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PubMedDate not supplied

Coping styles and psychosocial-related variables in HIV-infected patients.

The study examined the relationship between coping and psychosocial variables (psychological stress symptoms, locus of control, emotional repression, and social support) among 108 human immunodeficiency virus (HIV)-infected patients. The authors administered several tests, including one that measures fighting spirit and degree of hopelessness, to assess each patient's individual coping style. The patients who were adjusting well to their HIV-positive status tended to have a higher level of fighting spirit and lower degree of hopelessness than those patients who were not adjusting well to their HIV-positive status. A coping style based on incapacity to face and confront HIV infection was associated with symptoms of psychological stress, repression of anger, external locus of control, and low social support in the latter group. These patients showed symptoms indicating maladjustment to HIV infection (43% of the sample) and differed from the "noncases" (the well-adjusted patients) in that the former group reported inadequate coping responses (lower fighting spirit and higher hopelessness, fatalistic attitude, and anxious preoccupation) and poorer social support, and had a greater tendency to repress anger and express sadness. The data support the hypothesis that coping with HIV infection is a complex phenomenon involving multiple and interacting variables. Interventions aimed at improving the coping style for many HIV patients are needed.

Adaptation, Psychological↗

PubMedDate not supplied

Interactive patterns of social support and individual coping strategies in melanoma patients and their correlations with adjustment to illness.

Combined patterns of social support and coping style and correlations with adjustment to cancer were investigated in early-stage melanoma patients. The authors studied 358 consecutive patients attending regular follow-up who answered standardized instruments that assess social support, coping behavior, and tumor-related distress. Regression analyses identified high active and low depressive coping behavior as stronger predictors for perceived support than sociodemographic and clinical variables. Cluster analyses yielded four coping-support patterns. High social support, combined either with active coping or with stoicism, was associated with good adjustment, whereas low perceived support in the subjects living alone or in the patients exhibiting depressive coping behavior was associated with poor adjustment.

Adaptation, Psychological↗

PubMed1998

Coping with stress in rats and mice: differential peptidergic modulation of the amygdala-lateral septum complex.

This chapter focuses on the parvicellular vasopressin (VP) system originating from the medial nucleus of the amygdala (MeA) and bed nucleus of the stria terminalis (BNST). The vasopressinergic fibers of these nuclei innervate a number of limbic brain areas including the septum-hippocampal complex. Interestingly, this VP system is sexually dimorphic and the VP synthesis in this system depends on circulating gonadal steroids. Studies in rats and mice show that the variation in the lateral septal VP network within the male gender is as large as the variation between the sexes as reported in the literature. Non-aggressive males are characterized by a far more extensive VP network and a higher VP content in the lateral septal area than aggressive males. A review of the literature on the function of lateral septal VP in the organization of behavior reveals not only a modulatory role of behavior in a social context, but also of fear- and anxiety-related behaviors. It is argued that these seemingly diverse functions might be explained by the concept of coping style. Extensive behavioral and physiological analyses in a variety of animal species show that males may be characterized by the way in which they cope with environmental challenges in general. Aggressive males tend to cope actively with their environment whereas non-aggressive males seem to accept the situation as it is more easily. In several tests, we determined the effects of chronic infusion of the V1 receptor antagonist locally into the lateral septal area in male rats. The main conclusion from these experiments is that LS VP does not modulate coping style in general. However, the experiments confirm the idea that LS VP has a certain degree of functional specificity in social behavior and social learning tasks. Together with the observation that the size and distribution of the vasopressinergic system may be highly variable between individual males in relation to their coping style, this suggests that the lateral septal vasopressinergic system is involved in the differential capacity of individuals to cope behaviorally with challenges of a social nature.

Adaptation, Psychological↗

PubMed1999

Adolescent survivors of childhood sexual abuse: the mediating role of attachment style and coping in psychological and interpersonal functioning.

OBJECTIVE: To examine attachment style and coping strategies as potential mediating variables between childhood sexual abuse (CSA) and psychological and interpersonal functioning in an attempt to explain variability in extent of disorder and level of functioning. METHOD: Eighty adolescent females, aged 14-16 years, answered questions regarding abuse history, attachment style, coping with an interpersonal stressor, depression and trauma symptomatology, and conflict with a best friend. RESULTS: Structural equation modeling analyses indicated that attachment style mediates the effects of CSA and child abuse and neglect on coping and psychological distress. The indirect effects of CSA and other abuse through attachment accounted for most of the effects on coping and psychological distress. Avoidant and cognitive coping strategies also served as mediators in the models, accounting for most of the effects of the other variables on interpersonal conflict. CONCLUSIONS: The findings indicate that attachment style and coping strategies influence psychological and interpersonal functioning, mediating the direct effects of CSA and other types of child abuse and neglect. These results have implications for therapeutic intervention with children and adolescents who have experienced child abuse.

Adaptation, Psychological↗

PubMed2001

Coping strategies and health care-seeking behavior in a US national sample of adults with symptoms suggestive of overactive bladder.

BACKGROUND: Although millions of individuals have symptoms suggestive of overactive bladder (OAB), few ever seek or receive medical treatment for their condition. OBJECTIVE: The purpose of this study was to describe coping strategies and health care-seeking behavior in a community-based sample of adults with symptoms suggestive of OAB. METHODS: A cross-sectional household telephone survey of an age- and sex-stratified sample of adults was conducted. The survey consisted of general health-related questions as well as questions related to OAB symptoms. A total of 4896 adults completed the interview Respondents were considered to have OAB if they reported > or = 1 symptom of urinary urgency, frequency, or urge incontinence. A follow-up questionnaire was then mailed to a subsample of the telephone interview respondents. The mailed questionnaire contained questions related to type and severity of OAB symptoms, coping strategies, medical care/treatment, feelings/beliefs about OAB, and quality of life. Half of the phone respondents with urinary incontinence (n = 638) and a random sample of all other phone respondents received the mailed questionnaire (n = 873); 1,034 questionnaires were returned. RESULTS: Of the respondents with OAB, 69.6% tried > or = 1 nonmedical coping strategy. Respondents with incontinent OAB were significantly more likely than those with continent OAB or those with no OAB (controls) to use nonmedical coping strategies (incontinent OAB, 76.1%; continent OAB, 59.0%; controls, 31.9%; P < 0.001). Fewer than half of the respondents with OAB (43.5%) had spoken with a provider about OAB in the previous 12 months. Medical consultation was associated with sex, type and severity of OAB, number of nonmedical coping strategies tried, number of OAB information sources consulted, inclination to try new OAB medications, and feelings/beliefs about OAB. In 90% of patient-provider discussions about OAB, the patient initiated the topic. CONCLUSIONS: Individuals manage symptoms suggestive of OAB primarily by using nonmedical coping strategies rather than consulting health care providers. Results of this study support the need for improved clinical recognition of OAB and increased patient-provider communication about this condition.

Adaptation, Psychological↗

PubMed2003

Coping behavior in depressed patients: a longitudinal study.

The relationship of coping behavior to outcome in depressed patients was examined. Subjects (n=105) with major depressive disorder (n=85), depressive disorder not otherwise specified (n=7) or major depressive disorder with axis I comorbidity (n=13) were followed for 6 months. Their coping behavior (i.e. rumination, active distraction, cognitive distraction and dangerous activities) was defined using the Comprehensive Assessment List for Affective Disorders. Based on their Hamilton Rating Scale for Depression (HRSD) scores at 6 months, the patients were categorized as having had a good or a poor outcome. Severity of depression and coping behavior were similar among the three diagnostic groups. At baseline assessment, coping behavior was not correlated with either HRSD score or age. However, males were significantly more likely to be engaged in dangerous activity as a coping behavior than females. Patients with a good outcome at 6 months were significantly more likely to use rumination as a coping behavior while patients with a poor outcome were significantly more likely to use dangerous activity. Multiple regression analysis confirmed this finding, indicating that rumination and dangerous activity were significant predictors of outcome at 6 months. Rumination might be associated with good outcomes in depressed patients while dangerous activity might be associated with poor outcomes.

Adaptation, Psychological↗

PubMed1997

Coping and adjustment during childhood and adolescence.

This paper reviews research published within the last 10 years on child and adolescent strategies for coping with commonly occurring stressors in nonclinical populations and the relationship of these strategies to adjustment. Current conceptual and classification schemes for children's coping strategies are analyzed and compared. Studies of child coping are reviewed in three clusters: (a) descriptive and taxonomic studies, (b) age-group comparisons, and (c) evaluations of coping-adjustment relationships. Developmental commonalities and changes are identified across studies and conceptual models. Conceptual models compatible with problem-focused/ emotion-focused and approach/avoidance frameworks have proven to be useful for descriptive purposes. However, it is of concern that categories in the current classification systems do not distinguish coping strategies that promote adjustment from ones that limit adjustment. Future directions for addressing this issue and developmental considerations are suggested, including an alternative model pertaining to coping competence.

Adaptation, Psychological↗

PubMed2001

Coping and illness cognitions: chronic fatigue syndrome.

The chronic fatigue syndrome (CFS) is described, and research on coping with this illness reviewed and analysed. CFS is a severely disabling illness of unknown etiology, which has occurred in epidemic forms all over the world. However, the number of sufferers has dramatically increased over previous years. The heterogeneous symptomatology of CFS was reviewed, and diagnostic criteria were discussed. The difficulty in establishing causality was emphasized. An interaction of factors appears most likely to be associated with illness onset and maintenance. As the mediating factor could be sufferers' coping behavior, the existing coping literature was reviewed. There might be an association between coping and physical and psychological well-being. Finally, recommendations are made for longitudinal research on coping and coping effectiveness, and for the development of therapeutic interventions.

Adaptation, Psychological↗

PubMed2001

Assessment of cognitive coping styles: a closer look at situation-response inventories.

Cognitive coping style approaches establish two concepts central to the understanding of people's responses to a stressful situation: "attention" and "avoidance". Theoretical frameworks corresponding to these conceptions are Sensitization-Repression (Byrne, 1961), Monitoring-Blunting (Miller, 1980), and Vigilance-Cognitive Avoidance (Krohne, 1986). Such types of cognitive coping styles are usually measured by means of situation-response inventories. In the present article, we take a closer look at this kind of coping assessment by considering the scenarios, the coping options and response formats, the dimensionality of the constructs, and published data on the reliability and the validity of seven situation-response inventories. Three important points deserve to be highlighted: (a) it probably makes little sense to assess coping style using scenarios that diverge maximally with respect to controllability and predictability since coping is not assumed to show such complete cross-situational stability; (b) similarly named inventories rely on largely different operationalizations and can hardly be considered as measuring similar constructs; and (c) monitoring/vigilance and blunting/avoidance generally emerge as independent constructs, which argues against use of summary scores.

Adaptation, Psychological↗

PubMed2003

Gender and coping: the parents of children with high functioning autism.

Gender is a concept that is frequently discussed in the literature on stress, coping and illness. Research has reported that women are more vulnerable than men are to stressful events and use different strategies to cope with them. Furthermore, it is often asserted that these gender-based differences in coping may partially explain the differential impact of stressful events on men and women. Unfortunately, much of this research has equated gender with sex and failed to contextualise the experience of illness and coping. This paper presents a qualitative analysis of the role of gender and coping among parents of children with high functioning autism or Asperger's syndrome in an Australian sample. It attempts to analyse the different meanings of the disability for mothers and fathers and describes the various strategies that parents use to cope with their child's disability.

Adaptation, Psychological↗

PubMed2003

The Chronic Pain Coping Inventory-42: reliability and validity.

Coping responses have been shown to be associated with physical and psychological functioning in patients with chronic pain. Assessment of coping strategies has received increasing attention, with several measures of cognitive and behavioral coping showing promise. One such instrument is the Chronic Pain Coping Inventory (Pain 60 (1995) 203), a 65-item measure of behavioral and cognitive pain coping strategies often targeted as part of multidisciplinary pain treatment. Initial research has supported the reliability and validity of the CPCI. This article describes the development of an abbreviated (42-item) CPCI. The results demonstrate very high correlations between the original and abbreviated CPCI scales, as well as comparable internal consistency, test-retest stability, and validity coefficients. The findings support the reliability and validity of the abbreviated CPCI, and suggest that it could be substituted for the CPCI without sacrificing reliability and validity in situations where a briefer measure of coping with chronic pain is preferable.

Adaptation, Psychological↗

PubMed2003

Coping or acceptance: what to do about chronic pain?

Research and treatment of chronic pain over the past 20 or more years have tended to focus on patient coping as the primary behavioral contribution to adjustment. The purpose of the present study was to compare a coping approach to chronic pain with a different behavioral approach referred to as acceptance of chronic pain. These approaches were compared in terms of their ability to predict distress and disability in a sample of patients seeking treatment for chronic pain. Subjects were 230 adults assessed at a university pain management center. All patients completed the coping strategies questionnaire and the chronic pain acceptance questionnaire among other standard measures. Results showed that coping variables were relatively weakly related to acceptance of pain and relatively unreliably related to pain adjustment variables. On the other hand, acceptance of chronic pain was associated with less pain, disability, depression and pain-related anxiety, higher daily uptime, and better work status. Regression analyses examined the independent contributions of coping and acceptance to key adjustment indicators in relation to chronic pain. Results from these analyses demonstrated that acceptance of pain repeatedly accounted for more variance than coping variables.

Adaptation, Psychological↗

PubMed1997

Pain coping and the pain experience in children with juvenile chronic arthritis.

This study examined the pain experience and pain coping of children with juvenile chronic arthritis (JCA). The purpose of the study was to describe present pain and the pain coping strategies utilized by children with juvenile chronic arthritis and examine pain coping strategies and pain efficacy as a predictor of pain intensity and distribution. Fifty-six children with JCA rated their present pain using two measures of pain intensity, the Oucher and the pain thermometer, and reported on the number of pain locations using a body map. In addition, each child completed the Child Version of the Coping Strategies Questionnaire (CSQ-C) and health status was determined by a physician's disease activity rating. On average, children reported current pain in the low to middle range on the different pain scales, although there was considerable variability in pain ratings. Up to 30% of all children had pain ratings higher than or equal to the middle range on both the Oucher and the pain thermometer. On average, children reported pain in more than two body areas. Correlational analyses were conducted to examine how the composite factors on the CSQ-C (Pain Control and Rational Thinking, and Coping Attempts) related to variations in reported pain intensity and location. Children who scored higher on the Pain Control and Rational Thinking factor of the CSQ-C had much lower ratings of pain intensity and reported pain in fewer body areas. Hierarchical regression analyses indicated that disease activity and scores on the Pain Control and Rational Thinking factor of the CSQ-C each accounted for a unique, statistically significant proportion of variance in the measures of pain intensity and pain location. Behavioral and cognitive therapy interventions designed to increase pain coping efficacy may be useful adjuncts in treating pain in children with chronic arthritis.

Adaptation, Psychological↗

PubMed1999

The relationship of arthritis self-efficacy to daily pain, daily mood, and daily pain coping in rheumatoid arthritis patients.

There is an increasing awareness in the medical community that psychosocial variables such as beliefs in self-efficacy are important determinants of treatment outcome. However, before measures of self-efficacy are widely incorporated into clinical practice, there needs to be a better understanding of how they relate to daily pain, mood and coping. In the present study 128 rheumatoid arthritis patients completed diaries for 30 days in which they provided daily ratings of joint pain, negative and positive mood, the use of pain coping strategies, and coping efficacy. The patients then participated in an evaluation session during which measures of self-efficacy (the Arthritis Self Efficacy Scale (ASES)), demographic variables, and medical status were collected. A series of hierarchical regression analyses was conducted to determine the degree to which self-efficacy measures collected at the time of the evaluation session were related to daily diary measures collected during the 30 preceding days. The results revealed that self-efficacy was significantly related to daily ratings of pain, mood, coping and coping efficacy. Interestingly, the findings regarding self-efficacy were obtained even after taking into account the effects of important demographic and medical status variables. Taken together, these results suggest that self-efficacy ratings collected from arthritis patients at the time of an evaluation session may well be related to recent experiences of daily pain and mood, as well as the daily use and perceived effectiveness of pain coping strategies.

Activities of Daily Living↗

PubMed2000

Central circuits mediating patterned autonomic activity during active vs. passive emotional coping.

Animals, including humans, react with distinct emotional coping strategies to different sets of environmental demands. These strategies include the capacity to affect appropriate responses to "escapable" or "inescapable" stressors. Active emotional coping strategies--fight or flight--are particularly adaptive if the stress is escapable. On the other hand, passive emotional coping strategies-quiescence, immobility, decreased responsiveness to the environment-are useful when the stress is inescapable. Passive strategies contribute also to facilitating recovery and healing once the stressful event is over. Active vs. passive emotional coping strategies are characterised further by distinct patterns of autonomic change. Active strategies are associated with sympathoexcitation (hypertension, tachycardia), whereas passive strategies are associated with sympathoinhibitory patterns (hypotension, bradycardia). Distinct neural substrates mediating active vs. passive emotional coping have been identified within the longitudinal neuronal columns of the midbrain periaqueductal gray region (PAG). The PAG offers then a potentially useful point of entry for delineating neural circuits mediating the different forms of emotional coping and their associated patterns of autonomic activity. As one example, recent studies of the connections of orbital and medial prefrontal cortical (PFC) fields with specific PAG longitudinal neuronal columns are reviewed. Findings of discrete orbital and medial PFC projections to different PAG columns, and related PFC and PAG columnar connections with specific subregions of the hypothalamus, suggest that distinct but parallel circuits mediate the behavioural strategies and patterns of autonomic activity characteristic of emotional "engagement with" or "disengagement from" the external environment.

Adaptation, Psychological↗

PubMed1999

Pain, coping and analgesic medication usage in rheumatoid arthritis patients.

The major purposes of this study were to describe pain characteristics and coping strategies used in rheumatoid arthritis (RA) patients. Further purposes were to examine relationships among pain, coping and analgesic medication intake. Sixty-eight consecutively sampled subjects with RA participated in the study. The Pain-O-Meter was used to evaluate pain intensity and quality, and the Coping Strategies Questionnaire (CSQ) to determine coping strategies. The results showed that the patients with RA scored more intense sensory than affective pain although they used more affective pain descriptors. The sensory and total pain components were related to coping self-statements and increased pain activities. There were significant relationships between analgesic medication intake and all coping strategies used in the RA patients. The findings' implication for education and treatment are discussed.

Adaptation, Psychological↗

PubMed2000

Social support, coping and subjective well-being in patients with rheumatic diseases.

The purpose of this cross-sectional study is to examine the relationship between social support, coping, and subjective well-being by testing three hypotheses: (1) social support influences subjective well-being via coping; (2) coping influences subjective well-being via social support; (3) there is a reciprocal relationship between social support and coping, and both concepts influence subjective well-being. Data were analyzed from 628 patients with one or more chronic rheumatic disorder(s) affecting the joints, in some patients combined with another rheumatic disease (no fibromyalgia). Although causal inferences are not possible, the results present a plausible causal sequence in supporting the second hypothesis. This is only true, however, for coping by awaiting/avoidance: coping by awaiting/avoidance led to less social support and this decrease in social support influenced subjective well-being negatively.

Adaptation, Psychological↗

PubMed2000

Coping with new treatments for cancer: a feasibility study of daily diary measures.

This article describes a study of the feasibility and value of using daily diary measures to assess coping, adjustment and symptoms in patients participating in phase I clinical trials of new anticancer drugs. Ten patients (six women, four men) with advanced metastatic cancer were studied during a four-week phase I trial. Measures of psychological well-being, mental adjustment and symptoms were determined prior to treatment, and participants also completed daily ratings of psychological coping responses, mood and symptoms. Completion rates for diaries were high, and the amount of missing data averaged only 3.2% per patient. Overall, the most frequently endorsed coping responses were 'acceptance' and 'positive reinterpretation and growth'. There were systematic variations in coping by seeking social support across the trial, with more frequent use during phases of hospitalisation. Idiosyncratic fluctuations in patterns of coping were also observed. Positive daily mood was greater among patients who coped by ignoring their condition, and was also correlated with fighting spirit. Daily symptoms were inversely associated with positive mood and with fighting spirit. It is concluded that the daily diary approach is feasible, and may help to increase understanding of the experience of patients taking part in experimental anticancer drug trials.

Adaptation, Psychological↗