The role of familism in stress and coping processes among African American and White dementia caregivers: effects on mental and physical health.

OBJECTIVE: To explore how familism, burden, and coping styles mediate the relationships between ethnicity and the mental and physical health of caregivers. DESIGN: A probability sample of 65 White and 95 African Americans respondents caring for an older family member with dementia was used to test hypotheses from a sociocultural stress and coping model using path analysis. MAIN OUTCOME MEASURES: Measures of caregivers' health included subjective health, self-reported diseases, blood pressure, and heart rate. Mental health measures included self-reported depression and psychological symptoms. RESULTS: Contrary to the hypothesis, familism had an adverse effect on outcomes and was related to low education levels rather than to African American ethnicity. A buffering effect of active coping between being African American and diastolic blood pressure was found even after controlling for levels of education. CONCLUSIONS: Findings supported a core stress and coping model in which more behavior problems of care recipients were associated with poorer mental health of caregivers via greater burden and more use of avoidant coping. Results also demonstrate that this core model can be extended to physical health.     

Collective stress and coping in the context of organizational culture

We examined from a cultural perspective how well-being was collectively defined, what were the sources of collective stress, and what kind of collective coping mechanisms were used to alleviate such stress in three divisions of a multinational company. In the first phase of the study we collected data on organizational culture by using individual thematic interviews (N = 63). Applying the grounded theory methodology and an inductive analysis, specific cultures describing the divisions were identified. In terms of co-operation we found the following fundamental cultural recipes: joint focused efforts on money-making, despite the awareness of the common goals employees interested only in fulfilling their own role (jig-saw puzzle), and the awareness of the common goals lacking (scattered islands). In the second phase we conducted group interviews (N = 32) using the critical incident technique to assess collective definitions of well-being, sources of collective stress and respective collective coping mechanisms. These data were complemented with observations at the work site, participant observations at meetings, and analysis of documents. The definitions of well-being varied across cultures as regards their emphasis either on work or on other life domains as sources of well-being. Furthermore, the more hectic the organizational context, the more permissive the collective conception of well-being was. Collective stress emerged as a response to two types of signals: (1) adaptation to the environment of the division or work unit was imperfect (fluctuation, risk of unemployment, continuously changing customer needs, poor client satisfaction, multinational game, group bonus, culture shock due to a merger, work overload, and pressure toward more extensive autonomy), or (2) friction inside the community (undervaluation of a group of employees, and the “penal colony” reputation). Of the corresponding coping mechanisms, a large proportion were found to be collective, learned uniform responses to remove the stressor, to change the interpretation of the situation or to alleviate negative feelings. In conclusion, our results suggest that stress experiences and coping strategies have collective qualities. Culture not only seems to moderate the appraisal of stress, but also contains collective coping responses to stressors, which seem to have their origin either in the organizational environment or inside the community itself.     

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.     

Perceptions of organizational change: a stress and coping perspective

Few organizational change studies identify the aspects of change that are salient to individuals and that influence well-being. The authors identified three distinct change characteristics: the frequency, impact and planning of change. R. S. Lazarus and S. Folkman's (1984) cognitive phenomenological model of stress and coping was used to propose ways that these change characteristics influence individuals' appraisal of the uncertainty associated with change, and, ultimately, job satisfaction and turnover intentions. Results of a repeated cross-sectional study that collected individuals' perceptions of change one month prior to employee attitudes in consecutive years indicated that while the three change perceptions were moderately to strongly intercorrelated, the change perceptions displayed differential relationships with outcomes. Discussion focuses on the importance of systematically considering individuals' subjective experience of change.     

Community types and mental health: a multilevel study of local environmental stress and coping

Research has found that neighborhood structural characteristics can influence residents' mental health. Few studies, however, have explored the proximal reasons behind such influences. This study investigates how different types of communities, in terms of environmental stressors (social and physical disorder and fear of crime) and social resources (informal ties and formal organizational participation), affect well-being, depression, and anxiety in adult residents. Data are from a survey of 412 residents nested in 50 street blocks. Block stressors and resources were cluster analyzed to identify six block types. After controlling for several individual- and block-level characteristics, results from multilevel models suggest that in communities facing relatively few stressors, higher levels of formal participation are associated with better mental health. Because high levels of formal participation were not found in communities with higher levels of stressors, the impact of participation in such contexts could not be examined. However, results suggest that in communities where stressors are more common, isolation from neighbors may have a protective effect on mental health.     

Posttraumatic stress and physical health among adults: The role of coping mechanisms

The purpose of the present study was to examine whether coping mechanisms predict physical health, after controlling for posttraumatic stress disorder (PTSD) symptom clusters in a non-clinical sample of adults. Data were collected from 483 adults through an online survey. Most of the participants (66.7%) reported lifetime exposure to at least one traumatic event. The final sample of this study included 319 trauma-exposed individuals. Results indicated that PTSD symptoms on the avoidance and hyperarousal clusters had significant positive relationships with self-reported physical health symptoms. After controlling for gender and PTSD, denial, behavioral disengagement, and self-blame significantly and positively predicted physical health symptoms.     

Acculturation strategies, coping process and acculturative stress

Using structural equation modeling, this study examines the influences of motivational factors (Need for Cognitive Closure--NCC--and Decisiveness), coping strategies and acculturation strategies on levels of acculturative stress. Two groups of immigrants in Rome (Croatians n= 156 and Poles n= 179) completed a questionnaire that included scales for the various factors. Although our initial hypothesized model was not confirmed, a modified model showed that the motivational factors of NCC and Decisiveness indirectly influence acculturative stress. The modified model with good fit indices indicated that the relationship between NCC and Decisiveness are mediated by coping strategies and acculturation strategies. Specifically, NCC is associated positively with avoidance coping, which in turn is negatively associated with the host group relationships and positively with the original culture maintenance. The last two dimensions predicted lower levels of acculturative stress. Decisiveness was positively associated with the problem-oriented coping and, negatively, with emotional and avoidance coping.     

Stressful situations and coping strategies in relation to age

Whether people cope differently with negative events at different ages was assessed by relation to age by type of situation perceived as potentially stressful and by type of coping strategy used, and also whether the kind of coping strategy used to reduce the potential stressor was related to type of stressor. To do this the factor structure of the Spanish version of the Ways of Coping Checklist of Lazarus and Folkman was examined in an Argentine sample of 153. The factor analysis of checklist scores identified five factors: Cognitive redefinition, Problem focus, Seeking social support, Wishful thinking, and Avoidance. For two groups, ages 20 to 24 and 40 to 45 years, analysis indicated a significant association of type of situation perceived as potentially stressful with age. The middle-age group (40-45 yr.) chose a way of coping in problem solution but the young adult group (20-24 yr.) seemed more often to elude problems. It appears that the type of stressor influences type of coping.     

Disaggregating the effects of acculturation and acculturative stress on the mental health of Asian Americans

This study examines the impact of level of acculturation and acculturative stress on the mental health of Asian American college students. Hierarchical regression analyses were used to clarify the relation between level of acculturation, acculturative stress, and mental health outcomes (psychological distress and clinical depression). Being less identified with mainstream United States culture was associated with higher psychological distress and clinical depression, but lost significance when acculturative stress was introduced into the model. Retention or relinquishing of identification with one's heritage culture was not associated with mental health outcomes. Although understanding level of acculturation can help us identify those at risk, findings suggest that acculturative stress is a more proximal risk factor and increases risk for mental health problems independently of global perceptions of stress.     

A model of stress and coping and their influence on individual and organizational outcomes

A model of coping with stress is proposed in which coping mediates the relationship among organizational stressors and personal characteristics, and job-related strains and organizational outcomes. Study results, based on a sample of professional salespeople, provide overall support for most of the hypothesized relationships among work-related stressors, personal characteristics, and coping styles. Findings also support the influence of emotion-focused coping on the psychological outcomes of emotional exhaustion and job-induced anxiety; which in turn are found to influence job satisfaction and intention to withdraw. While problem-focused coping had no effect on job-induced anxiety, problem-focused coping did effect emotional exhaustion, which in turn influences job satisfaction and intention to withdraw. Minor differences were found when the proposed model was applied to saleswomen versus salesmen. Overall, however, the model was robust across both genders.     

The organizational context of children's mental health services

This paper reviews what is known about the organizational context of children's mental health services and describes organizational constructs, conceptual models, research methods, and intervention strategies that can be used to link organizational context to service quality and outcomes. Using evidence from studies of business and industrial organizations as well as studies of children's service organizations, the paper presents a model of organizational effectiveness that depends on several contextual characteristics that include organizational culture, structure, climate, and work attitudes. These characteristics are believed to affect the adoption of efficacious treatments (EBPs [evidence-based practices]), adherence to treatment protocols, therapeutic alliance, and the availability, responsiveness, and continuity of services. Finally, 10 components of the ARC(Availability Responsiveness and Continuity) organizational intervention are described as examples of strategies that can be used to develop organizational contexts with the prescribed characteristics. Mental health researchers are encouraged to consider including these constructs, conceptual models, research methods, and intervention strategies in dissemination, effectiveness, and implementation studies that address the gap between research-based knowledge about mental health treatment and what is actually offered in the community.     

Self-defeating personality and strategies for coping with stress.

People who scored higher on a measure of self-defeating personality also scored low on ego-strength, showed an external locus of control, and used less adaptive coping strategies than those who scored lower. These strategies (denial, mental disengagement, alcohol and drug use) were viewed as helping to perpetuate their positions as victims.     

Homeless mothers: is there a relationship between coping strategies,mental health and goal achievement?

This study examined the relationship between coping, mental health and goal achievement among homeless mothers. Seventy-two women took part and 44 were re-interviewed 4 months later. The Family Crisis Oriented Personal Evaluation Scales (F-COPES) were used to identify their coping strategies at the time of homelessness; the General Health Questionnaire (GHQ) measured mental health problems; and a semi-structured questionnaire identified their goals. Outcome measures at follow-up were goal achievement and mental health. A variety of coping strategies were used, with some differences ascertained according to reason for homelessness and age of respondent. Lower use of problem-focussed coping was associated with poorer mental health at the time of homelessness. Mental health problems improved over time, but levels of psychopathology remained high at follow-up. Most women had achieved their primary goal of resettlement, and this was associated with use of problem-focussed coping. Lower use of problem-focussed coping, in particular, acquiring social support, was associated with continuation of mental health problems at follow-up, however the greatest predictor of mental health at follow-up was mental health status whilst homeless. Despite exposure to major stressors and poor mental health, mothers experiencing homelessness can maintain their ability to cope effectively, in order to achieve their goals. Copyright © 2007 John Wiley & Sons, Ltd.     

The effects of social support on adjustment to stress: The mediating role of coping

The present research tested Thoits' (1986) proposal that coping mediates in the relationship between social support and adjustment to stress in two different contexts, namely adjustment to work stress and women's adjustment to the birth of their first child. The research was also designed to examine whether sources of support are more likely to influence coping if they are similar to the support recipient or proximal to the source of stress. In the first study, 137 employees from a large retail organization participated. Measures of social support (from supervisor, work colleagues, nonwork network members) and coping were obtained at Time 1. Two weeks later (Time 2), measures of employee adjustment were obtained. The second study was conducted on 197 expectant mothers. The measures of social support (from partner, family members, nonfamily members) were obtained at Time 1, coping was assessed at Time 2, and adjustment (self-report and husband ratings) was assessed at Time 3. Results of structural equation analyses revealed, in the first study, that the effects of colleague support on levels of adjustment were mediated through coping responses. In contrast, the effects of supervisor support on adjustment (job satisfaction) were direct. In Study 2, there was evidence that the effects of partner support on women's adjustment to new parenthood were mediated through coping responses. In contrast, levels of family support had direct effects on self-reported and external measures of adjustment.     

Differences between men and women on stress producers and coping strategies.

Differences in stress producers and coping strategies for 158 men and 243 women were investigated. Analyses of participants' responses to a survey on stress showed significant differences between men and women on eight stress producers and on five coping strategies.     

Immunity and health after bereavement in relation to coping

Coping was examined as an intervening variable between the stressor of bereavement and its effects on subjective health and immunity in thirty-nine recently bereaved Norwegian women. Coping was defined as: "positive response outcome expectancies". Data were collected approximately one month after the death of the husband, and twelve months thereafter. Data collected were: expected coping success (self-scoring), subjective health (UHI), anxiety and depression (GWB), and immunoglobulins (IgA, IgM, IgG) with components (C3, C4). Statistics were: frequencies, paired t -test, ANOVA, and MANOVA. Permissions and confidentiality were in accordance with the Helsinki-declaration. Coping was found to be related strongly to health and to health changes. Few relations were found between immunity and health. Coping, health, and anxiety and depression formed a triangle of interrelations. It was concluded that coping defined as "positive response outcome expectancies" may be a predictor of the adaptational outcome after a crisis.     

Relationship between dispositional optimism/pessimism and stress coping strategies

Recent studies confirm that dispositional pessimism is related with a worse state of physical health, in comparison with dispositional optimism . The efficacy of stress coping strategies has been considered as a mediating mechanism in this relationship. The aim of the present study is to analyze in a sample of university students (n = 200) the association between dispositional optimism/pessimism and different categories of self-reported somatic symptoms , and evaluate the possible mediation of the stress coping strategies in this relationship. The results indicate that: 1) pessimism is positively related with the report of physical symptoms, whereas optimism is negatively associated to somatic complaints; and 2) this relationship can be mainly explained by the differential utilization of the coping strategy denominated self-criticism (characteristic of pessimism).     

Endorsement of proactively aggressive caregiving strategies moderates the relation between caregiver mental health and potentially harmful caregiving behavior

This research tested the proposition that the oft-reported relation between caregiver mental health outcomes (i.e., resentment, depression) and potentially harmful caregiver behavior (PHB) would be mediated or moderated by caregiver endorsement of proactively aggressive caregiving strategies (PA). Caregiver resentment was the strongest predictor of PHB in the sample of 417 informal caregivers who resided with their care recipients; in fact, resentment mediated the impact of caregiver depression, thus suggesting that depressed affect was associated with PHB only if depressed caregivers resented their caregiving burdens. As predicted, caregiver endorsement of PA moderated the relation between resentment and PHB, such that links between these two constructs were strongest when caregivers were high in both resentment and PA. Endorsement of PA also mediated the relations between demographic or contextual variables (i.e., income, care recipient dementia) and PHB. Implications of these results for research and intervention are discussed.