Adjustment to multiple sclerosis: application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.     

Coping strategies and diastolic blood pressure

An organizational field study involving 95 civil service employees examined the ways these individuals coped with the stressful events of their daily living. Lazarus' cognitive-phenomenological analysis of psychological stress provided the theoretical framework. Subjects indicated on Lazarus' Ways of Coping Checklist those coping thoughts and actions used in the specific encounter described as stressful. As hypothesized, individuals experiencing higher diastolic blood pressure were more likely to cope using strategies characterized by wishful thinking, avoidance, and minimization of threat than were individuals exhibiting lower blood pressure. Implications from both an individual and organizational perspective are discussed.     

压力情境认知评价与工作倦怠的关系

为探讨压力情境认知评价与工作倦怠的关系,选取北京、河南两家公司的303名员工进行了调查。分层结果分析发现,在控制了人口统计学因素之后,挑战评价对玩世不恭存在显著正向预测作用,控制评价对情绪衰竭、玩世不恭和成就感低落存在显著负向预测作用;进一步分析发现,控制评价在情绪中心应对和情绪衰竭、问题中心应对与成就感低落之间按的关系上具有调节作用。结果表明,压力情境认知评价是影响员工工作倦怠的重要因素。     

The relationship of appraisal and coping to chronic illness adjustment

There is evidence that adaptation to chronic illness may be affected by psychological factors, especially how patients appraise and cope with the stress of their illness. The purpose of the present study was to examine the relationship of stress appraisal and coping responses to multiple behavioral indices of illness adjustment among patients with diverse chronic medical conditions. One hundred and one patients admitted to a multidisciplinary medicine/psychiatry unit completed measures of functional impairment, depression, symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical regression analyses indicated that emotion-focused coping was positively related to poor psychosocial adjustment and depression after controlling for physician rated disease severity. Appraising chronic illness as holding one back predicted greater emotion-focused coping responses and poorer adjustment to illness. The use of problem-focused coping strategies was generally unrelated to illness adjustment. These findings suggest the presence of an emotion-focused coping triad consisting of wishful thinking, self blame, and avoidance, all of which appear to be maladaptive strategies when coping with chronic medical conditions. Implications for coping skills training and the need for longitudinal research is discussed.     

Problem Solving,Stress, and Coping in Adolescent Suicide Attempts

Twenty adolescents who had made suicide attempts were compared with 20 nonpsychiatric control subjects on measures of problem solving, stress, and coping. The suicidal group did not show evidence of “rigid” thinking or of deficits in the ability to generate solutions to standardized interpersonal problems. However, they did report recent histories of more severe life stress and had inaccurate appraisal of the extent to which stressful events could be controlled. Although suicidal patients were able to generate as many adaptive strategies as control subjects for coping with their own most severe recent real-life stressor, they actually used fewer. They were also more likely to identify maladaptive behaviors as ways of coping. These findings support a transactional model of adolescent suicidal behavior, whereby inaccuracies in the appraisal aspects of problem solving (but not in the solution-generation aspects) in the face of high life stress lead to a reduction in the use of adaptive efforts to cope.     

Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat

How do people cope with a threat when they do not plan to adopt an adaptive, protective response? We explored this question by examining the effects of information about a health threat and two aspects of coping ability, self-efficacy and response efficacy, on two adaptive and five maladaptive coping strategies (e.g., avoidance, wishful thinking). The results disclosed that the high-threat condition energized all forms of coping; it did not differentially cue specific coping strategies. The critical factor in determining the specific strategies used was the coping information. The high-response-efficacy and high-self-efficacy conditions strengthened adaptive coping and did not foster any maladaptive coping. A supplementary path analysis revealed an intriguing pattern of relations, including the finding that the most maladaptive strategy was avoidant thinking, which simultaneously reduced fear of the threat and weakened intentions to adopt the adaptive response.     

Optimism and Traumatic Stress: The Importance of Social Support and Coping1

This study examined the effects of optimism following traumatic stress and pathways through which optimism may act. Rescue and recovery workers at the crash site of US Air Flight 427 (n= 159) were studied 2, 6, 9, and 12 months after the crash to examine optimistic outlook, social support, coping, and stress. As predicted, a more optimistic disposition was associated with less self‐reported distress, less use of avoidant and wishful‐thinking coping strategies, greater use of problem‐focused and seeking‐social‐support coping, and greater availability of social support. Contrary to expectations, coping did not account for the relationships observed between optimism and stress responding. Social support explained some of the effects of optimism on coping and stress, but these mediational effects varied over time. Findings suggest that optimism affects stress and coping directly and indirectly by affecting how much social support is available.     

Quality of life and benzodiazepine drug use by community-dwelling elderly: a stress and coping perspective

Framed in Lazarus and Folkman theory of stress and coping, a model of onset of long-term benzodiazepine use among community-dwelling older adults is presented within a perspective of quality of life enhancement. We focus on heightened emotional reactivity, and subsequent effect on cognitive appraisal of life circumstances (loss of control over the event and negative appraisal of personal resources). We examine ensuing coping strategy, namely an increased reliance on both emotion-reduction and problem-solving coping strategies. The effects of benzodiazepine use on quality of life are brought forth. Alternatives to benzodiazepine use are suggested.     

A structural model of the relationships among stress, coping, benefit-finding and quality of life in persons diagnosed with colorectal cancer

This study has used the structural equation modelling to examine the role of benefit-finding (BF) in the context of the stress and coping model. In the study, 1276 individuals diagnosed with colorectal cancer completed a written questionnaire and telephone interview at around 4.5 months (on average) and 12 months post-diagnosis. Analyses revealed that the final model fit the data, where stress, coping and BF accounted for 63% of the variance in Time 1 quality of life (QOL). Threat appraisal, coping resources, avoidant coping and BF directly impacted on Time 1 QOL, while threat appraisal, social support and approach coping directly impacted on BF. Approach coping and BF had differential relationships with stress, coping resources and outcomes, indicating that BF may not be a meaning-based coping strategy, as proposed by Folkman [Folkman, S. (1997). Positive psychological states and coping with severe stress. Social Science and Medicine, 45, 1207–1221]. Theoretical and clinical implications are discussed.     

Relations Between Coping and Positive and Negative Outcomes in Carers of Persons with Multiple Sclerosis (MS)

This study examined relations between stress and coping predictors and negative and positive outcomes in MS caregiving. A total of 222 carers and their care-recipients completed questionnaires at Time 1 and three months later, Time 2 (n = 155). Predictors included care-recipient characteristics (age, time since diagnosis, course and life satisfaction), and Times 1 and 2 carer problems, stress appraisal and coping. Dependent variables were Time 2 negative (anxiety, depression) and positive outcomes (life satisfaction, positive affect, benefits). Regressions indicated that, overall, the hypothesised direct effects of stress appraisal and coping strategies on positive and negative outcomes were supported. The hypothesised stress-buffering effects of positive reframing coping were also supported. All but one of the coping strategies were related to both positive and negative outcomes; specifically, practical assistance coping emerged as a unique predictor of distress. Of the model predictors, care-recipient life satisfaction emerged as the strongest and most consistent predictor of both positive and negative outcomes except benefit finding. Findings support the role of care-recipient characteristics and the carers appraisal and coping processes in shaping both positive and negative outcomes. The guiding framework and findings have the potential to inform interventions designed to promote well-being in carers.     

Individual differences in responses to workplace stress: the contribution of attachment theory

Work stress is a major cause of physical and psychological distress, and both theory and research highlight the importance of individual differences in coping efforts. The present research clarifies the mechanisms linking attachment insecurities (anxiety and avoidance) to maladaptive coping; specifically, we tested an integrative model assessing stress appraisals as a mediator between attachment insecurities and coping strategies, together with mediating and moderating effects of coping resources (perceived self‐efficacy and social support). A community sample of 113 men and 115 women completed an online survey which incorporated a standardized vignette depicting workplace stress. The results supported stress appraisal as a mediator between attachment anxiety and less adaptive coping, and established both mediating and moderating effects of perceived coping resources. The effects support the relevance of attachment theory to the study of workplace stress.     

Ethnicity, coping, and distress among Korean Americans, Filipino Americans, and Caucasian Americans

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.     

Enhancing Coping Resources in Early Adolescence Through a School-based Program Teaching Optimistic Thinking skills

This study examined the effectiveness of a universal school-based prevention program that was designed to increase coping resources in preadolescents through the modeling and teaching of optimistic thinking skills. School psychologists, together with classroom teachers, implemented an eight-week program in eight Year 5 and 6 class groups as part of the regular school curricula. One hundred and sixty children who participated in the program were compared to 135 children in 8 control groups on pre- and post-test questionnaires. Post-test responses show that children who participated in the program reported significant improvements in coping efficacy, and reductions in depressive attributions and use of the non-productive coping strategies of worry, wishful thinking, not coping, and ignoring the problem when compared to controls. These results support the feasibility of implementing low-cost, non-intrusive programs in school settings that address the emotional health of all young people. Support is also provided for theories that suggest attributions for events and coping efficacy influence the selection of coping strategies.     

The dimensionality of cognitive appraisal and its relationship to physical and psychological well-being

In current adjustment models, an individual's appraisal of life events has been included as an important determinant in the stress-illness process. In particular, these events have been defined in terms of a variety of unidimensional concepts, such as desirability, controllability, or as having the potential for threat or challenge. The present study investigated the multidimensional nature of cognitive appraisal and its relationship to physical and psychological well-being. Residents of a Canadian community (N = 184) responded to an extensive survey on life-event stress, appraisal, alcohol consumption, health status, and depression. A principal-axis factor analysis of 19 appraisal dimensions revealed five factors accounting for 60% of the variance: Undesirability/Threat, Gain/Challenge, Need for Information, Familiarity, and Need to Accept. Entered with total number of life events and coping behavior as predicted aspects of well-being.     

Social support, coping, life events, and posttraumatic stress symptoms among former peacekeepers: a prospective study

This study examined both cross-sectionally and longitudinally the relationship between social support, coping strategies, additional stressful life events, and symptoms of posttraumatic stress disorder (PTSD) among Dutch former peacekeeping soldiers. Two groups of peacekeepers were investigated: 311 peacekeepers who participated in the peacekeeping operation in Lebanon between 1979 and 1985, and 499 peacekeepers who were deployed after 1990. These peacekeepers completed a questionnaire in 1996 and again in 1998. The results show that more negative social contacts and fewer positive social contacts were associated with more PTSD symptom severity. More use of the coping strategies ‘wishful thinking’ and ‘accepting responsibility’ was related to more PTSD symptoms. Conversely, more planful problem solving and seeking social support was related to less PTSD symptom severity. In addition, a bilateral relationship was found between additional stressful life events and PTSD symptom severity. The results indicate that social support and coping strategies may be valuable aspects of prevention and intervention programs.     

Experimentally testing Taylor's stress,coping and adaptation framework

Abstract

Taylor (1995) constructed a comprehensive framework of stress and adaptation, which considers internal and external resources/impediments as moderators, based on previous studies and models. However, most past research used correlation designs and has not taken into account all of the framework's components within one study. This study tested the effects of the event (minor, major), primary appraisal (benign, severe), coping (problem-focused coping (PFC) versus emotion-focused coping), external resources (with/without social support), and internal impediments (hostility), on estimated distress (dependent variable) in written imagined stressful daily scenarios. All components except hostility were experimentally manipulated within subjects in the scenarios. The scenarios were rated by 281 Dutch students. The variables event, appraisal, and social support significantly and independently affected estimated distress. Event and appraisal synergistically interacted in relation to estimated distress. Finally, appraisal interacted with coping such that the distress-reducing effects of PFC occurred only in benign events, while coping did not affect estimated distress in severely appraised events. This study experimentally tested most components of Taylor's framework, and showed that events, appraisal, and social resources were independent determinants of estimated distress, and that appraisal interacts in a complex manner with the event and with 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.     

The Dimensionality of Cognitive Appraisal and Its Relationship to Physical and Psychological Well-Being

In current adjustment models, an individual's appraisal of life events has been included as an important determinant in the stress-illness process. In particular, these events have been defined in terms of a variety of unidimensional concepts, such as desirability, controllability, or as having the potential for threat or challenge. The present study investigated the multidimensional nature of cognitive appraisal and its relationship to physical and psychological well-being. Residents of a Canadian community (N = 184) responded to an extensive survey on life-event stress, appraisal, alcohol consumption, health status, and depression. A principal-axis factor analysis of 19 appraisal dimensions revealed five factors accounting for 60% of the variance: Undesirability/Threat, Gain/Challenge, Need for Information, Familiarity, and Need to Accept. Entered with total number of life events and coping behavior as predictors in a series of stepwise regressions, these appraisal factors differentially predicted aspects of well-being.     

Development of the HIV/AIDS Stress Scale

Development of a self-report measure of stress specific to HIV/AIDS is needed to advance our understanding of the role of stress in adaptation to HIV/AIDS; hence, the aim of this study was the development of the HIV/AIDS Stress Scale. A total of 132 homosexual/bisexual men with HIV/AIDS were interviewed and completed the HIV/AIDS Stress Scale and measures of coping strategies, appraisal, social support and adjustment (global distress, depression, social adjustment, number of HIV symptoms, and subjective health status) at three time points. Thirty-nine primary caregivers were interviewed and completed measures of stress and adjustment. Exploratory factor analyses of the HIV/AIDS Stress Scale items revealed three factors: Social, Instrumental and Emotional/Existential Stress. Factors had adequate internal reliabilities and were stable over 12 months. Construct validation data are consistent with recent stress/coping research that links higher levels of stress with more HIV symptoms, reliance on emotion-focused coping, lower social support, poorer levels of adjustment and higher levels of caregiver stress. Results extend this research by revealing new differential relations between various stress dimensions and stress/coping variables. Convergent validation data suggest that the HIV/AIDS Stress Scale shares conceptual similarity with threat appraisal, and differs from controllability and challenge appraisals. The HIV/AIDS Stress Scale shows potential for the elucidation of the role of stress in coping and adaptation to HIV/AIDS and disease progression in both research and clinical applications.     

Quality of Life and Multiple Sclerosis: Comparison Between People with Multiple Sclerosis and People from the General Population

This paper evaluated the quality of life (QOL) of people with multiple sclerosis (MS) and people from the general population. Gender differences between the 2 groups of respondents and the influence of coping style on adjustment were also evaluated. The participants were 381 (144 males, 237 females) people with MS, and 291 (101 males, 190 females) people from the general population. The results demonstrated that people with MS experienced lower levels of QOL than people from the general population for both the objective and subjective dimensions of all domains (physical health, psychological adjustment, social relationships, environmental adjustment). All coping strategies (problem-focused, focusing on the positive, detachment, wishful thinking, seeking social support) were important predictors of QOL for both males and females with MS, with wishful thinking being the strongest predictor of poor QOL. These results are discussed in terms of the various factors that impact on QOL among people with MS, and the types of coping strategies that are most adaptive in improving the QOL of people with this illness.