- and low-risk sexual behaviors. Risk-reduction efforts and intent were associated with health-threat (to self or to partner) primary appraisals, secondary appraisals that respondents could change or do something about AIDS, and the coping factors of self-control, seeking social support, and confrontive coping (expression of anger). In addition, intent to engage in relatively high-risk behavior was associated with passive coping (acceptance). These results are discussed in terms of their relevance for risk-reduction education programs and for future research.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Coping behaviors of children hospitalized for cardiac surgery: a secondary analysis.

While the coping behaviors of hospitalized children continue to be an area of interest for researchers, systematic documentation in the literature concerning children's coping remains limited. In this descriptive secondary analysis, 23 master's thesis case studies were analyzed to determine how researchers described the range of coping behaviors that children used while hospitalized for cardiac surgery. The analysis sought to determine patterns of coping in both preschool and school-age children. A second aim was to validate further and refine the dimensions and items of the Children's Coping Behaviors Category System developed by Ritchie, Caty, and Ellerton in 1987. Results revealed that a broad range of names and labels of behavior was used to describe children's coping. The predominant patterns of behavior that emerged were direct action and information-seeking. Differences between preschool and school-age children's reported behaviors were evident. The coping category system was validated further and refinements are suggested.

Adaptation, Psychological↗

PubMed1995

Coping styles among Japanese women with breast cancer.

In order to investigate changes in coping styles before and after diagnosis of cancer, and the relationship between coping styles and emotional states among Japanese women, we conducted a study using the Profile of Mood States (POMS) and Dealing With Illness-Coping Inventory. Coping methods such as active-cognitive, active-behavioral and avoidance were found to be more frequently used after the women were diagnosed with cancer than before (p < 0.001). There were also positive correlations between active-reliance behavior and tension-anxiety and depression, between cognitive-passive behavior and depression and lack-of-vigor, between passive-resignation behavior and anger-hostility and confusion, and between avoidance-solitary behavior and anger-hostility, fatigue, depression, lack-of-vigor and confusion. In conclusion, a diagnosis of cancer causes a patient to use more frequently avoidance behavior as well as active coping styles, and these passive/avoidance coping styles are often correlated with negative emotions. These results imply that patients with breast cancer need support considering the relationship between passive/avoidance coping styles and negative emotions.

Adaptation, Psychological↗

PubMed1998

[Connection between disease progress and coping with stress in patients with retinopathy centralis serosa].

To illuminate the disease progression in retinopathy centralis serosa, 50 patients were enrolled in a basic study. Evaluated data included medical and sociodemographic data as well as data regarding the patient's coping with everyday conflicts and the disease. Hence, the German multidimensional coping inventory (SVF, Janke, Erdmann u. Boucsein 1985), measuring the trait aspects of coping with everyday troubles, as well as the German coping questionnaire (EFK, Franke 1997), dealing with coping with retinopathy, were applied. We described three different clusters of patients according to active and passive coping strategies. These three clusters also differed in terms of coping with the disease as well as in ophthalmological parameters. To illuminate the individual situation of the members of the clusters, we discuss the specific situation of three patients.

Adaptation, Psychological↗

PubMed1996

Differential effects of coping in mental disorders: a prospective study in psychiatric outpatients.

The present follow-up study investigated the differential effects of dispositional coping styles on change in nine clinical syndromes of the Axis I spectrum of the DSM-III-R. Subjects were 155 psychiatric outpatients who were examined 6 and 7 years after their enrollment in the study. Coping accounted for up to 9% of the variance of symptom change over 1 year. As hypothesized, the effects of different coping styles varied considerably across the clinical syndromes. Active goal-oriented coping improved symptoms of the anxiety and the dependency spectrum; seeking social support had beneficial effects on symptoms of the depressive spectrum. The effects of the coping styles distraction, use of alcohol and other drugs, and focusing on and venting of emotions were detrimental, but again in a specific way. The results suggest that the differentiation of outcome criteria for coping is important.

Adaptation, Psychological↗

PubMed1996

Relationships between coping style and PAI profiles in a community sample.

Relationships between coping style and psychological functioning were examined in a heterogeneous community sample (N = 168). Psychological functioning was categorized with the Personality Assessment Inventory (PAI; Morey, 1991). Subjects were assigned to PAI configural profile clusters, using T-scores from PAI clinical scales. Three PAI clusters were prominent in this sample: normal, anxious, and eccentric. Multivariate analysis of covariance revealed that these clusters differed significantly in coping style, as measured by the dispositional format of the COPE Inventory (Carver, Scheier, & Weintraub, 1989). Normals coped through avoidance significantly less than anxious or eccentric subjects. Also, normals engaged in seeking social support and venting more than eccentric but less than anxious subjects. Gender differences also were noted, with women more likely to cope by seeking social support and men more likely to cope through hedonistic escapism.

Adaptation, Psychological↗

PubMed1997

Coping and problem solving of self-mutilators.

People who self-mutilate have been hypothesized to have deficient skills in coping and problem-solving that leave them vulnerable to the adoption of self-mutilation as a coping strategy. This hypothesis was tested using male incarcerated self-mutilators with comparisons being made with non-multilating, prisoner, and non-prisoner control groups. Examination of the inherent resources which enable an individual to effectively cope with stress demonstrated a depressed score for self-mutilators on the scale measuring self-worth and optimism about life. Assessment of the strategies used to cope with real problems demonstrated that self-mutilators engage in more problem avoidance behaviors. Self-mutilators also recorded less perceived control over problem-solving options. The results are discussed in terms of the effectiveness of self-mutilation as a coping strategy and the need to adopt a multidimensional approach to the investigation of coping.

Adaptation, Psychological↗

PubMed1997

Avoidance coping, binge eating, and depression: an examination of the escape theory of binge eating.

The relationship between binge eating, avoidance coping, and depression was investigated with reference to the escape theory of binge eating which predicts binge eaters will exhibit elevated avoidance coping. Undergraduate females were selected into one of three groups: control (nonrestrained/nonbinge eating) (n = 73), restrained (restrained/ nonbinge eating) (n = 61), and binge eating (restrained/binge eating) (n = 15). The groups did not differ on use of avoidance coping. Binge eating scores were significantly correlated with avoidance coping and depression, but hierarchical regression analyses indicated avoidance coping did not significantly add to the prediction of binge eating above the contribution of depression. It is proposed therefore, that it is not appropriate to use findings of elevated avoidance coping in individuals with eating disorder in support of the escape theory.

Adaptation, Psychological↗

PubMed1998

Stress, coping, and crisis support in eating disorders.

OBJECTIVE: Recent research has supported the role of stress in the development and maintenance of eating disorders. However, coping and crisis support, important aspects of this stress process, have received little systematic attention. The cognitive-transactional approach to coping emphasizes the importance of the relationship between the individual and the particular problematic situation and yet most studies investigating coping in eating disorders have failed to measure situation-specific coping. METHOD: The present study used semistructured interviews to measure coping and crisis support in response to severe events and/or marked difficulties in 12 women with anorexia nervosa (AN), 21 women with bulimia nervosa (BN), and 21 women without an eating disorder (non-ED). RESULTS: Women with eating disorders were more likely to use cognitive avoidance or cognitive rumination and were less likely to downplay their problems. In addition, BN subjects were more likely to blame themselves and were less likely to receive crisis support from a core-tie. Overall, women with eating disorders were less likely to be masterful in response to crises than women without eating disorders. DISCUSSION: It is concluded that women with eating disorders are less effective in their coping than women without eating disorders.

Adaptation, Psychological↗