Stress and coping strategies in spouses of depressed patients.

The relationships between the coping strategies used by spouses of clinically depressed patients and spouses' anxiety, depression, and marital maladjustment were investigated. Fifty spouses of clinically depressed patients completed a biographical questionnaire, the Coping Strategy Indicator (J. H. Amirkhan, 1990, 1994), the Beck Depression Inventory (A. T. Beck, 1967; A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961), the State-Trait Anxiety Inventory (C. D. Spielberger, R. E. Lushene, B. A. Vagg, & E. Jacobs, 1983), and the Locke-Wallace Marital Adjustment Test (H. J. Locke & K. M. Wallace, 1959, 1987). Anxiety was highly prevalent in the spouses; more than half were depressed, and half showed marital maladjustment. Significant positive correlations were found between an avoidant coping strategy and anxiety as well as depression, and a significant negative correlation was found between an avoidant coping strategy and marital adjustment. These findings indicate the ineffectiveness of an avoidant coping strategy for spouses of clinically depressed patients.     

Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients

The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.     

Attachment, sleep quality, and depressed affect.

This study examined the role of attachment insecurity in sleep problems among married adults (N=78 couples). Using the Pittsburgh Sleep Quality Index and structural equation modeling, attachment anxiety was associated with higher levels of self-reported sleep difficulties for men and women, whereas attachment avoidance was not. Depressed affect was included as a control variable, and the effect of attachment anxiety remained significant. Men and women did not differ significantly in the magnitude of the effect of attachment anxiety on sleep quality. In addition, there were no cross-partner effects of attachment insecurity on sleep quality or depressed affect. Implications and future directions are discussed.     

Extending the activity restriction model of depressed affect: evidence from a sample of breast cancer patients.

Survey data from 95 women with Stage 1 (n = 36), Stage 2 (n = 49), or Stage 3 (n = 10) breast cancer both confirm and extend prior research indicating that restriction of normal activities is an important factor in depressed affect. Illness severity was directly related to more restricted routine activities, and more activity restriction was associated with higher public self-consciousness and less social support. Beyond the effects of age, self-consciousness, illness severity, and social support, activity restriction explained significant additional variance in symptoms of depression. Moreover, activity restriction mediated the impact of pain, public self-consciousness, and social support on depressed affect, which implies that these factors foster symptoms of depression by disrupting normal activities.     

Stress,coping, executive function,and brain activation in adolescent offspring of depressed and nondepressed mothers

This study examined the associations among chronic stress, activation in the prefrontal cortex (PFC), executive function, and coping with stress in at-risk and a comparison sample of adolescents. Adolescents (N = 16; age 12–15) of mothers with (n = 8) and without (n = 8) a history of depression completed questionnaires, neurocognitive testing, and functional neuroimaging in response to a working memory task (N-back). Children of depressed mothers demonstrated less activation in the anterior PFC (APFC) and both greater and less activation than controls in distinct areas within the dorsal anterior cingulate cortex (dACC) in response to the N-back task. Across both groups, activation of the dorsolateral PFC (DLPFC; Brodmann area [BA9]) and APFC (BA10) was positively correlated with greater exposure to stress and negatively correlated with secondary control coping. Similarly, activation of the dACC (BA32) was negatively correlated with secondary control coping. Regression analyses revealed that DLPFC, dACC, and APFC activation were significant predictors of adolescents’ reports of their use of secondary control coping and accounted for the effects of stress exposure on adolescents’ coping. This study provides evidence that chronic stress may impact coping through its effects on the brain regions responsible for executive functions foundational to adaptive coping skills.     

Bulimic symptomatology and coping in a nonclinical sample.

This study examined the relationship between bulimic symptomatology as measured by scores on the Bulimia Test--Revised and coping orientation as measured by Endler and Parker's Coping Inventory for Stressful Situations given to a nonclinical sample of 164 female college students. A relationship was obtained among emotionally oriented coping, task-oriented coping, and scores on the Bulimia Test.     

Stress, coping, and high-risk sexual behavior.

We examined the relation between stress, coping, and a high-risk sexual behavior (unprotected anal intercourse) in 398 nonmonogamous gay and bisexual men from the AIDS Behavioral Research Project in San Francisco. Unprotected anal intercourse during the previous month, the amount of stress experienced during the previous month in each of 10 domains, six types of coping (self-controlling coping, escape-avoidance, distancing, planful problem-solving, seeking social support, and positive reappraisal), and spiritual beliefs and spiritual activities were assessed through self-report. There was no relation between stress and unprotected anal intercourse. However, there was a relation between coping and unprotected anal intercourse. Subjects who reported unprotected anal intercourse used sex more of the time to help cope with stressful situations than did subjects who did not report unprotected anal intercourse. Unprotected anal intercourse was negatively associated with seeking social support and spiritual activities and positively associated with self-controlling coping, which involves keeping one's feelings to oneself, and positive reappraisal. The findings suggest that social aspects of coping may be a key to understanding differences between those who engage in high-risk sexual behavior and those who do not.     

Personality, coping, and coping effectiveness in an adult sample

Two studies of coping among community-dwelling adults (N= 255,151) were used to examine the influence of personality on coping responses, the perceived effectiveness of coping mechanisms, and the effects of coping and personality on well-being In both studies a wide range of potential stressors was examined, categorized as losses, threats, or challenges The personality dimensions of neuroticism, extraversion, and openness to experience, as measured by both self-reports and spouse- and peer-ratings, were systematically related to coping mechanisms in both studies There was general agreement across types of stressors on the use and perceived effectiveness of the 27 coping mechanisms, and individuals who used more effective ways of coping generally reported higher subsequent happiness and life satisfaction However, personality variables are also known to be determinants of well-being, and the associations between coping and well-being were reduced when personality measures were partialled out Some implications for the design and interpretation of coping effectiveness studies are discussed     

Stress,social support,and problem-solving appraisal/skills: Prediction of suicide severity within a college sample

This study assessed whether stress, social support, and interpersonal problem-solving appraisal/skills were predictive of level of suicidality within a chronic suicidal college sample. Stepwise regression analyses were used to assess whether stress, social support, and problem-solving were independently predictive of severity of suicide ideation. In addition, hierarchical regression analyses were used to test the mediational nature of social support and problem-solving in the stress-suicidality relationship. Problem-solving confidence was found to be a significant predictor of severity of suicide ideation. In addition, both perceived problem-solving skills and social support mediated the relationship between stress and level of suicide ideation. However, only one of the two perceived problem-solving skills interactions was in the expected direction. This study provided support for the importance of problem-solving confidence and the interaction of stress and social support in the prediction of suicide severity. Unlike previous studies, this study did not find problem-solving skills/deficits to mediate the stress-suicidality relationship.This research was supported by NIMH Grant 1-18MH48133.     

Characteristics of intrusive memories in a community sample of depressed, recovered depressed and never-depressed individuals

An accumulating body of evidence has revealed that intrusive autobiographical memories of negative events play a role in depression. Despite increasing understanding of the phenomenological experience of these memories, previous research in this area has been conducted in either nonclinical samples, or in clinical samples without an adequate control group. This study aimed to replicate and extend findings with dysphoric samples by comparing the content and characteristics of intrusive memories in clinically depressed (n = 25), recovered (n = 30) and never-depressed (n = 30) participants. Participants completed mood measures, and a battery of self-report questionnaires that indexed intrusive memory frequency, avoidance and characteristics. Intrusive memories were common and shared strikingly similar characteristics across the three groups. The key finding was that depressed participants reported higher levels of intrusion-related distress, associated emotions (especially sadness and helplessness), interference as a result of the memories and memory vividness compared to the never-depressed group. Despite similar levels of intrusion, there were group differences in avoidance such that depressed participants reported higher levels of avoidance than the never-depressed group. These results provide further support for the proposal that clinical interventions for depression could usefully incorporate components that aim to reduce intrusive autobiographical memories and target avoidance strategies.     

Adolescents' evaluative beliefs of failure: explorations in a Chinese Singaporean sample

Our study explored evaluative beliefs of failure to see whether positive and negative beliefs of failure are bivariate in nature within three domains of an adolescent's life (academic, social, and athletic) and how such beliefs are differentially linked to the importance of a domain, the frequency of failure in a domain, and the extremity of negative emotions experienced when encountering failure in a domain. A total of 163 Chinese Singaporean students in Secondary 3 and 4 (Grades 9 and 10) from two Singapore schools participated in the study by completing a questionnaire. Results from various analyses converged to demonstrate that evaluative beliefs could be distinguished by both valence (positive and negative) and domain (academic, social, and athletic). The six evaluative beliefs were also distinguished from failure attributions. While there was consensus in what constituted negative beliefs of failure across domains, positive beliefs of failure showed some domain specificity, with unique aspects in particular domains (e.g., the inevitability of failure only in the academic domain). Positive and negative beliefs in the different domains were correlated among themselves, but positive and negative beliefs were uncorrelated within (except for academic) and across domains. Positive and negative beliefs were also differentially linked to domain importance, failure frequency, and extremity of negative emotion. Unexpectedly, domain importance was not linked to negative beliefs but was linked to positive beliefs, while positive and negative beliefs showed domain-specific links with failure frequency. As expected, however, negative beliefs were (positively) linked to extremity of negative emotions while positive beliefs were not linked to such extremity. The conceptual, substantive, and practical implications of these results are discussed.     

Intergenerational continuity of parental rejection and depressed affect.

Using survey and observational data from a sample of 451 intact families, this study used structural equation modeling to examine the intergenerational continuity of depressed mood and rejecting parenting. The model partially replicated the intergenerational model of Elder, Caspi, and Downey (1986) that indicates a cyclical transmission process by which parents' personality traits affect parent-child interaction, which, in turn, increases the propensity for developmental problems among offspring. The results indicated a pattern of intergenerational transmission of depressed mood through parental rejection of offspring. Multiple reporters and multiple indicators strengthen previous intergenerational findings by reducing some of the method variance biases that have been problematic in prior studies.     

Performance benefits of depression: sequential decision making in a healthy sample and a clinically depressed sample

Previous research reported conflicting results concerning the influence of depression on cognitive task performance. Whereas some studies reported that depression enhances performance, other studies reported negative or null effects. These discrepant findings appear to result from task variation, as well as the severity and treatment status of participant depression. To better understand these moderating factors, we study the performance of individuals-in a complex sequential decision task similar to the secretary problem-who are nondepressed, depressed, and recovering from a major depressive episode. We find that depressed individuals perform better than do nondepressed individuals. Formal modeling of participants' decision strategies suggested that acutely depressed participants had higher thresholds for accepting options and made better choices than either healthy participants or those recovering from depression.     

Self-mutilation and coping strategies in a college sample

The goal of this study was to examine the use of specific coping strategies among self-mutilating college students. The self-mutilating group (n = 44) reported utilizing avoidance strategies more often than did a control group (n = 44) matched for general psychological distress but with no history of self-mutilation. In addition, female, but not male, self-mutilators endorsed using problem-solving and social support seeking strategies less often than nonmutilators. These findings suggest that coping strategies in general and avoidance-based strategies in particular may be important targets for the treatment of self-mutilative behaviors.     

Stress,coping resources,and injury risk

Over the last two and a half decades, researchers have tried to determine if psychological variables predispose or buffer athletes from injury. They have found that sport participants who experience many recent stressors, and who do not have the resources and skills to cope with the stress, seem most at risk for injury. This article reviews that research as well as efforts to identify mechanisms that might explain why the stress-injury relationship occurs and interventions that will hopefully reduce the injury risk. Because the multicomponent stress-injury model of Andersen and Williams (1988) helped provide the impetus and theoretical base for much of that research, it serves as the foundation for organizing and summarizing the findings. Although the research has focused largely on sport injuries, the findings have relevance for understanding and potentially preventing many accidents and injuries that occur outside the realm of sport participation.     

Relations among positive affect, negative affect, and somatic symptoms in a medically ill patient sample

The Positive and Negative Affect Scale (PANAS), a brief measure of Positive and Negative Affect, may be useful in assessing mood of medical patients because it does not include somatic items frequently confounded with medical conditions. In previous research Positive and Negative Affect have been independent and uncorrelated, and Negative Affect but not Positive Affect has been positively correlated with somatic symptoms. However, relationships between variables may vary in different populations, and there is relatively little information on Positive and Negative Affect in medical patients. In the current study, the PANAS was used to assess the relationships among Positive Affect, Negative Affect, and somatic symptoms and pain in a medically ill hospital population. Positive and Negative Affect scores were positively correlated and for patients reporting pain, Positive Affect scores were positively correlated with pain intensity. Results from this and other studies indicate that Positive and Negative Affect are independent but in some populations may be correlated; positive affects such as hopefulness may co-occur with both somatic complaints and psychological distress.     

Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.