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Maltreatment and coping strategies among male adolescents living in the Gaza Strip.

OBJECTIVE: To establish the nature and extent of maltreatment experiences, coping strategies, and behavioral/emotional problems, and their relationships, in a sample of Palestinian adolescents. METHOD: A study of 97 male adolescents aged 15-19 years, and attending a vocational training center based in the Gaza Strip. Adolescents completed the Child Maltreatment Schedule and the Ways of Coping Scale (WAYS). The Strengths and Difficulties Questionnaire (SDQ) was completed by adolescents and by their teachers. RESULTS: Findings revealed high rates of emotional and physical maltreatment. Reliance on emotion-focused or avoidant coping strategies was associated with exposure to maltreatment. Use of maladaptive coping also predicted emotional difficulties in the respondents. CONCLUSIONS: Coping strategies are an important indicator of psychosocial functioning in adolescents who have experienced maltreatment. Identification of coping styles can augment the assessment of at-risk adolescents. Emotion-focused strategies, in particular, appear to be widely used by young people from non-Western cultural backgrounds.

Adaptation, Psychological↗

Coping strategies in men and women with type 2 diabetes in Swedish primary care.

Based on findings regarding gender differences in the experience and complications of diabetes, we studied coping strategies in men and women with type 2 diabetes in relation to their demographic, medical, socio-economic and psychosocial situation. Altogether 232 Swedish-born type 2 diabetes patients aged 35-64 years at four primary health care centres in Stockholm County were studied, 121 men and 111 women. Coping strategies were assessed by the General Coping Questionnaire (GCG), which describes five orientations dichotomised into positive and negative opposites: self-trust/fatalism; problem focusing/resignation; cognitive revaluation/protest; social trust/isolation; and minimisation/intrusion. Socio-economic and medical data were taken both from a questionnaire and from medical records. Gender differences for the coping strategies resignation, protest and isolation were found (p<0.05), with higher scores for women. The most important medical factor associated with coping strategies was HbA1c. Other significant factors detected in the multivariate analyses were psychiatric disorder, cohabitation and daily smoking. Thus, coping strategies and gender are important factors that should be addressed more in diabetes health care.

Adaptation, Psychological↗

Boundary ambiguity, coping patterns and depression in mothers caring for children with epilepsy in Taiwan.

A descriptive correlational study was designed to examine the relationships between boundary ambiguity, coping strategies and depression in mothers caring for children with epilepsy. A total of 316 mothers were recruited from three medical centers in Taiwan. A pilot study established the reliability and validity of the Chinese language version of the Coping Health Inventory for Parents (CHIP). Results showed that boundary ambiguity was negatively associated with the total score by CHIP for family coping patterns I and II. In addition, family coping patterns I, II, and III were negatively associated with depression in the mothers. These results provide insight into family stress management strategies that are unique to these mothers and are associated with the relationships between boundary ambiguity, family coping patterns and outcome. The results also suggest methods to improve family centered nursing intervention, which may help mothers to establish effective interactions with their epileptic children as well as develop for them effective coping patterns to manage family stress.

Adaptation, Psychological↗

Possible interactive effects of demographic factors and stress coping mechanisms on depression and anxiety in maintenance hemodialysis patients.

OBJECTIVE: The aim of this study was to assess the possible interactive effects of age, sex, duration of hemodialysis (HD), educational and income levels, and stress coping mechanisms on depression and anxiety in patients on maintenance HD. METHODS: Uremic patients (N=416), regularly undergoing HD for more than 1 year, who did not have apparent cerebrovascular disease or serious intellectual impairment, were investigated. The interactive effects of age, sex, duration of HD, and educational and income levels, in relation to stress coping mechanisms, on depression or anxiety were assessed by hierarchical multiple regression analyses. RESULTS: Regression lines illustrating significant (P<.05) interactions were constructed. The decrease in depression accompanying the increase in task-oriented stress coping was greater in highly educated patients than it was in the other patients. Anxiety levels decreased when patients had both high income and demonstrated a range of task-oriented stress coping mechanisms. For patients undergoing HD for long duration, or with a relatively high income, the decrease of depression and anxiety accompanying a decrease of emotion-oriented stress coping was greater, as compared with other patients. The decrease of depression accompanying an increase of avoidance-oriented stress coping was greater in patients with low income and in older patients than it was in the other patients. CONCLUSIONS: These findings may lead to the development of specific and focused interventions for depression or anxiety in maintenance HD patients.

Adaptation, Psychological↗

Gender differences in pain, coping, and mood in individuals having osteoarthritic knee pain: a within-day analysis.

This study examined gender differences in prospective within-day assessments of pain, pain coping, and mood in men and women having OA, and analyzed gender differences in dynamic relations between pain, mood, and pain coping. A sample of 64 women and 36 men diagnosed as having pain due to osteoarthritis of the knee(s) rated their pain, pain coping, and mood two times each day (once in the afternoon and once in the evening) for 30 days using a booklet format. Two gender differences were found in between person-analyses: women used more problem focused coping than men, and women who catastrophized were less likely than men to report negative mood. Several within-day and across-day gender differences were noted. First, women were much more likely to show a significant increase in pain over the day. Second, men were more likely than women to experience an increase in coping efficacy over the day. Third, men were more likely than women to use emotion-focused coping when their mood was more negative. Finally, men were more likely than women to experience an increase in negative mood and a decrease in positive mood in the morning after an evening of increased pain. Taken together, these findings underscore the importance of obtaining multiple daily assessments when studying gender differences in the pain experience.

Adaptation, Psychological↗

Self-efficacy and neurocognition may be related to coping responses in recent-onset schizophrenia.

Although stressful life events can trigger psychotic and depressive symptom exacerbation in schizophrenia, many patients who experience stressful events do not subsequently relapse. Models of vulnerability, stress, and protective factors in schizophrenia suggest that effective coping responses may serve as protective factors. Coping behavior, in turn, may be influenced by a schizophrenia patient's level of self-efficacy and neurocognitive functioning. Using the Coping Responses Inventory, we examined how 29 recent-onset schizophrenia outpatients and 24 demographically matched normal comparison subjects responded to a negative interpersonal life event. Approach oriented coping responses, such as "Think of different ways to deal with the problem" and "Make a plan of action and follow it," were used significantly more often by normal subjects (M=2.27) than by schizophrenia patients (M=1.89; p < 0.02). Among schizophrenia patients, greater use of approach, problem-focused coping strategies was associated with high self-efficacy (r=0.55, p < 0.01) and better performance on a measure of sustained attention emphasizing perceptual processing (r=0.42, p < 0.05). Multiple regression indicated that self-efficacy and sustained attention accounted for 56% of the variance in the use of problem-focused coping, strategies by schizophrenia patients.

Adaptation, Psychological↗

Coping strategies in epilepsy: 50 drug-resistant and 50 seizure-free patients.

We investigated the coping styles and their correlation to psycho-social functioning in two groups of patients, the first group with drug-resistant epilepsy and the second with well-controlled epilepsy. The instruments administered were the following: the Raven's Coloured Progressive Matrices (non-verbal intelligence), the Echelle Toulousaine de Coping, ETC (coping styles), the Self-esteem Questionnaire (self-esteem), the Self-efficacy Questionnaire (social self-efficacy), a Quality of Life Measure and a semi-structured interview on psycho-social adjustment. We found a significant difference in coping responses between the two groups: drug-resistant patients seemed to adopt the "denial" and the "exclusion" strategies more (P<0.05). On the contrary, seizure-free subjects used the "control" strategy more (P<0.05). A significant correlation between disengagement patterns and poorer social outcomes was pointed out, while "control" was associated with better social adaptation. Our findings provide evidence of the importance of coping assessment, considering the influence of these strategies on the well being of patients. Offering psychological support to epilepsy patients should be considered when orientating the effectiveness of the patients' coping styles.

Adaptation, Psychological↗

Coping with stress among Aboriginal women and men with diabetes in Winnipeg, Canada.

Many Aboriginal peoples are widely exposed to stress in their lives. This exposure to stress appears linked not only to their contemporary and immediate life circumstances (e.g., marginal economic and at-risk living conditions) but also to their historical, cultural, and political contexts. Recently, diabetes has become prevalent in many Aboriginal communities worldwide. The purpose of the present study was to gain a better understanding of the ways in which Aboriginal peoples with diabetes cope with stress. The study used a series of focus groups among First Nations and Metis women and men with diabetes in Winnipeg, Manitoba, Canada. Based on our cross-thematic analyses of the data, three overarching themes were identified: (1) individual and collective strengths of Aboriginal peoples with diabetes must be recognized and utilized to facilitate healing from or coping with the experience of stress and trauma; (2) healing must be accomplished holistically by maintaining balance or harmony among mind, body, and spirit; and (3) effective ways of coping with stress and healing from trauma potentially promote positive transformations for Aboriginal peoples and communities at both individual and collective levels. Also, sub-themes of stress-coping and healing that underlie and further describe the above three overarching themes emerged from the data. These include: (a) interdependence/connectedness, (b) spirituality/transcendence, (c) enculturation/facilitation of Aboriginal cultural identity, (d) self-control/self-determination/self-expression, and (e) the role of leisure as a means of coping with stress and healing from trauma. Accordingly, our deeper analyses resulted in the development of an emergent model of stress-coping and healing among Aboriginal peoples with diabetes, which is presented as a dynamic system in which the three overarching themes are embedded in the five specific themes of coping/healing. This evidence-based emergent model appears to provide some important insights into health policy and program planning for Aboriginal peoples with diabetes and their communities.

Adaptation, Psychological↗

Active coping mediates the association between religion/spirituality and quality of life in ovarian cancer.

OBJECTIVES: This study investigated the role of religion/spirituality (R/S) and coping in quality of life (QOL) in 129 women immediately prior to a course of adjuvant chemotherapy for ovarian cancer. METHODS: Participants completed the COPE, the Functional Assessment of Cancer Therapy-Ovarian (FACT-O), and the Systems of Belief Inventory-15R (SBI-15R). Women averaged 58.9 years of age (SD = 11.5) and were primarily Caucasian (86%), married (74%), and had received at least some college education (67%). Eighty-five percent of the participants had stage III or IV ovarian cancer at study entry. RESULTS: Correlational analyses revealed that R/S was associated with active coping (r = 0.23, P = 0.022), overall QOL (r = 0.25, P = 0.012), emotional and functional well-being (r = 0.24, P = 0.014 and r = 0.28, P = 0.004), and fewer ovarian cancer-specific concerns (r = 0.27, P = 0.006). In addition, active coping was related to overall QOL (r = 0.22, P = 0.029) and social and functional well-being (r = 0.20, P = 0.042 and r = 0.33, P = 0.001). Tests of mediation between these variables suggested that the positive associations between R/S and functional well-being and R/S and overall QOL were mediated through the use of active coping. CONCLUSION: Future studies are needed to better understand the complex relationships between R/S, coping, and QOL throughout the ovarian cancer treatment experience.

Adaptation, Psychological↗

Influence of coping style and precolonoscopy information on pain and anxiety of colonoscopy.

BACKGROUND: This study assessed the relationship between patient coping style, precolonoscopy information, and anxiety and pain associated with colonoscopy. METHODS: Eighty consecutive adult patients undergoing initial colonoscopy were classified into two groups on the basis of coping style: information seekers or information avoiders. All were given standardized information about colonoscopy. Half of each group was randomly assigned to receive additional sensory information describing what they could expect to feel. Self-report, physiologic, and behavioral indices of anxiety and pain were measured. RESULTS: Patients given information congruent with coping style experienced significantly less self-report anxiety immediately after the information intervention and spent less time in recovery. In contrast, patients given information not congruent with coping style maintained their pre-intervention anxiety level. Patients given information congruent with coping style scored lower on behavioral indices of pain, but there were no differences with respect to patient perception of pain or the dosage of sedative drugs. Most patients reported that the bowel preparation was the most distressing part of the colonoscopy. CONCLUSIONS: Assessment of coping style and provision of congruent information reduces anxiety, recovery time, and observed behavioral indices of pain of colonoscopy but has no effect on sedation dose or patient perception of pain.

Adaptation, Psychological↗

Coping and adjustment in Chinese patients with chronic obstructive pulmonary disease.

The purpose of this study was to examine the relationships between coping and psychosocial adjustment of Chinese patients with chronic obstructive pulmonary disease (COPD). A convenience sample of 54 hospitalized COPD adult patients participated in the study. All participants had moderate to severe scores in respect of pulmonary functional status and symptoms. The findings indicated that the participants adopted limited coping strategies and had poor psychosocial adjustment to their illness. No significant correlation was found between the total scores for coping and psychosocial adjustment. Both confrontive and optimistic coping scores of the perceived use and helpfulness of the coping scale were negatively correlated with the total adjustment score. Fatigue, older age, worse perception of current health status, and use of confrontive and emotive coping styles were predictors of worse psychosocial adjustment. This study provides a better understanding of the needs and difficulties experienced by Chinese COPD patients and concludes that modification of such factors by health professionals may lead to a better psychosocial adjustment.

Adaptation, Psychological↗

Quality of life, coping and concerns in Chinese patients after renal transplantation.

This study aims to identify the coping methods used by patients to deal with stress after renal transplantation and to assess patients' perceived quality of life at two different time intervals after the transplant. The study conducted in one transplant centre in Hong Kong and 101 survivors participated. The Chinese Coping Scale (CCS) and the Hong Kong Chinese version of the WHOQOL scale were used together with an open question inquiring about stressors or concerns experienced by patients posttransplant. The results revealed that the main stressors identified were fear of rejection, compliance with medication and side-effects of medication, uncertainty about the future, fear of infection and the cost factor. Not statistically significant differences were found in all the CCS subscales measuring internal coping or external coping between patients within one year posttransplant (n = 23) and patients more than one year posttransplant (n = 78). Overall, patients used more internal locus of coping to deal with stress. Not statistically significant differences were also found in all the quality of life subscales between the two groups of patients. The results showed that quality of life was moderate in the Chinese renal transplant patients in Hong Kong. The findings of this study would enable renal nurses to design interventions to help transplant recipients to cope with the demands of life with a renal graft.

Adaptation, Psychological↗

Comparison of the accuracy of working casts made by the direct and transfer coping procedures.

STATEMENT OF PROBLEM: A working cast with dies that accurately record the prepared abutments, surrounding soft tissues, and adjacent and opposing teeth is necessary. PURPOSE: This study compared the accuracy of the direct and transfer coping methods in recording the vertical and horizontal dimensional relationship of a pair of removable dies in a working cast before and after separation from the stone base. Among the procedures used for making impressions of abutments for fixed partial dentures, the transfer coping procedure has specific advantages. In particular, where there are multiple abutments, this procedure, in which individual impressions are made of the abutments, transfer copings are made, and a transfer impression of the copings is used for seating the dies and fabrication of a dental stone base, is useful. METHODS: Two groups of working casts were fabricated from a stone master cast containing 2 ivorine teeth to simulate abutments. The first group of working casts was fabricated directly from the elastomeric impression of the abutments using a 2-pour procedure. The second group of working casts was made using the transfer coping procedure. RESULTS: When the interdie dimensions in each group were compared with that of the master cast, after separation and replacement of the dies in the stone base, the differences were less than 100 microm and similar for both the direct and transfer coping techniques. CONCLUSIONS: These findings show that either procedure is equally effective in positioning the dies in the working casts.

Analysis of Variance↗

Coping and psychological adjustment among people with multiple sclerosis.

OBJECTIVE: This study was concerned with examining the coping and psychological adjustment of people with multiple sclerosis (MS) and determining how they were different in these dimensions from people from the general population. The role of severity and duration of illness as well as levels of social support on coping style and adjustment were also evaluated. METHOD: The participants were 381 (144 men, 237 women) people with MS and 291 (101 men, 190 women) people from the general population. RESULTS: The results demonstrated that people with MS (particularly men) were less likely to adopt coping styles related to problem solving and seeking support and demonstrated poorer levels of adjustment on all dimensions. Adopting a wishful thinking coping style, as well as a lack of problem-focused coping or failure to seek social support, was also more likely to be associated with poorer psychological adjustment for both men and women with MS. Levels of health impairment were only minimally related to psychological adjustment, particularly for men. DISCUSSION: These findings highlight the importance of developing educational programs that include strategies to adopt more problem-focused coping strategies, so that people with MS can more readily adjust to their illness.

Adaptation, Psychological↗

Tinnitus coping style and its relationship to tinnitus severity and emotional distress.

The structure of the Tinnitus Coping Style Questionnaire (TCSQ) is examined in a sample of 108 tinnitus sufferers. Factor analysis of the TCSQ items identified two coping styles that were termed "effective coping" and "maladaptive coping". It is shown that "maladaptive coping," but not "effective coping," is related to reports of subjective tinnitus severity and emotional distress. The clinical implications of these findings are discussed.

Adaptation, Psychological↗

Coping with illness-related problems and quality of life in adult individuals with muscular dystrophy.

Illness-related problems and coping were examined in 60 individuals with muscular dystrophy (MD) identified in a population survey of the county of Orebro, Sweden. In addition, the extent to which coping is related to quality of life (QoL) was investigated as was the impact of impairment and disability on the relation between coping and QoL. Emotion/appraisal-focused coping was utilized by respondents more than twice as often as problem-focused coping. High QoL was significantly correlated to "Stoic acceptance" and "Tried alternative treatment." Low QoL was associated with "Helpless/hopeless," "Anxious preoccupation," "Minimization," "Social comparison," "Establishment of control over everyday life," "Performs the task with the aid of an appliance" and "Accepts help or leaves it to others." When measures of impairment and disability were included in the analysis, the impact of these measures explained the association between coping and physical QoL by 16% to 43%.

Activities of Daily Living↗

Dissociation, somatization, substance abuse, and coping in women with chronic pelvic pain.

OBJECTIVE: To examine the relationships between histories of sexual or physical abuse and current reports of dissociation, somatization, substance abuse, adaptive coping, and maladaptive coping strategies among chronic pelvic pain patients. METHODS: Using a structured interview, we assessed sexual and physical abuse and somatization. The Dissociative Experiences Scale was used to assess dissociation, and an abbreviated version of the COPE scale was employed to assess adaptive and maladaptive coping strategies as well as substance abuse. Participants included 46 women with chronic pelvic pain. RESULTS: Women with self-reported sexual or physical abuse histories were found to have significantly higher dissociation, somatization, and substance abuse scores than women without such a history. Significant positive correlations were found between reports of both dissociation and somatization with maladaptive coping strategies and among dissociation, somatization, and substance abuse. CONCLUSION: These results support the association between a positive abuse history and the high levels of dissociation, somatization, and substance abuse often noted in the chronic pelvic pain population. Findings suggest that such psychological variables are more likely to be associated with abuse than with the general medical condition. These psychological variables are conceptualized as maladaptive coping, which may be addressed as part of a biopsychosocial model of treatment for chronic pelvic pain patients.

Adaptation, Psychological↗

Effects of housing and individual coping characteristics on immune responses of pigs.

The impact of environmental factors on immune responses may be influenced by coping characteristics of the individuals under study. The behavioral response of pigs in a so-called Backtest early in life seems indicative of their coping style at a later age. The present study investigated the effects of housing, barren versus enriched, and coping style, as assessed by Backtest classification, on immune responses of pigs. Pigs were housed either without a rooting substrate (barren housing) or in identical pens enriched with deep straw bedding (enriched housing) from birth. During the suckling period, pigs were subjected to the Backtest. Each pig was restrained on its back for 1 min and the resistance (i.e., number of escape attempts) was scored. Pigs classified as 'high-' or 'low-resisting' (HR and LR, respectively) were immunized with di-nitrophenyl-conjugated keyhole limpet haemocyanin (DNP-KLH) at 9 weeks of age. Blood samples were drawn before immunization (Day 0) and weekly thereafter, until Day 35. KLH-specific lymphocyte proliferation following immunization was higher for HR pigs than for LR pigs. Housing did not affect proliferative responses. Housing and coping style interacted in their effect on KLH-specific humoral immune responses. LR pigs from barren housing showed higher KLH-specific antibody titers than LR pigs from enriched housing. Differently housed HR pigs, however, showed similar antibody titers. These findings support other research indicating that individual coping styles of pigs are reflected in their immune responses. More important, the present study demonstrates that effects of housing on humoral immune responses of pigs may differ for pigs with divergent coping styles.

Adaptation, Psychological↗