Pain appraisal and quality of life in 108 outpatients with rheumatoid arthritis

Individual differences in emotional functioning, pain appraisal processing, and perceived social support may play a relevant role in the subjective experience of pain. Due to the paucity of data regarding individuals with Rheumatoid Arthritis (RA), the present study aimed to examine pain intensity, emotional functioning (psychological distress and alexithymia), pain appraisal (pain beliefs, pain catastrophizing, and pain-related coping strategies) and social support, and their relationships with the health-related quality of life (HRQoL) in patients with RA. Data were collected from 108 female patients diagnosed with RA. Clinically relevant levels of depressive and anxiety symptoms assessed by the HADS subscales were present in 34% and 41% of the patients, respectively, and about 24% of them exhibited the presence of alexithymia. The results of hierarchical multiple regression analyses showed that pain intensity, alexithymia, the maladaptive beliefs regarding the stability of pain and the coping strategy of guarding explained 54% of the variance in the physical component of HRQoL (p < 0.001). Depression subscale of the HADS, alexithymia, the coping strategy of resting, and the rumination factor of pain catastrophizing significantly explained 40% of the variance in the mental component of HRQoL (p < 0.001). The present findings provide evidence regarding the importance of emotional functioning and pain appraisal in the negative impact of RA on patients’ quality of life. These findings provide additional evidence for the biopsychosocial model of chronic pain, further supporting the complex interaction between emotional, cognitive, and behavioral processes in patients with chronic pain.     

Repression and Coping Styles in Asthmatic Patients

The objectives of this study were to (a) determine prevalence of the dispositional repressive coping style as well as other situational coping styles in a sample of asthmatic patients and (b) to analyze the capacity of these styles to predict subsequent morbidity (emergency room visits or hospitalizations due to asthma) during a 12-month follow-up. A sample of 75 adult asthmatic patients was selected and information about sociodemographics, asthma severity, and patient’s perception of illness severity was collected. Repressive coping style was defined by a combination of scores obtained on the Trait Anxiety Inventory and the Marlowe-Crowne Social Desirability Scale. Coping styles were assessed with the dispositional version of the Coping Orientation to Problems Experienced Inventory. Eighteen patients (24%) were classified as repressors. Repressor asthmatics obtained scores significantly lower on Emotion-Focused Coping compared to non-repressors (F _(1,72) = 5.15, p = .026). Patients who perceived their asthma as severe reported to use Emotion-Focused Coping more than those who judged it as mild or moderate (F _(2,71) = 4.83, p = .011). A higher use of Denial (an Emotion-Focused strategy of coping) explained 8% of variance of the frequency of emergency room visits during the 12-month follow-up. The prevalence of repressive coping style in the asthmatic population is similar to that registered in other populations of chronic patients, and it is also associated with the tendency to report a lower use of strategies traditionally considered as maladaptive. The use of Emotion-Focused Coping strategies seems to be related to a worse perception of the physical status, and among this group of strategies, Denial also could favor a poor clinical course in bronchial asthma.     

Anxiety symptom interpretation in high-anxious,defensive high-anxious,low-anxious and repressor sport performers

Abstract

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.     

Physical activity: the relative associations with cognitive and affective risk beliefs

Abstract

Objective: The role of affectively oriented risk beliefs in explaining health behaviors has not been examined in the context of physical activity or in diverse study populations. We evaluated whether affective risk beliefs account for unique variance in physical activity intentions and behavior above and beyond that accounted for by cognitive risk beliefs.

Design: A cross-sectional survey of socio-demographically diverse US residents (N?=?835; 46.4% no college training; 46.7% minority racial/ethnic ancestry; 42.6% men).

Main outcome measures: Physical activity intentions and behavior.

Results: Hierarchical linear regressions showed that affective risk beliefs accounted for variance in physical activity intentions beyond that predicted by socio-demographics and cognitive risk beliefs (F-change ps<.001). Specifically, intentions were higher among people with higher anticipated regret (ps<.001) and with higher absolute feelings of risk (ps<.05) or worry (ps<.05). There was an indirect relationship between perceived absolute likelihood and intentions through anticipated regret and feelings of risk. Neither cognitive nor affective risk beliefs accounted for variance in physical activity behavior (F-change ps>.05), but unsurprisingly, behavior was positively associated with physical activity intentions (p<.001).

Conclusion: Future interventions could target affective risk beliefs—particularly anticipated regret—to increase intentions, and then add other intervention components to bridge the intention–behavior gap.     

The Importance of Emotional Intelligence and Cognitive Style in Institutionalized Older Adults' Quality of Life

Despite previous evidence showing a positive relationship between emotional intelligence (EI) and quality of life (QoL), associating older adults' emotional processing with several health indicators, few studies have explored both the IE and the a mechanisms through which they affect QoL. This cross-sectional study analyzes the mediator role of optimistic and pessimistic cognitive styles in the relationship between perceived EI (PEI) and QoL in 115 institutionalized older adults from Southern Spain. Regression analyses showed, after controlling for cognitive style, that PEI predicted a significant percentage of variance in: Health (β = .25, p < .01), Functional abilities (β = .20, p < .05), Activity and leisure (β = .17, p < .05) and Life satisfaction (β = .21, p < .05). Additionally, multiple mediation analysis revealed that cognitive style partially mediated the relationship between PEI and Health, Activity and leisure and Life satisfaction. Thus, PEI could promote personal but not external or environmental QoL aspects, highlighting the importance of developing emotional skills for healthy aging.     

The distribution of repressive coping styles among non-metastatic and metastatic breast cancer patients as compared to non-cancer patients

Abstract

Recent investigations have shown increased disease progression among breast cancer patients with a “repressive” coping style characterized as: passive, conforming, inclined to deny physical symptoms and emotionally unexpressive. The Millon Behavioral Health Inventory (MBHI) scales which delineate three discrete repressive coping styles include the: Introversive, Cooperative and Respectful. Forty-four women recently diagnosed (within four weeks) with non-metastatic (N=32) or metastatic (N=12) breast carcinoma, responded to the MBHI upon admission for treatment of their disease at a cancer treatment unit. All subjects received mastectomy as well as chemotherapy, radiation and/or endocrine therapy. These 44 Cancer patients were compared to 34 control subjects, comprising women who were seen at a colposcopy clinic for follow-up of a suspicious pap smear which was ultimately shown to be benign or consisted of mild dysplasia. Non-metastatic, metastatic and control subjects were compared with respect to coping style and psychological distress. The breast cancer patients were more likely to employ a repressive coping style as compared to non-cancer patients who utilized a “sensitizing” coping strategy predominantly. Cancer patients with the most severe prognosis (metastasis) were the only group within the study to attain a clinically significant mean base rate score on the respectful scale. Results suggest that the incidence of repressive coping styles may be disproportionately high among breast cancer patients.     

Negative cognitive emotion regulation as a predictor of adolescent heart rate variability and entropy under social stress

ABSTRACT

Background and Objectives: Negative cognitive emotion regulation (ER) strategies are particularly important within the framework of anxiety problems amongst youths and how they cope with stressful events. The aim of this study was to examine the associations between both negative and positive ER style and cardiac regulation under stressful conditions.

Design: Eighty-nine adolescents (M?=?13.31 years, SD?=?0.68, 44.94% girls) were exposed to a socially relevant stress induction protocol.

Methods: Participants’ emotion regulation strategies were assessed and their cardiac function was recorded.

Results: A negative ER style predicted heart rate (HR) entropy at the stressful stage after controlling for anxiety scores. In addition, heart rate variability reactivity and recovery and HR entropy recovery were larger (p?<?.05) in the low negative ER style group (n?=?16) than in the high negative ER style group (n?=?23).

Conclusions: Results suggest that individuals with a highly negative ER style have diminished autonomic flexibility.     

Social support coping style predicts women’s cortisol in the laboratory and daily life: the moderating role of social attentional biases

Background and Objectives: Social stress and associated coping responses can profoundly influence women’s stress physiology and health. Implicit social attentional biases can also influence psychological and physiological stress responses. The purpose of this study was to explore whether a coping style characterized by greater use of social support predicts indices of cortisol activity in laboratory and daily life contexts among female university students. We hypothesized that the relation of this coping style to cortisol activity would be moderated by women’s attentional biases.

Methods: Seventy-four women (M_age?=?19.44, range: 17.8–27.8, 64% White) completed an interpersonal stress task and an attentional bias task in the lab, along with a self-report coping inventory. Participants provided five saliva samples during the lab protocol, followed by three saliva samples per day for three consecutive weekdays. Outcome measures included cortisol response to lab tasks (AUCg), diurnal cortisol slope, diurnal AUCg, and cortisol awakening response (CARi).

Results: A coping style characterized by greater use of social support predicted lower lab AUCg and lower, flatter average diurnal cortisol slope for women with attentional avoidance compared to women with attentional vigilance (ps?<?.05).

Conclusions: Responding to stress by using social support is linked to lower cortisol responses to social stress and diurnal cortisol activity for women with implicit avoidance of social threat cues.     

Influence of Attachment Style on Sexual Abuse Survivors' Posttraumatic Growth

This study investigated the directional relationship between adults' (N = 292) attachment styles and perceived impact of child sexual abuse with their experience of posttraumatic growth (PTG). Structural equation modeling results identified that attachment style served as a partial mediator between trauma and PTG scores, with the mediating effect contributing to 8% of the variance in the presence of PTG (p < .05; standardized coefficient = ?.31).     

The psychometric properties of the Greek version of the State-Trait Anxiety Inventory in cancer patients receiving palliative care

Objectives: To validate the Greek version of the State-Trait Anxiety Inventory (STAI) in a sample of cancer patients. Design: The scale was administered twice, with a 3-day interval, to 99 eligible patients with cancer. Together with the Greek version of STAI scale, the patients also completed the anxiety subscale from the Hospital Anxiety and Depression scale (HAD). Observations: Factor analysis yielded a three-factor solution, explaining 47.143% of the variance. Cronbach α for three scales was between 0.729 and 0.852. Inter-scale correlations were moderate-to-high and ranged from 0.282 to 0.563 (p < 0.0005, p < 0.005). The assessment of the relationships among the Greek STAI scales and HAD-Anxiety showed statistically significant correlations between them (r ranged between 0.428 and 0.596, p < 0.0005). The test/retest reliability of scale (Pearson's ‘r’), showed that the coefficient agreement ranged between 0.85 and 0.90 (p < 0.0005). Univariate analysis revealed significant correlations between female gender, metastasis, performance status, chemotherapy, mild opioids and low education level with increased anxiety. Conclusions: These results support that the Greek version of STAI is an instrument with satisfactory psychometric properties, and is a valid research tool for Greek cancer patients.     

Is academic buoyancy anything more than adaptive coping?

Abstract

Academic buoyancy refers to a positive, constructive, and adaptive response to the types of challenges and setbacks experienced in a typical and everyday academic setting. In this project we examined whether academic buoyancy explained any additional variance in test anxiety over and above that explained by coping. Two hundred and ninety-eight students in their final two years of compulsory schooling completed self-report measures of academic buoyancy, coping, and test anxiety. Results suggested that buoyancy was inversely related to test anxiety and unrelated to coping. With the exception of test-irrelevant thoughts, test anxiety was positively related to avoidance coping and social support. Test-irrelevant thoughts were inversely related to task focus, unrelated to social support, and positively related to avoidance. A hierarchical regression analysis showed that academic buoyancy explained a significant additional proportion of variance in test anxiety when the variance for coping had already been accounted for. These findings suggest that academic buoyancy can be considered as a distinct construct from that of adaptive coping.     

Repression and effective coping styles

This study investigated the relationship between repressive coping style as defined by Weinberger (1990)—low reported anxiety and high reported defensiveness—and several individual difference measures related to general coping styles. Twenty‐nine studies looking at cognitive, behavioural, and individual difference factors associated with repressive coping were tabulated and reviewed. In the current study 116 women and 32 men were administered a questionnaire including measures of personality, ways of coping, self‐monitoring, interpersonal influence, and locus of control to further explore the repressor coping style. Two measures, as opposed to the usual one, were used to categorize repressors: the use of anxiety and social desirability measures of Weinberger, Schwartz and Davidson (1979) and the Gudjonsson (1981) method using Neuroticism and Lie scales from the EPQ(R). Analysis of variance showed that repressors reported using more positive/healthy and less negative/unhealthy coping styles. The results did not change substantially when more extreme scoring groups were used. Factor analysis of the scales revealed six clear factors relating to ways of coping; again, repressors scored highly on the factor denoting positive coping. It was also found that the Lie and Neuroticism scales of the revised EPQ personality questionnaire of Eysenck, Eysenck and Barrett (1985) could be used as a substitute for anxiety and defensiveness to predict repression with considerable success. However results from both one‐ and two‐way analysis of variance indicated that the two different ways of classifying repressors was not totally inter‐changeable as the overlap in results occurred only with highly significant effects. The results are discussed in the light of previous investigations into repression which suggested that repressors report an overly optimistic way of coping in order to avoid negative affect. Copyright © 1999 John Wiley & Sons, Ltd.     

Associations of ethnic discrimination with symptoms of anxiety and depression among Hispanic emerging adults: a moderated mediation model

Background and Objectives: Emerging adulthood is often marked with elevated symptoms of anxiety and depression. Hispanic emerging adults may face cultural stressors such as ethnic discrimination that further increase levels of anxiety and depression symptoms. The study aims were to examine if (a) self-esteem mediated effects of ethnic discrimination on symptoms of anxiety and depression, and (b) if gender moderated the indirect effects of discrimination. Design: The study design was cross-sectional self-report. Method: Two moderated mediation models were tested, with 1084 Hispanic emerging adults (ages 18–25) enrolled in institutions of post-secondary in the United States. Results: Results indicated that (a) higher ethnic discrimination was associated with higher anxiety symptoms (β?=?.05, p?=?.04), higher depression symptoms (β?=?.06, p?=?.02), and lower self-esteem (β?=??.30, p?Conclusions: Findings suggest that the mediating effects of self-esteem linking ethnic discrimination with symptoms of anxiety and depression vary between genders.     

The effects of stressors and coping resources on anxiety and peripheral narrowing

Abstract

The purpose of the study was to examine possible mechanisms which might help explain why individuals with high life stress and/or low coping resources are at greater risk for incurring athletic injuries. The effects of life events, daily hassles (DH), and coping resources (CR) on state anxiety and peripheral vision narrowing during a stress condition were examined. Subjects were 74 recreational athletes who completed the Life Events Survey, Daily Hassles Scale (DHS), Vulnerability to Stress Questionnaire (CR), and state portion of the State-Trait Anxiety Inventory. Peripheral vision was measured alone during baseline and while simultaneously performing a Stroop Color-Word Test accompanied by distracting noise during the stress condition. State anxiety was assessed during baseline and the stress condition. Analyses of covariance revealed that high negative life events (NLE) (p = .01) were related to greater peripheral narrowing during the stress condition. High TLE (p = .01) and DH (p = .005) were related to elevated state anxiety during the stress condition. The peripheral vision TLE main effect (p = .03) and the state anxiety interactions of NLE × CR and DHS × CR (ps = .05) approached significance. High CR tended to reduce perceived state anxiety during the stress condition for high NLE and DH subjects compared to similar subjects with low CR. Thus, partial support was offered for the mechanisms proposed in the Andersen and Williams (1988) stress-injury model. The results are discussed in terms of future research needs.     

Sleep problems,anxiety and cognitive style in school‐aged children

The associations between sleep problems, anxiety, anxiety sensitivity and attributional style were examined in self‐report data from 79 children aged 8–11 years. Total anxiety score was associated with different types of sleep problems (bedtime resistance, sleep anxiety and nightmares). Conversely, total sleep problem score was associated with different sub‐scales of anxiety (from r(78) = 0.15, p = NS to r(79) = 0.47, p < 0.01). Symptoms of anxiety correlated significantly with anxiety sensitivity, but not with attributional style. After controlling for other symptoms of anxiety, school phobias (Beta = 0.26, p < 0.05), the mental incapacitation concerns scale of anxiety sensitivity (Beta = 0.26, p < 0.05), and attributional style (Beta = −0.31, p < 0.01, R² = 0.45) predicted sleep problems. These results suggest that anxiety is associated with a range of sleep problems, and that sleep problems are associated with different types of anxiety. Furthermore, certain cognitive styles are associated with both anxiety and sleep problems and may be good candidates for further research into the association between sleep problems and anxiety in children. Copyright © 2005 John Wiley & Sons, Ltd.     

Study of Sexual Concordance in Men and Women with Different Typologies of Adherence to the Sexual Double Standard

Background/ObjectiveSexual concordance (i.e., relationship between genital response and subjective sexual arousal) is higher in men than in women. Among the factors that could explain this difference would be the sexual double standard (SDS). Sexual concordance is examined by SDS typologies of adherence (egalitarian, man-favorable, and woman-favorable).MethodDuring exposure to a film with sexual content, genital response (penile circumference/vaginal pulse amplitude) and self-reported sexual arousal were recorded in 104 young adults (42 men and 62 women), distributed into SDS typologies of adherence on the basis of their scores on the Sexual Double Standard Scale.ResultsSexual concordance was obtained in men and women with egalitarian and man-favorable typology. Subjective sexual arousal explained a significant percentage of the variance in genital response in the egalitarian typology (men: R² = .32, p < .01; women: R² = .19, p < .05) and man-favorable typology (men: R² = .21, p < .05; women: R² = .23, p < .05).ConclusionsAgreement between genital responsiveness and subjective sexual arousal depends on DES adherence typology.     

Mechanisms underlying the self-talk–performance relationship: The effects of motivational self-talk on self-confidence and anxiety

ObjectivesThe present study examined the effects of motivational self-talk on self-confidence, anxiety, and task performance in young athletes.MethodsParticipants were 72 tennis players. The experiment was conducted in five sessions: baseline assessment, three training sessions, and final assessment. After the baseline assessment participants were divided and assigned randomly into experimental and control groups. The two groups followed the same training program with the experimental group practicing the use of self-talk. In the last session, the final assessment took place. A forehand drive test was used to evaluate task performance, and the Competitive Anxiety Inventory-2R was used to assess self-confidence and anxiety.ResultsA two-way mixed model MANOVA revealed that task performance improved for the experimental group (p < .01) and remained stable for the control group; self-confidence increased (p < .01) and cognitive anxiety decreased (p < .05) for the experimental group, whereas no changes were observed for the control group. Correlation analysis revealed that changes in task performance were moderately related to changes in self-confidence (p < .05).ConclusionsThe results of the study showed that self-talk can enhance self-confidence and reduce cognitive anxiety. Furthermore, it is suggested that increases in self-confidence can be regarded as a viable function explaining the facilitating effects of self-talk on performance.     

Anxiety and Asthma Symptoms in Urban Adolescents with Asthma: The Mediating Role of Illness Perceptions

Twenty to 40% of adolescents with asthma experience significant symptoms of anxiety. This study examined the mediational role of illness perceptions in the relationship between anxiety and asthma symptoms in adolescents. One hundred fifty-one urban adolescents (ages 11–18) with asthma completed measures of illness perceptions, and anxiety and asthma symptoms. Using the Baron and Kenny approach and Sobel tests, we examined whether illness perceptions mediated the anxiety-asthma symptom relationship. Three illness perceptions significantly mediated the relationship between anxiety and asthma symptoms, z = 1.97–2.13, p < .05; adjusted R ² = 0.42–0.51, p < .05. Greater anxiety symptoms were associated with perceptions that asthma negatively impacted one’s life and emotions and was difficult to control. These negative illness perceptions were, in turn, related to greater asthma symptoms. Illness perceptions helped explain the anxiety-asthma symptoms link in adolescents. Results suggest that targeting illness perceptions in adolescents with asthma and anxiety may help reduce asthma symptoms.