The relation of coping, appraisal, and burnout in mental health workers.

This study was undertaken as an attempt to determine the relationship between individual coping (in response to stressful work events) and concomitant symptoms of burnout and the relationship between coping and burnout as moderated by secondary cognitive appraisal. Professional mental health workers (N = 234) employed by a state psychiatric facility completed the Ways of Coping Checklist (revised) (Lazarus & Folkman, 1984) and a measure of secondary appraisal, after reporting a typical stressful work event. They also completed the Maslach Burnout Inventory (Maslach & Jackson, 1986) and a demographic questionnaire. Results suggested that individual coping was related to burnout. Escape-avoidance was the primary coping strategy related to all three symptoms of burnout: emotional exhaustion, depersonalization, and lack of personal accomplishment. Secondary appraisal did not moderate the relation of coping and burnout.     

Appraisal and Coping as Mediators of the Effects of Cumulative Risk on Preadolescent Adjustment

This study examined the concurrent and longitudinal relations among cumulative risk, appraisal, coping, and adjustment. Longitudinal path models were tested in a community sample of 316 children in preadolescence to examine hypotheses that threat appraisal and avoidant coping mediate the effects of cumulative risk on child adjustment, whereas positive appraisal and active coping were hypothesized to predict better adjustment independently. Children and their mothers were assessed during in-home interviews at three time points at one-year intervals. Children reported on appraisal and coping strategies. Mothers and children reported on child adjustment problems and positive adjustment. Rank-order changes in appraisal and coping predicted rank-order changes in adjustment. Cumulative risk was concurrently related to higher threat appraisal and avoidant coping at each time point. Threat appraisal and avoidant coping mediated the relations of cumulative risk to rank-order changes in adjustment. There is specificity in the relations of cumulative risk to threat appraisal and avoidant coping, whereas positive appraisal and active coping are independent of risk and operate as individual resource factors.     

Family characteristics as mediators of the influence of problem drinking and multiple risk status on child mental health

Structural equation modeling was used to test a theoretical model in which family cohesion and family reframing coping were hypothesized as mediators between family drinking problems, multiple risk factors, negative life events, and child mental health (conduct disorder, depression, anxiety) in two-parent families. Family cohesion mediated the relationships of family drinking problems and negative life events to child conduct disorder and depression. Negative life events mediated the relationships of family drinking problems and family multiple risk to child conduct disorder. Family reframing coping did not function as a mediator nor was it related to child mental health when other factors were considered simultaneously. Results indicate that increasing family cohesion and reducing sources of stress within the family (negative life events) represent promising areas for interventions for children with problem-drinking parents. Work on this study was funded in part by the National Institute for Mental Health Grant 2-P50-MH39246-06 to support a Preventive Intervention Research Center. The authors gratefully acknowledge contributions made by Rita Shell, Marcia Michaels, Joanne Gersten, George Knight, and Carolyn Berg.     

Application of a stress and coping model to antenatal depressive symptomatology

This study examined the utility of a stress/coping model of antenatal depressive symptomatology. The direct and moderating effects of appraisal, coping resources and coping strategies on depression were explored. A total of 242 primiparous women completed questionnaires during the third trimester of pregnancy. Predictors included life events, coping resources (social support, quality of women's earlier relationships with parents), appraisal (threat, self-efficacy) and coping strategies (wishful thinking, positive reappraisal, problem solving, emotional approach). Results of regression analyses indicated that higher depression was related to higher stressful life events, threat appraisal and wishful thinking coping, and lower positive reappraisal coping. The expected stress exacerbation effects of wishful thinking on depression were supported. There was no support for the expected stress buffering effects of coping resources and coping strategies on depression. Findings provide preliminary support for the use of a stress/coping model to guide future research into psychosocial predictors of antenatal depression.     

The dynamics of threat and challenge appraisals prior to stressful achievement events

Research on cognitive appraisal of stressful achievement events has emphasized threat appraisals and anxiety. The present research also focused on challenge and positive emotion. Study 1 used hypothetical scenarios of stressful events. Study 2 explored temporal pattems of appraisal and emotion prior to an exam. Compared with threat appraisals, trait and state challenge appraisals were associated with more confident coping expectancies, lower perceptions of threat, higher positive emotion, and more beneficial perceptions of the effects of appraisal and emotion on performance. Beneficial perceptions of state appraisals were associated with higher exam performance. These findings were interpreted in the context of theoretical perspectives on the cognitive appraisal of stressful events and the adaptive functions of challenge and positive emotion.     

Locus of Control as a Stress Moderator and Mediator in Children of Divorce

This paper examined the stress moderator and mediator effects of four dimensions of perceived control in children of divorce. The dimensions of locus of control included internal control for positive events, internal control for negative events, unknown control for positive events, and unknown control for negative events. The sample consisted of 222 children between the ages of 8 and 12 whose parents had divorced in the previous 2 years. Moderational analyses showed that unknown control for positive events interacted with negative events to predict total symptoms. Plots of the simple slopes indicated a stress buffering effect whereby the slope of negative events on symptoms was higher for high than for low levels of unknown control for positive events. Mediational analysis showed that the relations between negative events and symptoms were mediated by both unknown control for positive events and unknown control for negative events. In contrast, evidence was not found for either a stress mediational or a moderational model for perceived internal control for positive or negative events. These results suggest that unknown control beliefs may be a particularly important dimension of control for children of divorce.     

Control Beliefs and Faith as Stress Moderators for Korean American Versus Caucasian American Protestants

Examined relationships among negative life events, four locus of control attributions (Internality, Powerful Others, Chance, and God Control), and psychological distress for Korean American versus Caucasian American Protestants. Negative events and Powerful Others beliefs were positively related to distress, whereas Internality was negatively related to distress. Ethnicity and God Control interacted: The relationship between God Control beliefs and anxiety was negative for Caucasians but positive for Koreans. Three-way interactions (Ethnicity × Locus of Control × Negative Events) also emerged. As Caucasians' Powerful Others beliefs increased, the positive relationship between negative events and depression became stronger; Koreans' Powerful Others beliefs had no such effect. As Caucasians' God Control beliefs increased, the negative event–depression relationship changed from positive to negative; the reverse was true for Koreans. Findings support the value of assessing ethnoculture and religiousness in stressful life events research.     

Prediction of Health Patterns from General Appraisal,Attributions, Coping,and Trait Anxiety

We examined the relationships among general appraisal style, attributional style, trait anxiety, coping styles, and health status (i.e., depression, hostility, and flu-like symptoms) in a study for which we also examined the validity of a trait measure of general appraisal. Participants completed personality measures at the beginning of an academic semester, and health assessments at regular intervals throughout the semester. Consistent with our predictions, after removing the influence of neuroticism and attributional style, general appraisal style led to more negative, and less positive affect 2 weeks later, and to more stressful and threatening appraisals of a life event occurring 3 months later. Multiple regression techniques showed that as predicted, after controlling for baseline health general appraisal style and attributional style predicted hostility and flu-like symptoms, and attributional style also predicted depression. These effects were mediated by trait anxiety. We discuss why both negative general appraisal and attributional styles may be risk factors for ill health.     

Abortion and Mental Health

Abstract

Unwanted pregnancy and abortion are common life events, and therapists are likely to work with clients who experience them. Legal abortion currently entails little physical or mental health risk; most women currently cope effectively with these life events without need of clinical intervention. But current abortion politics include efforts to make abortion a more threatening, stressful, and stigmatized experience and to create a “postabortion syndrome.” Using a stress and coping framework, we examine how antiabortion activists spread myths and misinformation aimed at women's appraisal processes, and discuss approaches therapists can use to enhance women's strategies for coping with abortion. We also discuss specific issues and useful techniques for counseling about abortion concerns, including cultural sensitivity and strategies for promoting positive sexual health.     

Resilience in the Face of Catastrophe: Optimism, Personality, and Coping in the Kosovo Crisis

Optimism, personality, and coping styles may alter the effects of stressful events through appraisal and stress reduction. The 1999 Kosovo crisis offered an opportunity to test this proposition under real-life, traumatic stress conditions. Dispositional optimism, personality, and coping contributions were predicted based on geographical distance and degree of reported stress for 3 groups: Kosovar refugees, Albanian citizens helping the refugees in Albania, and Albanian immigrants living in the United States. Results showed Kosovars significantly higher on all stress measures, and on maladjustment. Reduced optimism and reduced control coping were related to higher levels of maladjustment. Pessimism and escape coping showed no relation to psychological adjustment. Resilience was related to a combination of higher optimism, extraversion, openness to experience, conscientiousness, and control coping, paired with lower neuroticism.     

Measuring abuse stress and negative cognitive appraisals in child sexual abuse: Validity data on two new scales

The validity of two measures assessing degree of stress associated with child sexual abuse was examined in a sample of 48 girls who had been sexually abused. The Checklist of Sexual Abuse and Related Stressors (C-SARS) assessed negative life events that were part of or were related to the abuse, and the Negative Appraisals of Sexual Abuse Scale (NASAS) assessed negative cognitive appraisals of threat, harm, or loss associated with the abuse. Total scores for victim reports of both stressful events and negative appraisals were positively and significantly related to two other measures of abuse severity: therapist ratings of abuse stress and the number of types of sexual abuse reported. Stressful event scores were also related to aggressive behavior problems, sexual concerns, and total symptom scores on the Child Behavior Checklist. Negative cognitive appraisal scores were related to victims' self-reports of depression, anxiety, and posttraumatic stress symptoms, and to parent reports of child depression and total symptoms. Regression analyses indicated that there were significant effects of negative appraisals on internalizing symptoms when controlling for the level of stressful events experienced. The results suggest that negative life events and negative appraisals associated with sexual abuse are valid constructs that help account for variability in mental health outcomes among child victims. The implications of these results and future research directions in examining variable outcomes among sexual abuse victims are discussed.     

The Rasch Scaling of Mystical Experiences: Construct Validity and Correlates of the Mystical Experience Scale (MES)

This study evaluated the relationships that exist between the Brief Multidimensional Measure of Religiousness/Spirituality (BMMRS) and the mental health of individuals with heterogeneous medical disorders. The participants were 168 individuals with heterogeneous medical disorders (i.e., 61 brain injury, 32 stroke, 25 spinal cord injury, 25 cancer, 25 primary care). The measures were BMMRS subscales (conceptualized as spiritual experiences, religious practices, and congregational support), Medical Outcomes Scale–Short Form 36 General Mental Health scale. Pearson correlations indicated that, in general, mental health is positively correlated with positive spiritual experiences and positive congregational support but negatively correlated with negative spiritual coping and negative congregational support. Mental health was not correlated with private religious practices (e.g., prayer). Hierarchical regressions indicated that congregational support was the only BMMRS scale to predict mental health, explaining 6% of the variance beyond the 14% explained by demographic factors. The mental health of individuals with significant medical conditions appears to be primarily related to positive spiritual beliefs and especially congregational support. Mental health does not appear to be related to religious practices such as prayer, which is likely related to the fact that many individuals with serious medical conditions increase prayer with declining mental health status. These results stress the need for active congregational support and spiritual interventions to improve the mental health of persons with serious medical conditions.     

Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes

Despite the importance that is attributed to coping as a factor in psychological and somatic health outcomes, little is known about actual coping processes, the variables that influence them, and their relation to the outcomes of the stressful encounters people experience in their day-to-day lives. This study uses an intraindividual analysis of the interrelations among primary appraisal (what was at stake in the encounter), secondary appraisal (coping options), eight forms of problem- and emotion-focused coping, and encounter outcomes in a sample of community-residing adults. Coping was strongly related to cognitive appraisal; the forms of coping that were used varied depending on what was at stake and the options for coping. Coping was also differentially related to satisfactory and unsatisfactory encounter outcomes. The findings clarify the functional relations among appraisal and coping variables and the outcomes of stressful encounters.     

Psychological wellbeing and the diathesis-stress hypothesis model: The role of psychological functioning and quality of relations in promoting subjective well-being in a life events study

Negative life events are associated with poor wellbeing and mental health outcomes. Following a diathesis-stress model, we tested whether psychological functioning and quality of interpersonal relationships moderated the effect of life events on subjective wellbeing. This study comprised data from a young and middle-aged adult sample (n = 364) drawn from an Australian university-student population. Results indicated that life events were associated with negative but not positive wellbeing outcomes. Perceived impact of life events was a stronger predictor of wellbeing than was the number of life events. Psychological functioning and quality of interpersonal relationships were associated with both wellbeing dimensions but only quality of interpersonal relationships moderated the effect of life events on wellbeing. In conclusion, perceived impact of life events was more strongly related to wellbeing than number of life events. Interpersonal relationships moderate the effect of life events with those reporting higher levels of quality of interpersonal relationships reporting less decrement in negative affect following stressful life events.     

Memory and coping with stress: the relationship between cognitive-emotional distinctiveness, memory valence, and distress

Cognitive-emotional distinctiveness (CED), the extent to which an individual separates emotions from an event in the cognitive representation of the event, was explored in four studies. CED was measured using a modified multidimensional scaling procedure. The first study found that lower levels of CED in memories of the September 11 terrorist attacks predicted greater frequency of intrusive thoughts about the attacks. The second study revealed that CED levels are higher in negative events, in comparison to positive events and that low CED levels in emotionally intense negative events are associated with a pattern of greater event-related distress. The third study replicated the findings from the previous study when examining CED levels in participants' memories of the 2004 Presidential election. The fourth study revealed that low CED in emotionally intense negative events is associated with worse mental health. We argue that CED is an adaptive and healthy coping feature of stressful memories.     

A Four-Factor Model of Perceived Control: Avoiding, Coping, Obtaining, and Savoring

ABSTRACT This study provides evidence that people evaluate their control over events and over feelings separately with respect to both positive and negative experiences Confirmatory factor analyses revealed that subjects made separate self-evaluations of control regarding their ability to (a) avoid negative outcomes, (b) cope with negative outcomes, (c) obtain positive outcomes, and (d) savor positive outcomes In addition, beliefs about avoiding and obtaining were more highly correlated (r = 50) than were beliefs about coping and savoring (r= 27) It is argued that coping and savoring involve different sets of cognitive and behavioral skills Multiple regression analyses generally indicated that beliefs about avoiding and coping related more strongly to measures of subjective distress, whereas beliefs about obtaining and strongly related more strongly to measures of subjective well-being These four control beliefs are discussed in relation to other conceptual models of control, and ways in which savoring may promote perceived control are described     

Coping efforts in daily life: role of big five traits and problem appraisals

The role of problem appraisal and Big Five traits in coping with bothersome daily events was investigated. Community-residing men completed diaries regarding stressful events and coping for eight consecutive days. Results of multi-level analyses indicated that lower perceived control over events was associated with greater reliance on distraction, catharsis, acceptance, seeking emotional social support, but less use of direct action. Stressor severity was positively associated with catharsis and religion, but negatively associated with acceptance. Neuroticism, Extraversion, Openness to experience, and Conscientiousness predicted coping strategy use. In addition, broad personality dimensions moderated relations between appraisals (perceived uncontrolability and severity) and coping strategy use. Although previous research implicated perceived control in coping, the present study suggests that both appraisals of stressor severity and individual differences in personality are also important determinants of coping strategy use at the daily level.     

The relationship between self-control and health: The mediating effect of avoidant coping

Trait self-control is related to a number of positive outcomes, including mental health, interpersonal success, academic success and health-related behaviours. This study sought to explore the relationships between self-control, reports of mental and physical health symptoms and coping styles. The results revealed that higher self-control was related to fewer mental and physical health symptoms and less avoidance coping. There was not a significant relationship between self-control and problem-focused or emotion-focused coping styles. Further, the relationships between self-control and mental and physical health outcomes were partially mediated by avoidance coping style. Specifically, the data suggest lower self-control is associated with unhealthy coping strategies (avoidance coping), which in turn are associated with worse mental health outcomes and greater reports of physical health symptoms. Thus lower trait self-control can serve as an indicator, suggesting circumstances in which individuals' tendencies to engage in unhealthy coping strategies are increased. These findings add to a growing body of literature underscoring the importance of trait self-control.     

The relationship between self-control and health: The mediating effect of avoidant coping

Trait self-control is related to a number of positive outcomes, including mental health, interpersonal success, academic success and health-related behaviours. This study sought to explore the relationships between self-control, reports of mental and physical health symptoms and coping styles. The results revealed that higher self-control was related to fewer mental and physical health symptoms and less avoidance coping. There was not a significant relationship between self-control and problem-focused or emotion-focused coping styles. Further, the relationships between self-control and mental and physical health outcomes were partially mediated by avoidance coping style. Specifically, the data suggest lower self-control is associated with unhealthy coping strategies (avoidance coping), which in turn are associated with worse mental health outcomes and greater reports of physical health symptoms. Thus lower trait self-control can serve as an indicator, suggesting circumstances in which individuals’ tendencies to engage in unhealthy coping strategies are increased. These findings add to a growing body of literature underscoring the importance of trait self-control.     

A Systematic Review of the Literature Exploring Illness Perceptions in Mental Health Utilising the Self-Regulation Model

Psychologists have utilised a range of social cognition models to understand variation in physical health and illness-related behaviours. The most widely studied model of illness perceptions has been the Self-Regulation Model (SRM, Leventhal, Nerenz, & Steele, 1984). The illness perceptions questionnaire (IPQ) and its revised version (IPQ-R) have been utilised to explore illness beliefs in physical health. This review examined 13 quantitative studies, which used the IPQ and IPQ-R in mental health in their exploration of illness perceptions in psychosis, bipolar disorder, eating disorders, depression and adolescents experiencing mood disorders. Across these studies the SRM illness dimensions were largely supported. Mental illnesses were commonly viewed as cyclical and chronic, with serious negative consequences. Perceptions regarding chronicity, controllability and negative consequences were associated with coping and help seeking, while engagement with services and help seeking were also related to illness coherence beliefs. Treatment adherence was linked to beliefs that treatment could control one’s illness. Whilst a major limitation of the reviewed studies was the use of cross-sectional designs, overall the applicability of the SRM to mental health was supported. The IPQ and IPQ-R were shown to be valuable measures of illness perceptions in mental health, offering implications for clinical practice.