Reviewers for Special Issue

Objective: An enhanced stress and coping model was used to explain depression among HIV‐positive women in healthcare and community settings where highly active anti‐retroviral treatment (HAART) was commonplace. Method: HIV‐infected women in four cities (N=978) were assessed, cross‐sectionally, for mental and physical health, stress, social support, and other background factors. Results: Self‐reported level of depressive symptomatology was high. Number of physical symptoms, illness intrusiveness, and perceived stress were positively associated with depressed mood, while coping self‐efficacy and social support were negatively associated. Stress mediated the effect of health status on depression and coping self‐efficacy mediated the effect of psychosocial resources on depression. Our enhanced stress and coping model accounted for 52% of variance in depressive symtpomatology. Conclusions: Interventions focused on improving coping self‐efficacy, bolstering social supports, and decreasing stress in the lives of HIV‐positive women may help to reduce the negative effects of HIV disease on mood.     

Stress,coping, HIV status,psychosocial resources,and depressive mood in African American gay,bisexual, and heterosexual men

The associations between stress, physical health, psychosocial resources, coping, and depressive mood were examined in a community sample of African American gay, bisexual, and heterosexual men (N=139). Data were collected from physical exams and in-person interviews. In our theoretical framework, depressive mood scores were regressed first on stressors, next on psychosocial resources, and finally on coping strategy variables. Results revealed that psychosocial resources mediate the effects of stressors, including health symptoms, hassles, and life events, on depressive mood. There were no significant differences in depressive mood associated with HIV status or sexual orientation. Results are discussed in terms of community interventions needed to provide social support as a buffer between stress and psychological distress in African American men. The research was completed at the Center for AIDS Prevention Studies, University of California at San Francisco and was supported in part by National Institute of Mental Health Grants MH44045 and MH42459. The authors express their appreciation to the participants in this study.     

The Roles of Social Support and Self-Efficacy in Physical Health’s Impact on Depressive and Anxiety Symptoms in Older Adults

Physical illness may precipitate psychological distress among older adults. This study examines whether social support and self-efficacy moderate the associations between physical health and depression and anxiety. Predictions were tested in 222 individuals age 60 or older presenting for help with worry. Physical health was assessed through self-report (subjective) and physical diagnoses (objective). Objective physical health did not have a significant association with depression or anxiety. Worse subjective physical health was associated with increased somatic anxiety, but not with depression or worry. The relationship between subjective physical health and depressive symptoms was moderated by self-efficacy and social support. As predicted, when self-efficacy was low, physical health had its strongest negative association with depressive symptoms such that as physical health improved, depressive symptoms also improved. However, the moderation effect was not as expected for social support; at high levels of social support, worse physical health was associated with increased depressive affect.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

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.     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

Functional roles of social support within the stress and coping process: A theoretical and empirical overview

This article reports four longitudinal field studies and one experimental study designed to shed light on the functional roles of social support within the stress and coping context. First, the enabling hypothesis is examined that assumes a facilitating effect of support on self-efficacy, which, in turn, promotes coping with the aftermath of cardiac surgery. Second, we discuss the support cultivation hypothesis that regards support as a mediator between self-efficacy and various outcomes, such as depressive mood, as illustrated by a finding on the experience of macrosocial stress during the East German transition. Third, support is highlighted as a coping resource by specifying provided partner support as a predictor of patients' coping with cancer. It was found that the direct effect of provided support on coping needs to be mediated by received support in order to become effective. Fourth, coping efforts of a target person are found to be predictive of support intentions of a potential provider. The better a victim appears to cope with various stigmas, the higher the likelihood that a significant other is willing to help. Fifth, in a dyadic study on coping with cancer, partners were found to provide high levels of support to patients, but received support was affected only at later points in time. Time-lagged partner effects may characterize resource transfer in asymmetric social situations in which only one element of the dyad is under severe stress.     

Resource loss,resource gain,and emotional outcomes among inner city women

The authors examined a dynamic conceptualization of stress by investigating how economic stress, measured in terms of material loss, alters women's personal and social resources and how these changed resources impact anger and depressive mood. Resource change in women's mastery and social support over 9 months was significantly associated with changes in depressive mood and anger among 714 inner city women. Greater loss of mastery and social support was associated with increased depressive mood and anger. Loss of mastery and social support also mediated the impact of material loss on depressive mood and anger. Resource loss and worsening economic circumstances had more negative impact than resource gain and improving economic circumstances had positive impact, suggesting the greater saliency of loss than gain.     

The Relational Context of Social Support in Young Adults: Links with Stress and Well-Being

This study examined the roles of relationship-specific social support and gender in the associations between perceived stress and well-being. Three sources of support (family, friends, and romantic partners) and three well-being indicators (loneliness, depressive symptoms, and physical health) were assessed in 628 young adults attending college (M _age = 19.72; range of 18–24). Stress directly predicted all well-being indicators, and indirectly predicted well-being through social support in relationship-specific ways. Family support mediated the relationship between stress and physical health, friend support mediated the association between stress and loneliness, and romantic partner support mediated the relationships of stress with both loneliness and depressive symptoms. With regard to loneliness and physical health, women were more strongly impacted when they had less support from friends.     

Hope,social support,and depression among Hong Kong youth: personal and relational self-esteem as mediators

Previous studies have shown that depression is negatively associated with hope and social support. However, little research has been undertaken to investigate the theoretical mechanisms underlying the connections among hope, social support, and depression. This study examined how two types of self-esteem (personal and relational) would mediate the relationship of hope and social support to depression among 384 Hong Kong adolescents (age: 12–18 years; M = 14, SD = 1.19). Participants reported their levels of hope, social support, personal self-esteem, relational self-esteem, and depressive mood. Results of the path analysis showed that both personal and relational self-esteem mediated the associations of hope and social support with depression. Hope and social support were associated with higher levels of personal and relational self-esteem, which were in turn related to decreased levels of depression. Theoretical and practical implications are discussed.     

Depressive symptoms, social support, and personal health behaviors in young men and women.

This study investigated the relationship of depressive symptoms, social support, and a range of personal health behaviors in 2,091 male and 3,438 female university students from 16 countries. Depressive symptoms and social support were measured using the short Beck Depression Inventory and the Social Support Questionnaire; 9 personal health behaviors were also assessed. After the authors took age, social support, and clustering by country into account, depressive symptoms were significantly associated with lack of physical activity, not eating breakfast, irregular sleep hours, and not using a seat belt in both men and women, and additionally with smoking, not eating fruit, and not using sunscreen among women. Low social support was independently associated with low alcohol consumption, lack of physical activity, irregular sleep hours, and not using a seat belt in men and women. Bidirectional causal pathways are likely to link health behaviors with depressed mood.     

Social Support and Postdeployment Coping Self-Efficacy as Predictors of Distress Among Combat Veterans

This study evaluated the indirect effect of received social support on distress severity (i.e., posttraumatic stress and depression symptom severity) among 89 combat veterans. Through integrating the social support deterioration deterrence model and the enabling hypothesis, mediating roles of perceived social support and self-efficacy specific to postdeployment adaptation were investigated. Results showed that (a) received social support and perceived social support were not related, and (b) both received and perceived social support indirectly predicted distress severity (posttraumatic stress and depression symptom severity) through postdeployment coping self-efficacy. Specifically, high received and perceived social support independently predicted high postdeployment coping self-efficacy, and high postdeployment coping self-efficacy predicted lower distress severity levels. Theory enhancement and future research needs are discussed.     

Coping-related expectancies and dispositions as prospective predictors of coping responses and symptoms

We used Rotter's (1954, 1982) social learning theory and Kirsch's (1985, 1999) response expectancy extension thereof to clarify distinctions between coping-related expectancies (beliefs about the outcomes of coping efforts) and coping dispositions (tendencies to use particular coping responses), specifically focusing on the role of generalized expectancies for negative mood regulation (NMR) as a predictor of individual differences in coping and well-being. Two studies using structural equation modeling provided support for direct and indirect associations between NMR expectancies and symptoms of depression. In Study 1 NMR expectancies predicted situational avoidance coping responses and symptoms of depression and anxiety, independent of dispositional avoidance coping tendencies. In Study 2, NMR expectancies were associated with depressive symptoms, concurrently and prospectively, independent of dispositional optimism and pessimism. Both studies indicated that NMR expectancies are more strongly associated with depressive symptoms than with symptoms of anxiety and physical illness. Results underscore the importance of distinguishing between expectancies and other personality variables related to coping.     

Sexual Minority Stress and Social Support Explain the Association between Sexual Identity with Physical and Mental Health Problems among Young Lesbian and Bisexual Women

Bisexual women report more physical and psychological health problems than lesbian women do, which may be attributed to greater sexual minority stress and less social support. However, many studies combine lesbian and bisexual women into a single group. The current study examined if sexual minority stress and social support mediated the association between women’s sexual identity (lesbian or bisexual) and health-related outcomes. A total of 650 U.S. young adult lesbian (n?=?227) and bisexual (n?=?423) women completed an online survey about sexual minority stress, social support, and physical and mental health problems. Bisexual women reported more physical and mental health problems. A sequential mediation model showed that bisexual women reported greater sexual minority stress than lesbian women, which in turn was associated with less social support, which was associated with more physical and mental health problems. Greater sexual minority stress and lower social support may help explain why bisexual women report more health-related problems than lesbian women. The results of the present study support the importance of examining risk and protective factors for health problems separately for lesbian and bisexual women. Health-related intervention programs that target sexual minority women may need to be tailored differently for lesbian and bisexual women.

     

Active Coping and Perceived Social Support Mediate the Relationship Between Physical Health and Resilience in Liver Transplant Candidates

Without a transplant, end-stage liver disease is associated with significant morbidity and mortality. Transplant candidates endure physical and psychological stress while awaiting surgery, yet little is known about the relationship between physical health and psychological resilience during the wait-list period. This study examined predictors of psychological resilience and mediators of the relationship between physical health and psychological resilience in liver transplant candidates. Wait-listed candidates (N?=?120) from a single Northeast transplant center completed assessments of physical functioning, coping, perceived social support, and resilience. Findings revealed that physical functioning, active coping, and perceived social support were positively associated with resilience; maladaptive coping was negatively associated with resilience. Perceived social support and active coping partially mediated the relationship between physical functioning and resilience. Transplant center care providers should promote active coping skills and reinforce the importance of effective social support networks. These interventions could increase psychological resilience among liver transplant candidates.     

The Joint Effects of Stress,Coping, and Coping Resources on Depressive Symptoms in the Elderly

The objective of the present study was to examine the joint effects of stress, coping, and coping resources in predicting depressive symptoms. A community sample comprising 194 people aged 65 and older was interviewed. Task-oriented coping and emotion-oriented coping both appeared to be directly related to depressive symptoms. In addition, emotion-oriented coping moderated the impact of stress to varying degrees, depending on the amount of stress experienced. Coping resources (social support and coping self-efficacy) also were directly related to depressive symptoms. Furthermore, coping self-efficacy appeared to be related to the kind of coping strategies used. Respondents with higher coping self-efficacy used more task-oriented coping and less emotion-oriented coping. These findings suggest that it is advisable to include coping resources when studying stress-coping processes. Developing prevention and intervention programs aimed at teaching people adaptive coping strategies and helping them to build up their coping resources seems advisable.     

Children's coping with peer rejection: the role of depressive symptoms,social competence,and gender

The present study investigated children's anticipated emotional response and anticipated coping in response to peer rejection, as well as the qualifying effects of gender, depressive symptoms, and perceived social competence. Participants (N = 234), ranging in age between 10 and 13 years, were presented with two written vignettes depicting peer rejection. The most highly endorsed coping strategies were behavioural distraction, problem‐focused behaviour, and positive reappraisal. Results indicate that children higher in depressive symptoms reported a more negative anticipated mood impact. Moreover, children higher in depressive symptoms were less inclined to endorse behavioural and cognitive coping strategies typically associated with mood improvement (e.g., behavioural distraction, positive reappraisal). Independent of depression, children scoring higher on perceived social competence reported more active, problem‐oriented coping behaviour in response to the stressors. Types of coping were largely unaffected by gender, however girls reported higher levels of anticipated sadness than boys in response to the rejection vignettes. Theoretical and clinical implications are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

Type D personality,physical symptoms and subjective stress: The mediating effects of coping and social support

Coping style and social support may represent mechanisms to explain the relationship between Type D personality and ill-health. This study investigated whether Type D is associated with physical symptoms and perceived stress in a non-cardiac population, and if these relationships are mediated by coping and social support. In a cross-sectional study, 304 participants (110 males, mean age 22.1 years) completed measures of Type D, physical symptoms, coping, perceived stress and social support. Results showed that Type D, the interaction of negative affectivity and social inhibition (NA?×?SI), was positively correlated with physical symptoms, perceived stress, and avoidant coping, and negatively correlated with social support, problem-focused coping and emotion-focused coping. A series of bootstrapped multiple mediator tests showed that social support and avoidant coping fully mediated the relationship between Type D and physical symptoms. Furthermore, social support and emotion-focused coping partially mediated the relationship between Type D and perceived stress. These findings demonstrate for the first time that Type D personality is associated with physical symptoms in a non-cardiac population. Social support and coping style represent mechanisms that can, in part, explain the relationship between Type D and physical symptoms, and Type D and perceived stress.     

Acculturative stress, social support, and coping: relations to psychological adjustment among Mexican American college students

This study examined the relations between acculturative stress and psychological functioning, as well as the protective role of social support and coping style, in a sample of 148 Mexican American college students (67% female, 33% male; mean age = 23.05 years, SD = 3.33). In bivariate analyses, acculturative stress was associated with higher levels of anxiety and depressive symptoms. Moreover, active coping was associated with better adjustment (lower depression), whereas avoidant coping predicted poorer adjustment (higher levels of depression and anxiety). Tests of interaction effects indicated that parental support and active coping buffered the effects of high acculturative stress on anxiety symptoms and depressive symptoms. In addition, peer support moderated the relation between acculturative stress and anxiety symptoms. Implications for reducing the effects of acculturative stress among Mexican American college students are discussed.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.