The psychosocial predictors of long-term distress in partners of patients with acute coronary syndrome

Objective: Partners of acute coronary syndrome (ACS) patients are at risk of experiencing long-term distress and the purpose of this study was to identify its predictors.

Design: Using an observational design, 80 partners of ACS patients completed validated questionnaires at three time points. The predictor variables, marital satisfaction and optimism were assessed three weeks after patient hospital discharge (T1). The outcomes, depressive symptoms and physical health status (from a quality of life scale) were measured 6 (T2) and 12 (T3) months post-discharge, and scores were combined to indicate the long-term response.

Main outcome measures: Depressive symptoms and physical health status.

Results: Partner depressive symptoms increased and physical health status deteriorated over the months following the patients’ ACS. After controlling for demographics, clinical severity of ACS and T1 levels of the outcome variable, partners’ long-term depressive symptoms were predicted by poor marital satisfaction and low optimism at T1, and poor physical health status was predicted by low T1 optimism.

Conclusion: Psychosocial factors are predictors of long-term distress for ACS partners. Partners in an unhappy marriage or with low optimism after ACS are at an increased risk of depression and low physical health status, and should be the target of additional support.     

Coping,mastery, stress appraisals,mental preparation,and unit cohesion predicting distress and performance: a longitudinal study of soldiers undertaking evacuation tasks

Abstract

The study aimed to assess the associations of psychological and military variables with distress and performance evaluation among 168 Israeli soldiers who took part in evacuating fellow Israeli civilians in the summer of 2005 during the disengagement from Gaza. Coping, mastery, stress appraisals, mental preparation, unit cohesion, and psychological distress were assessed at T1, one to two weeks before the disengagement. A sub-sample of 68 of the 168 soldiers completed the distress measure again at T2, eight to nine weeks after T1, together with performance evaluation of the disengagement task. The main findings indicated positive associations of T1 distress with high T1 emotion-focused coping, and negative associations with education and T1 mastery. Emotion-focused coping at T1 predicted low performance evaluation at T2, while mental preparation at T1 predicted high performance evaluation at T2. Stress appraisals at T1 were found to be an important mediator of the associations of T1 coping, mastery, unit cohesion, and mental preparation with T1 distress. Similar mediator results were found for T2 performance evaluation.     

The two roads of passionate goal pursuit: links with appraisal,coping, and academic achievement

Background and Objectives: In this research, we tested the role of cognitive appraisals in explaining why harmonious and obsessive passion dimensions are related to distinct forms of coping and explored if performance was impacted by these appraisal and coping processes. Design: Undergraduate students (N = 489) participated in a longitudinal study and completed three surveys throughout the course of an academic year. Methods: Participants completed assessments of both passion dimensions (Time 1), reported how they were appraising and coping with the mid-year examination period (Time 2), and provided consent to obtain their final grade in Introductory Psychology (Time 3). The hypothesized model was tested using structural equation modeling. Results: Harmonious and obsessive passion dimensions were linked with approach and avoidant coping responses, respectively. Cognitive appraisals, particularly appraisals of challenge and uncontrollability, played an indirect role in these relationships. In addition, both appraisals and coping responses had an indirect effect in the relationship between passion dimensions and final grade. Conclusions: These results identify cognitive appraisal as a reason why passion dimensions are linked with distinct coping tendencies and demonstrate the role of appraisal and coping processes in the journey to passionate goal attainment.     

Children's self-reported coping strategies: The role of defensiveness and repressive adaptation

Abstract

This study examined differences in self-reported coping strategies across children classified according to Weinberger et al.'s (1979) adaptive style paradigm. Consistent with the larger literature, it was hypothesized that repressors (i.e. characterized by high self-reported defensiveness and low self-reported distress) would endorse fewer behaviorally and cognitively avoidant coping strategies than other adaptive style groups. Participants included 134 children, ranging in age from 10 to 13 (M=11.26, sd=.59), who completed measures of defensiveness, trait anxiety, and coping. Consistent with the hypotheses, results indicated significantly lower endorsement of avoidant coping strategies, and significantly higher endorsement of approach-oriented strategies among repressors, but no significant differences across adaptive style groups for other forms of coping. Results indicate that, consistent with other indicators of psychological functioning, the measurement of coping strategies is subject to the effects of socially desirable responding. Further, results provide evidence that measures of coping may be contaminated by items reflecting adjustment problems.     

Distress and Coping Strategies Among Patients with Skin Cancer

Non-melanoma skin cancer (NMSC) is the most common cancer world-wide, yet few studies have investigated the psychosocial implications of this disease. The current study provides an account of the distress experienced by patients with NMSC and the coping strategies they use to deal with the NMSC diagnosis. The results demonstrate that 19 % of the patients experience significant levels of psychological distress. Furthermore, those who engaged in avoidant coping strategies (specifically behavioural avoidance) were more likely to experience distress. These findings highlight the importance of further investigating this patient population, since patients report difficulties adjusting to this disease and its treatment.     

Partner unsupportive responses, avoidant coping, and distress among women with early stage breast cancer: patient and partner perspectives.

This 18-month longitudinal study examined the associations among partner unsupportive behavior, avoidant coping, and distress experienced by 219 women with early stage breast cancer. The role of patient and partner ratings of unsupportive behavior were evaluated. Results indicated that patient and partner ratings of unsupportive behavior were highly correlated. Growth curve modeling suggested that unsupportive behavior, from both patient and partner perspectives, predicted more avoidant coping and distress. When partner and patient perceptions were placed in the same model, patient perceptions mediated the association between partners' ratings of their unsupportive behavior and patient distress. Avoidance also mediated the association between unsupportive behavior and distress, extending prior cross-sectional findings. Results highlight the long-term detrimental effects of partners' unsupportive behavior on the quality of life of women with early stage breast cancer.     

Self-acceptance,resilience, coping and satisfaction of life in people who stutter

PurposeThe purpose of the present study was to evaluate self-acceptance and satisfaction with life with people who stutter and the influence of coping and resilience on the two factors.MethodForty-seven people who stutter (PWS) and 47 people who do not stutter (PWNS) participated in an online survey. Participants completed a survey assessing 6 main areas: (a) background information, (b) satisfaction with life, (c) coping, (d) avoidance, (e) self-acceptance, and resilience.ResultsAvoidant coping and maladaptive coping moderated the association between stuttering and self- acceptance but not satisfaction with life. Resilience was found to moderate the association between stuttering and self-acceptance as well as satisfaction with life.ConclusionStuttering was associated with lower self-acceptance at higher levels of avoidant coping and maladaptive coping. PWS who have lower levels of resilience were more likely to have a lower satisfaction with life indicating that higher levels of resilience could serve as a protective factor for having a greater satisfaction with life. Further, stuttering was associated with lower self-acceptance at lower levels of resilient attitude. Resilience and coping appear to protect against having diminished self-acceptance and satisfaction with life for PWS.     

Predictors of burnout and health status in Samaritans’ listening volunteers

Samaritan listening volunteers provide emotional support to people in distress or suicidal. Samaritans’ has high volunteer turnover, which may be due to burnout. This study evaluated the role of demographic and psychosocial factors in predicting Samaritans listening volunteers’ burnout and health status. Samaritans’ listening volunteers (n = 216) from seven branches across UK completed an online survey to assess their levels of burnout (emotional exhaustion, depersonalisation, personal accomplishment), subjective health status, coping, empathy and social support. Overall, listeners showed low levels of burnout and good health. Regression analysis revealed that higher emotional exhaustion was predicted by younger age and avoidant coping style; higher depersonalisation was predicted by lower empathy fantasy and higher avoidant coping style; lower personal accomplishment scores were predicted by higher empathy personal distress and worse health status was predicted by more hours per week spent on listening duties, lower social support and higher avoidant coping style. Overall, different factors influenced different facets of burnout. However, higher use of avoidant coping style consistently predicted higher burnout and worse health status, suggesting avoidant coping is an important target for intervention.     

Lung function,sociodemographic characteristics,and psychological reaction to transplant associated with chronic stress among lung recipients

Abstract

Patterns of coping, defined as complex sets of coping strategies, were identified in a group of surgical patients awaiting surgery. The patterns were labelled as asthenic, problem-oriented, active and avoidant. The four patterns consisted of different combinations of eight forms of coping, measured by the Ways of Coping Questionnaire. The obtained results show that—compared to the coping strategies analysed separately—those coping patterns were poorer predictors of the emotional outcome. Patients assigned to groups representing particular coping patterns showed different levels of anxiety measured at the beginning of hospitalization; however, no differences or changes in emotions were observed after a one-week lapse. More relationships were found between the coping strategies and measures of negative emotions (anxiety and anger) and their changes.     

Physical recovery in Arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity

Few studies have examined whether certain coping behaviors are associated with physical outcomes following surgery. This prospective, longitudinal study investigated the effect of active and avoidant coping behaviors on two physical outcomes over time, pain and knee function, in a group of patients experiencing knee arthroscopic surgery (n = 81). Structured interviews and physician clinical assessments were conducted preoperatively and at 3 and 24 weeks postoperatively. Coping behavior was assessed during the preoperative interview, and patients were divided into high and low avoidant and active coping groups. Using repeated measures MANCOVA/ANCOVA, avoidant coping was significantly associated with knee pain and active coping was associated with knee function. Serum cortisol levels were available for a patient subset (n = 16); higher cortisol was related to both avoidant coping and poorer functioning during early recovery. Results suggest that these divergent coping behaviors are differentially associated with stress reactivity and physical outcomes in healthy patients undergoing minor knee surgery.     

Coping with type 1 diabetes through emerging adulthood: Longitudinal associations with perceived control and haemoglobin A1c

Objective: This study, which is part of a larger longitudinal study focusing on the biopsychosocial functioning of emerging adults with type 1 diabetes, examined how perceived personal control, coping and HbA_1c relate to one another over time.

Design and main outcome measures: Emerging adults with type 1 diabetes (18–30 years old) participated in a two-wave longitudinal study spanning five years (N = 164 at Time 1). At both times, patients completed questionnaires on perceived control and coping (i.e. diabetes integration, avoidant coping and passive resignation). HbA_1c values were obtained from treating clinicians. We investigated the directionality of effects using cross-lagged path analysis.

Results: Higher HbA_1c values predicted relative decreases in diabetes integration and increases in avoidant coping five years later. Feeling less in control over diabetes predicted the use of passive coping over time. Passive coping predicted a relative decrease in perceived control five years later.

Conclusion: These findings indicate that tackling poor glycaemic control is not only important to avoid medical complications but also to prevent patients from resorting to more avoidant coping strategies. Furthermore, given the longitudinal interplay between perceived control and passive coping, it is important that intervention efforts include both cognitive and behavioural components to be effective.     

The effectiveness of a proactive coping intervention targeting self-management in diabetes patients

Objective: The study’s aim was to investigate psychological, behavioral and medical long-term outcomes of an existing self-management intervention targeting the development of proactive coping skills (e.g. goal setting and identifying barriers) in type 2 diabetes patients. The study aimed to replicate prior research showing the intervention’s effectiveness, and to extend it by (a) adding booster sessions and (b) prolonging the period of follow-up measurement to capture long-term effects.

Design/outcome measures: A total of 141 type 2 diabetes patients were included in the intervention. The intervention employed a 5-step approach to target proactive coping skills. Psychological (e.g. proactive coping and self-efficacy) and behavioural variables (e.g. self-care, diet and physical activity) were assessed at baseline (T1), after the initial phase of the intervention (T2), after the booster phase (T3) and at follow-up (T4), comprising a total period of 15 months. Medical variables were assessed at T1 and T4.

Results: Employing piecewise Latent Growth Curve Modelling, results showed that participants improved on all psychological and behavioural variables during the initial phase and maintained these improvements over 12 months. The booster phase yielded no further improvements. Mixed findings were obtained on medical outcomes.

Conclusion: The original intervention is effective, but the added value of the booster sessions is uncertain.     

Expérience du stress à l'adolescence

This study concerns stress—protective factors—distress relationships with 297 adolescents. The first goal was to study if these relationships change depending on the sex of the participant. The second goal of the present research was to predict stress experience (frequency, intensity, severity) by depression, self‐esteem, social support and coping. Controlling the age of the participant, the results indicate that female teenagers are more threatened by chronic stress, more depressive, have more available persons in their social network, use social or avoidant coping more often whereas the male adolescents show a better self‐esteem. Concerning the second objective, self‐esteem and avoidant coping can predict stress experience (frequency and severity), while the state of depression is the only factor that can predict the three aspects of stress (frequency, intensity, severity), as opposed to social support, and social or problem‐solving coping.     

Ethnicity,Coping, and Distress Among Korean Americans,Filipino Americans,and Caucasian Americans

Abstract

The authors examined appraisal, coping, and distress among Korean American, Filipino American, and Caucasian American Protestants. No interaction effects emerged among ethnic groups, but there were significant ethnic main effects for appraisal and coping. Compared with the Caucasian Americans, both Asian American groups appraised stressors as more challenging, and the Korean Americans appraised them also as greater losses. Both Asian American groups reported using more strategies of accepting responsibility, religious coping, distancing, and escape-avoidance than the Caucasian Americans did; the Filipino Americans also reported more problem-solving strategies than the Caucasian Americans. For all participants, challenge appraisals predicted adaptive coping (problem solving and positive reappraisal) and less distress. Problem solving, seeking social support, and positive reappraisal predicted less distress; self-control, accepting responsibility, and escape-avoidance predicted greater distress. The authors stressed the value of assessing ethnicity in coping research.     

Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection

We examined a model of stress and coping in 749 African-American women at risk for HIV infection. Women in the sample were either homeless, intravenous drug users (IVDUs) sexual partners of IVDUs, or prostitutes. A model was hypothesized based on stress and coping theory and research. Antecedents studied were personal resources, specifically self-esteem and available support. Mediators were threat appraisal and coping efforts. Outcomes studied were emotional distress and HIV risk behaviors. Structural equation modeling techniques were used to test hypothesized pathways between these variables. Forty-five percent of the variance in emotional distress in these women was explained by the model with self-esteem and avoidant coping the strongest predictors. Ten percent of the variance in risk behavior was explained by the model with emotional distress the strongest predictor. Direct and indirect pathways predicting risk behavior and distress are discussed. Implications of results for intervention and theory building are considered.     

Psychological adjustment of children in the pretransplant phase of bone marrow transplantation: Relationships with parent distress,parent stress,and child coping

Families of 22 children preparing to undergo bone marrow transplantation (BMT) provided information concerning parent-reported major negative life stress, child coping strategies, parental psychological symptomatology, and child adjustment. Immediately prior to BMT, children and families are confronted with multiple stresses which challenge the child's coping and strain the parents' ability to assist the child with coping. Hence, stress, parental adjustment (distress), and child coping may be important factors affecting the child's overall psychological adjustment. Results showed that 15–25% of children and parents experienced clinically significant levels of psychological distress. Parent and child psychological distress were closely related. Major negative life stresses experienced by the parent and use of avoidant coping by the child significantly predicted child adjustment problems in the pretransplant period. Coping skills interventions targeting avoidant coping and management of parental stress/distress may reduce child psychosocial risk prior to BMT.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Coping with HIV Related Stigma and Well-Being

The goal of this study was to analyze the relationships to be found among stigma perception, active and avoidant coping strategies, and subjective and psychological well-being in a sample of 133 people with HIV. The results showed that stigma perception and avoidant coping strategies (venting, self-blame, denial, behavioural disengagement and substance use) were positively associated, whereas, both stigma perception and avoidant coping were negatively associated with different measures of well-being (affect balance, self-acceptance and environmental mastery). These negative relationships between stigma perception and the three well-being measures were mediated by the use of avoidant coping strategies. Results suggest that psychosocial intervention programs for people who report psychological distress arising from prejudice must be aimed at developing appropriate ways to deal with this prejudice. Intervention programs should also include strategies to directly increase well-being since from a positive psychology viewpoint certain interventions have been shown to do so, and HIV research has also shown that well-being is associated with lower mortality rates.     

Negative affectivity,coping, immune status,and disease progression in hiv iwected individuals

Abstract

The primary goal of the study was to assess the relationship between personality dispositions, coping styles, immune markers, clinical status, and subjective somatic symptoms in a mixed sample of HIV positive individuals. Specifically, the prognostic value of psychological and immunological measures in HIV progression was emphasized. Subjects (n = 104) were recruited from a cohort of 422 HIV positive individuals enrolled in the Oslo HIV Cohort Study. The partkipants were given self-administered questionnaires assessing behavioral, psychological, and psychdal variables. Clinical assessment and immunological tests were performed at regular follow-up visits. Clinical status was assessed according to the Centers for Disurse Control criteria. The immune markers used were CD4 T cell counts, beta2-microglobulin concentration, sewn levels of HIV-1 p24 core protein, and levels of antibodies to core protein. In addition, subjective somatic symptoms were assessed.

The results showed that measure-s of negative affectivity (NA; e.g. anxiety, distress, tension) were consistently related to subjective somatic symptoms and passivedefensive coping style. However, no amistent association between NA measures and immune markers was found. Individuals who developed AIDS in the study period had significantly lower initial CD4 cell counts as well as lower scores on measures of active-pmblem related wping (e.g. Positive reappraisal, Seeking social support) and passivedefensive coping (i.e. Escape-Avoidance, Self-control).

The results suggest (1) that coping styles may merit a specific focus in future research of psychological factors and medical outcomes in HIV infection, and (2) because of associations of NA measures with symptom reports studies of the relationship between e.g. stress, depression and HIV outcome should consider these variables as confounders.     

Discriminative facility in the face of threat: Relationship to psychological distress

Abstract

This study explored whether discriminative facility in dealing with threatening situations is negatively associated with distress. Discriminative facility entails the ability to (1) “accurately” appraise the controllability of stressors and (2) use more problem-focused relative to emotion-focused coping with controllable stressors and at the same time more emotion-focused relative to problem-focused coping with uncontrollable stressors. We conducted a preliminary study to obtain “accurate” appraisals of the controllability of two stressors. In the main study, college students (N = 109) provided information regarding their appraisal of the controllability of the two stressors, how they coped with these two stressors, and their level of both stressor-specific distress and general distress. The relationship between coping strategy (problem- vs emotion-focused) and stressor-specific distress was found to be a function of the controllability of the stressor. Specifically, with controllable stressors, the high use of problem-focused coping was associated with less distress than the high use of emotion-focused coping. The opposite was found to be the case with uncontrollable stressors. More importantly, discriminative facility was negatively related to general distress. The results suggest that discriminative facility in the appraisal of and coping with stressors is an important mediator in the experience of psychological symptoms as a result of stress.