Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Coping,life stress,and psychological and somatic distress

Theory and research have focused on the relationships among coping processes, stressful life events, and psychological and physical distress. This study was designed to examine the relationship of stressful life events and three styles of coping—emotion oriented, task oriented, and avoidance oriented—to physical and psychological distress. Questionnaires measuring coping styles, recent life stressors, and both physical symptoms and psychological symptoms were completed by 205 undergraduates (101 males and 104 females). It was hypothesized that task-oriented coping would negatively predict distress and that emotion-oriented coping would positively predict distress. The relationships of two types of avoidance-oriented coping (distraction and social diversion) to distress were also examined. Multiple regression analyses revealed that task-oriented coping was negatively related to distress, but only for males. Emotion-oriented coping was significantly positively predictive of distress for both males and females. The two subcomponents of avoidance-oriented coping—distraction and social diversion—were differentially related to measures of distress. Life event stress positively predicted distress, both as an independent contributor of variance and in interaction with several coping styles.     

Coping Strategies and Psychological Outcomes: The Moderating Effects of Personal Resiliency

Certain coping strategies alleviate stress and promote positive psychological outcomes, whereas others exacerbate stress and promote negative psychological outcomes. However, the efficacy of any given coping strategy may also depend on personal resiliency. This study examined whether personal resiliency moderated the effects of task-oriented, avoidance-oriented, and emotion-oriented coping strategies on measures of depression, anxiety, stress, positive affect, negative affect, and satisfaction with life. Results (N = 424 undergraduates) showed higher personal resiliency was associated with greater use of task-oriented coping strategies, which were in turn associated with more adaptive outcomes, and less reliance on nonconstructive emotion-oriented strategies, which in turn were associated with poorer psychological outcomes. In addition, individual differences in personal resiliency moderated the effects of task-oriented coping on negative affect and of emotion-oriented coping on negative affect and depression. Specifically, proactive task-oriented coping was associated with greater negative affect for people lower in personal resiliency. Moreover, high personal resiliency attenuated the negative effects of emotion-oriented coping on depression and negative affect. The effects of avoidance-oriented coping were mixed and were not associated with or dependent on levels of personal resiliency.     

The gulf war: Distressful reactions to scud missiles attacks

This study investigated the relationships among coping strategies, trait anxiety and distressful reactions (State anxiety and fears and symptoms) of Israeli civilians under missile attack during the 1991 Gulf war. During the war sixty-six subjects (46 females and 20 males) completed a questionnaire that measured their distressful reactions and included fears in various situations (e.g., during the night, in the sealed room) and various symptoms (e.g., sleep disturbances, sensitivity to noise). In addition each subject completed the Coping Inventory for Stressful Situations (CISS, Endler & Parker, 1990a), a multidimensional self-report measure of coping which measures three major coping strategies: task-oriented, emotion-oriented and avoidance-oriented. Subjects also completed the State and Trait anxiety scales of the Endler Multidimensional Anxiety Scales (EMAS, Endler, Edwards, & Vitelli, 1991). The state anxiety scales measure two components of the individual's state anxiety, cognitive worry and autonomic emotional reactions. The trait anxiety scales measure the individual's predisposition to experience anxiety in four different situations: social evaluation, physical danger, ambiguous situations and daily routines. The results showed that individuals who used emotion-oriented coping more frequently, experienced more state anxiety and symptoms and fears, (i.e., experienced greater distress) during the war. Task-oriented and avoidance-oriented coping were not related to the distressful reactions. It was further found that subjects high on physical danger trait anxiety and social evaluation trait anxiety experienced greater fears and more symptoms (i.e., experienced greater distress) during the war. Persons high on social evaluation trait anxiety also experienced great cognitive-worry state anxiety. The results are discussed within the framework of the multidimensional model of stress, anxiety and coping (Endler, 1988; Endler & Parker, 1990a, 1990b) and the special characteristics of the Gulf war situation.     

The Role of Coping Styles and Self-efficacy in the Development of Dysphoric Mood Among Nursing Students

Coping styles and self-efficacy have been recognized as important determinants of dysphoric mood. The objectives of this study were to determine the influence of these two factors on depression and anxiety in Japanese students. A set of questionnaires, including the Hospital Anxiety and Depression (HAD) Scale, the Coping Inventory for Stressful Situations (CISS), and the Self-efficacy Scale (SES) was distributed to 146 nursing students. Structural equation modelling was conducted to specify the relationships between measured variables. The HAD depression and anxiety scores were predicted by emotion-oriented coping. The HAD depression alone was predicted by avoidance-oriented coping. Self-efficacy scores predicted the emotion-oriented coping and HAD depression scores. Students’ dysphoric moods were influenced by emotional-oriented coping that mediated the effects of low self-efficacy, and self-efficacy also had a direct effect on depression.     

Multidimensional assessment of coping: a critical evaluation

Several existing self-report measures of coping and the relevant research using these instruments are reviewed. Many of these coping measures suffer from a variety of psychometric weaknesses. A self-report instrument, the Multidimensional Coping Inventory (MCI), was constructed that identifies 3 types of coping styles: task-oriented, emotion-oriented, and avoidance-oriented coping. Support for the multidimensional nature of the MCI is presented, along with support for the reliability of the MCI coping scales. Two studies are presented that assessed the validity of the MCI. The 1st study assessed the construct validity of the MCI by comparing it with the Ways of Coping Questionnaire. The 2nd study also assessed the criterion validity of the MCI by comparing it with measures of depression, anxiety, Type A behaviour, neuroticism, and extraversion. Overall, the results suggest that the MCI is a valid and highly reliable multidimensional measure of coping styles.     

The Effect of Intracouple Coping Concordance on Psychological and Marital Distress in Infertility Patients

The effect of intracouple coping concordance on psychological and marital distress was examined in a sample of 46 couples undergoing different stages of infertility treatment. Results indicate that the effect of coping similarity within couples is dependent on both the type of coping examined and the stage of the stressor. Specifically, for women the use of high levels of task-oriented coping by their partners and themselves is associated with the highest level of marital satisfaction. The findings also indicate that the use of high emotion-oriented coping by both partners is associated with the most psychological distress for men. Finally, the results show that marital satisfaction among women undergoing late stage treatment is highest in couples where the males are using low levels of emotion-oriented coping. Interestingly, the least satisfaction for women is evident when the woman is using less emotion-oriented coping while her partner is using more, rather than when both partners are using more emotion-oriented coping strategies. Clinical implications of the findings are discussed.     

The role of coping, anxiety, and stress in depression post-acute coronary syndrome

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.     

Perfectionism, Coping, Social Support, and Depression in Maltreated Adolescents

The current study examined the associations among dimensions of perfectionism, coping, social support, and depression in 58 adolescents with a history of maltreatment. Participants completed the Child-Adolescent Perfectionism, multidimensional measures of coping and social support, and the CES-D Depression Scale. Correlational analyses showed that depression was associated with socially prescribed perfectionism, internalized emotion-oriented coping, avoidant-oriented distancing, and low family support and peer support. Analyses of coping responses and perfectionism established links between self-oriented perfectionism and internalized emotion-oriented coping responses and self-reliant problem-solving. Socially prescribed perfectionism was associated with avoidance-oriented coping (i.e., distancing). While self-oriented perfectionism and social support were unrelated, socially prescribed perfectionism was associated with reduced levels of family support. Collectively, the findings highlight the roles of poor coping and social support as contributors to the emotional distress experienced by maltreated adolescents. Moreover, it is suggested that the distress experienced by perfectionistic youth with a history of maltreatment reflects, in part, the role of maladaptive coping styles and coping resource deficits. Our findings support further consideration of personality dimensions such as perfectionism as contributors to poor functioning among maltreated youth.     

Anxiety,coping and academic performance

Anxiety is a frequent response to stressful evaluation situations and may be correlated with the performance being evaluated. The present study investigated individual differences in social evaluation trait anxiety and coping dimensions as predictors of state anxiety and performance on a university examination. Separate multiple regressions were computed for coping assessed as a style, an individual difference measure, and as situational specific responses. Emotion-oriented coping predicted state anxiety in the evaluation situation. Social evaluation trait anxiety and task-oriented and emotionoriented coping responses predicted exam performance. The regression models predicted approximately a quarter of the variance in course grades. When coping was measured as a response, task-oriented coping response was a significant predictor of course grade. When coping was measured as a style or individual difference, avoidance-oriented coping style predicted aggregated course grade. It was suggested that different coping dimensions predict different outcomes and that coping be assessed over time to better understand its relation to performance.     

Adolescents and Young Adults Living with Congenital Heart Disease: Coping,Stress Reactivity,and Emotional Functioning

Living with congenital heart disease (CHD) presents survivors with numerous stressors, which may contribute to emotional problems. This study examined (a) whether coping with CHD-related stress predicts symptoms of depression and anxiety, and (b) whether associations between coping and emotional distress are moderated by involuntary stress reactivity. Adolescents and young adults diagnosed with CHD (M_age?=?26.4) were recruited from pediatric and adult outpatient cardiology clinics. Participants (N?=?168) completed online self-report measures. Hierarchical multiple regression analyses revealed that secondary control coping (e.g., cognitive restructuring, positive thinking) predicted lower depression and anxiety. Primary control coping (e.g., problem-solving) and stress reactivity (e.g., rumination, emotional numbing) interacted to predict depression and anxiety: the higher individuals were in involuntary stress reactivity, the stronger was the association between primary control coping and lower depression and anxiety. These results can inform clinical efforts to prevent or reduce emotional distress among CHD survivors.     

Coping and Emotional Distress in Primary and Recurrent Breast Cancer Patients

The purpose of this study was to explore the emotional distress and coping strategies among women with primary as against recurrent (local or metastatic) breast cancer. The study sample consisted of 80 women, all 1 year postdiagnosis of primary or recurrent breast cancer. All women completed a demographic questionnaire, the Emotional Symptoms Checklist (SCL-90R) and the Ways of Coping Questionnaire (WCQ). Patients with recurrence reported higher levels of depression and anxiety as well as a higher global severity index (GSI). This group used significantly fewer problem-solving and positive-focus strategies. Emotion-focused coping predicted depression and the GSI, but only positive attitude predicted the level of anxiety. The state of disease was a major predictor of emotional symptoms, and to a lesser extent of the coping strategies used. Although emotion-focused coping had a deleterious effect on emotional well-being, our study highlighted the importance and relevance of positive attitude for reducing emotional distress in general and level of anxiety in particular. Promotion of positive-focus coping strategies should thus be a key element in psychological interventions with cancer patients.     

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.     

Predicting depression, anxiety and self-harm in adolescents: The role of perfectionism and acute life stress

Despite the growing evidence that perfectionism is associated with adolescent psychological distress, few studies have investigated this relationship prospectively with measures designed for use in adolescent populations. In the present study, within a diathesis-stress framework, we investigated the extent to which perfectionism and acute life stress predict depression, anxiety and self-harm among adolescent school children (n = 515) over a 6 month period (Time 1-Time 2). Socially prescribed perfectionism (SPP), self-oriented perfectionism-critical (SOP-critical) and the associated interactions with acute life stress differentially predicted anxiety, depression and self-harm. Acute life stress was an independent predictor of depression, anxiety and self-harm. SPP predicted depression and interacted with acute life stress to predict self-harm. SOP-critical and the SOP-critical by acute life stress interaction predicted anxiety. Self-oriented perfectionism-striving (SOP-striving) did not predict any of the Time 2 measures of distress. The dimensions of perfectionism are differentially associated with psychological distress. Tailored clinical interventions focused on adolescent perfectionism should offer promise in tackling psychological morbidity in adolescence.     

Perceived social support,coping, and symptoms of distress in American and Spanish students

Abstract

The aim of this study was to test whether coping responses mediated the influence of perceived social support on symptoms of anxiety/depression, social withdrawal, and aggressive behavior in American (N=349) and Spanish students (N=437). Participants completed measures of perceived support, social stress, coping, and distress. Coping partially mediated relations between perceived support and distress, with coping mediation most evident in individuals facing high levels of social stress. Decreased use of disengagement coping by individuals with high perceived support appears to partially explain the protective value of perceived social support. Multiple group covariance structure analysis showed that models linking perceived support, coping, and distress were very similar across cultures, suggesting that the mechanisms underlying decreased risk for individuals with high perceived support may be relatively independent of cultural context, and that interventions designed to increase perceived support and decrease disengagement could be appropriate in both cultures.     

Forbearance coping, identification with heritage culture, acculturative stress, and psychological distress among Chinese international students

Based on Berry's (1997) theoretical framework for acculturation, our goal in this study was to examine whether the use of a culturally relevant coping strategy (i.e., forbearance coping, a predictor) would be associated with a lower level of psychological distress (a psychological outcome), for whom (i.e., those with weaker vs. stronger identification with heritage culture, a moderator), and under what situations (i.e., lower vs. higher acculturative stress, a moderator). A total of 188 Chinese international students completed an online survey. Results from a hierarchical regression indicated a significant 3-way interaction of forbearance coping, identification with heritage culture, and acculturative stress on psychological distress. For those with a weaker identification with their heritage culture, when acculturative stress was higher, the use of forbearance coping was positively associated with psychological distress. However, this was not the case when acculturative stress was lower. In other words, the use of forbearance coping was not significantly associated with psychological distress when acculturative stress was lower. Moreover, for those with a stronger cultural heritage identification, the use of forbearance coping was not significantly associated with psychological distress regardless of whether acculturative stress was high or low. Future research and implications are discussed.     

Coping with human immunodeficiency virus: Do optimists fare better?

Individuals who test positive for human immunodeficiency virus (HIV) face a difficult adjustment task. It was hypothesized that those who were more optimistic would cope more effectively and experience less distress. Both general and health-specific measures of coping were used. Optimism and distraction were negatively related to state anxiety, whereas emotional preoccupation was positively related to state anxiety. Optimism was not a predictor of depression. Rather, distraction was negatively related to depression, whereas palliative coping, emotional preoccupation, and the interaction of palliative coping and optimism were positively related to depression. The mediation of optimism by coping variables indicated that emotion-oriented coping was a negative mediator of optimism on both state anxiety and depression. Distraction (which includes some social diversion content) was a mediator of the impact of optimism on depression.     

Coping with human immunodeficiency virus: Do optimists fare better?

Individuals who test positive for human immunodeficiency virus (HIV) face a difficult adjustment task. It was hypothesized that those who were more optimistic would cope more effectively and experience less distress. Both general and health-specific measures of coping were used. Optimism and distraction were negatively related to state anxiety, whereas emotional preoccupation was positively related to state anxiety. Optimism was not a predictor of depression. Rather, distraction was negatively related to depression, whereas palliative coping, emotional preoccupation, and the interaction of palliative coping and optimism were positively related to depression. The mediation of optimism by coping variables indicated that emotion-oriented coping was a negative mediator of optimism on both state anxiety and depression. Distraction (which includes some social diversion content) was a mediator of the impact of optimism on depression.     

Anxiety and Depression in Cancer Patients: The Association with Religiosity and Religious Coping

There is a lack of studies looking into religiosity and religious coping in cancer patient. In this cross-sectional study, we examined the religiosity using Duke University Religion Index, religious coping using Brief Religious Coping Scale, anxiety and depression based on Hospital Anxiety and Depression Scale among 200 cancer patients. The association between religiosity and religious coping with anxiety and depression was studied. The findings showed that subjects with anxiety or depression used more negative religious coping and had lower non-organization religiosity. Hence, measurements in reducing negative religious coping and encouraging religious activities could help to reduce psychological distress in cancer patients.     

Development of the Coping Flexibility Scale: evidence for the coping flexibility hypothesis

Coping flexibility was defined as the ability to discontinue an ineffective coping strategy (i.e., evaluation coping) and produce and implement an alternative coping strategy (i.e., adaptive coping). The Coping Flexibility Scale (CFS) was developed on the basis of this definition. Five studies involving approximately 4,400 Japanese college students and employees were conducted to test the hypothesis that flexible coping produces more adaptive outcomes. Studies 1, 2, and 3 provided evidence of the reliability of the CFS scores as well as of its convergent and discriminant validity for Japanese samples. Study 4 further demonstrated that flexible coping was positively associated with improved psychological health, including reduced depression, anxiety, and distress. In Study 5, coping flexibility as measured by the CFS was associated with reduced future depression, even after controlling for the effects of other coping flexibility measures and popular coping strategies. Overall, these results suggest that a valid approach for assessing coping flexibility has been developed and that flexible coping can contribute to psychological health. The implications of these findings for clinical practice are discussed.