Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Effects of disability and bereavement on the mental health and recovery of older adults

We investigated the role of two major stressors, recent disability and conjugal bereavement, in older adults' self-reports of mental health and recovery from stress. A sample of 246 older adults between the ages of 60-80 was interviewed monthly for 3 months by trained elderly interviewers; Month-10 interview data were also analyzed. Control subjects, who were not experiencing the stressors, were carefully selected from a sample of adults matched on age, sex, and socioeconomic status. Dependent variables were psychological distress and psychological well-being, each with component subscales. The disabled group evidenced significantly lower positive well-being and significantly greater distress than did the other groups. Bereaved subjects demonstrated high levels of depression compared with the disabled subjects, but showed less anxiety. Bereaved subjects showed recovery on several indicators of mental health, but disabled subjects continued to show considerable psychological upset in comparison with the other groups.     

Financial strain, economic values, and somatic symptoms in later life.

The purpose of this study was to evaluate whether the impact of financial strain on psychological distress depends on the value that older adults place on economic success. Feelings of personal control were specified as an intervening variable in this process. The data came from a nationwide survey of 819 people in Canada who were 55 years of age and older. The findings reveal that financial problems are associated with diminished feelings of control and that these effects are stronger when elderly people value economic achievement highly. In addition, financial strain and diminished feelings of control are related to increased distress regardless of how highly economic success is valued.     

Sacrilege: A Study of Sacred Loss and Desecration and Their Implications for Health and Well-Being in a Community Sample

In this study, we proposed that people understand major life events in terms of spiritual as well as psychological, social, and physical dimensions. Specifically, we examined the possibility that life events that are perceived to be sacred losses or violations of the sacred (i.e., desecrations) have significant implications for the health and well-being of the individual. A total of 117 adults, randomly selected from a community, identified the most negative life event they had experienced in the past two years. They then completed measures of the degree to which they appraised this event as a sacred loss and as a desecration, as well as measures of religious coping, the impact of the event, and four sets of criteria: traumatic impact, physical health, emotional distress, and growth. These hypotheses were largely supported. Sacred loss and desecration were unrelated to physical health. However, they were tied to higher levels, though somewhat differential patterns, of emotional distress. While sacred loss was predictive of intrusive thoughts and depression, desecration was tied to more intrusive thoughts and greater anger. Furthermore, sacred loss was linked to greater posttraumatic growth and positive spiritual change; in contrast, desecration was associated with less posttraumatic growth. The links between the spiritual appraisals and outcomes were partially mediated by positive and negative methods of religious coping. These findings underscore the importance and multidimensionality of the spiritual meanings people attribute to major life stressors.     

Coping and emotional distress in a sample of Swedish unemployed.

The study investigated the associations between coping and symptoms of emotional distress within a sample of 166 unemployed men and women (mean age 40 +/- 10 years, range 22 to 63 years, 52% males). All variables were measured with a questionnaire comprising sociodemographic background, length of unemployment, financial strain, coping style ("Ways of Coping Checklist"), and emotional distress (Hopkins Symptom Check List-25). Emotional distress was positively related to financial strain and more common among younger subjects, divorced subjects and those with foreign background, but less frequent among subjects who had been unemployed for more than three years. After controlling for age, gender, education, foreign background, length of unemployment and financial strain, hierarchical regression analyses showed that emotion-focused coping, i.e. self-blame and wishful thinking, was positively related to emotional distress. Problem-focused coping and cognitive restructuring were negatively associated with emotional distress. Younger subjects and divorced subjects made frequent use of both emotion-focused and problem-focused coping. Female subject and subjects with mandatory school made frequent use of emotion focused coping, if exposed to high financial strain. Problem-focused coping was less frequent among subjects with a low education coupled with low financial strain. Cognitive restructuring was less common among subjects who had been unemployed for more than three years. Younger subjects who were also divorced made less use of both problem-focused coping and cognitive restructuring. The results confirm that coping style has importance for the mental health of the unemployed, and indicate a differential use of coping strategies among subjects with different sociodemographic backgrounds and different levels of financial strain.     

Depression in Homebound Older Adults: Problem-Solving Therapy and Personal and Social Resourcefulness

The goal of problem-solving therapy is to teach patients systematic coping skills. For many homebound older adults, coping skills must also include both personal and social (help-seeking) resourcefulness. This study aimed to examine the relationship between perceived resourcefulness and depressive symptoms at postintervention and potential mediating effect of the resourcefulness among 121 low-income homebound older adults who participated in a pilot randomized controlled trial testing feasibility and preliminary efficacy of telehealth-PST. Resourcefulness Scale for Older Adults was used to measure personal and social resourcefulness. Only personal resourcefulness scores were significantly associated with depression outcomes at postintervention, and neither resourcefulness scores were significantly associated with group assignment. Analysis found no mediation effect of resourcefulness. The findings call for further research on potential mediators for the potentially effective depression treatment that could be sustained in the real world for low-income homebound older adults who have limited access to psychotherapy as a treatment modality.     

Coping Self‐Efficacy and Psychological Distress Following the Oklahoma City Bombing1

Findings from a study of 27 victims of the Oklahoma City bombing are reported. This research focused on the importance of subjective appraisals of coping self‐efficacy in predicting psychological distress following this tragedy. Results supported the hypothesis that judgments of coping self‐eficacy taken 2 months after the bombing added significantly to the explanation of general and trauma‐related distress after controlling for income, social support, threat of death, and loss of resources. Coping self‐eficacy judgments taken I year later were also important in explaining psychological distress after controlling for loss of resources and social‐support perceptions. Although coping self‐efficacy perceptions taken at 2 months were related to distress levels 1 year later, they did not remain significant in a regression analysis controlling for loss of resources and income. Implications of these findings for post‐terrorist bombing interventions are discussed.     

Long-Term Patterns and Predictors of Successful Stressor Resolution in Later Life

At 1 year, 4 years, and 10 years after baseline, late-middle-aged adults reported whether they had successfully resolved their most important stressor of the past year. Compared to individuals who never resolved focal stressors over the 10-year interval, those who always did consistently showed less negative stressor appraisal, less reliance on avoidance coping, and less use of exploratory relative to directed coping responses, independent of type and severity of focal stressor. Less use of exploratory relative to directed coping and having more social resources, fewer health problems, and fewer depressive symptoms at baseline predicted more stressor resolution over the next 10 years. These predictors are promising foci for prospective efforts to optimize ways in which aging adults manage late-life stressors.     

Approach and avoidance coping responses among older problem and nonproblem drinkers

The Coping Responses Inventory (CRI) was used to study coping among older problem and nonproblem drinkers. The CRI organizes coping efforts according to their focus (approach or avoidance) and method (cognitive or behavioral). Compared with nonproblem drinkers, older problem drinkers were more likely to use cognitive and behavioral avoidance responses to manage life stressors. Problem drinkers who experienced more negative life events and more severe stressors used both more approach and more avoidance coping. Those who had more financial and social resources relied more on approach and less on avoidance coping. Problem drinkers who relied more on avoidance coping tended to have more drinking problems and to report more depression and physical symptoms and less self-confidence. Positive reappraisal was associated with less depression and more self-confidence.     

Forgiveness by God, Forgiveness of Others, and Psychological Well-Being in Late Life

The purpose of this study is to examine the relationships among forgiveness by God, forgiveness of others, and psychological well–being with data provided by a nationwide survey of older adults. Three main findings emerge from the analyses. First, the data suggest that forgiving others tends to enhance psychological well–being, and these salubrious effects are greater than those associated with forgiveness by God. Second, the findings indicate that how older people go about forgiving others is important: older adults who require transgressors to perform acts of contrition experience more psychological distress than those who forgive unconditionally. Third, the results reveal that forgiveness by God may be involved in this process because older people who feel they are forgiven by God are less likely to expect transgressors to perform acts of contrition.     

Parental coping with their child's death

The impact of the death of 19 children form malignancy on subsequent patterns of parental coping was evaluated in a retrospective study of 33 Dutch parents, who had been bereaved for 19 months on average. Parents who had lost older children were compared with those who had lost younger ones on the Utrecht Coping List, which has been compared with a Dutch norm group. Coping styles of the bereaved parents differed significantly from those of the norm group. These differences were associated with the poorer mental health of the bereaved group as a whole. Parents of older children coped less well than those of younger ones.     

Family Unpredictability and Psychological Distress in Early Adulthood: The Role of Family Closeness and Coping Mechanisms

Unpredictability within the family environment has been consistently linked to anxiety and depressive symptomology in early adulthood. The current investigation sought to examine how individual and family factors may serve to protect college students from the potentially detrimental effects of growing up with family chaos. A multi-dimensional survey, including measures assessing family unpredictability, coping behavior, anxiety, and depressive symptoms, was administered to 260 (68% female) undergraduate college students. A series of regression models found mediating and moderating effects: the relationship between family unpredictability and psychological distress was explained in part by less family closeness, and this was especially true among students who engaged in more emotion-focused coping. Individuals who used less emotion-focused coping did not appear to suffer from psychological distress associated with family unpredictability. Conversely, task-focused coping did not moderate the association between family unpredictability and psychological distress; yet, individuals who used more task-focused coping, in general, experienced less distress. These findings could be used to inform intervention efforts targeted at improving parenting and caregiving practices as well as the development of campus programs aimed at improving students’ coping strategies.     

Filipino Americans and racism: A multiple mediation model of coping

Although the literature on Asian Americans and racism has been emerging, few studies have examined how coping influences one's encounters with racism. To advance the literature, the present study focused on the psychological impact of Filipino Americans' experiences with racism and the role of coping as a mediator using a community-based sample of adults (N = 199). Two multiple mediation models were used to examine the mediating effects of active, avoidance, support-seeking, and forbearance coping on the relationship between perceived racism and psychological distress and self-esteem, respectively. Separate analyses were also conducted for men and women given differences in coping utilization. For men, a bootstrap procedure indicated that active, support-seeking, and avoidance coping were mediators of the relationship between perceived racism and psychological distress. Active coping was negatively associated with psychological distress, whereas both support seeking and avoidance were positively associated with psychological distress. A second bootstrap procedure for men indicated that active and avoidance coping mediated the relationship between perceived racism and self-esteem such that active coping was positively associated with self-esteem, and avoidance was negatively associated with self-esteem. For women, only avoidance coping had a significant mediating effect that was associated with elevations in psychological distress and decreases in self-esteem. The results highlight the importance of examining the efficacy of specific coping responses to racism and the need to differentiate between the experiences of men and women.     

Gender role conflict and emotional approach coping in men with cancer

The utility of emotional approach coping (EAC), or expressing and processing emotions, has been equivocal for men. Gender role conflict, or the negative cognitive, emotional and behavioural consequences associated with male gender role socialisation, likely shape coping responses and may negatively affect the efficacy of men's emotion-directed coping efforts and adjustment to cancer. Perceptions of receptiveness of one's interpersonal environment may be particularly important to the effectiveness of EAC. This study examined the relationships among EAC, gender role conflict, and distress in a group of 183 men with cancer. Structural equation modelling revealed that higher gender role conflict was associated with lower emotional expression, which in turn was associated with greater distress. Gender role conflict was not related to emotional processing. Higher gender role conflict also was associated directly with more distress. In subsequent analyses, social constraints and age were examined as possible moderators of EAC. Emotional expression was related to more psychological distress for those in highly constrained environments; and emotional processing was associated with more distress with younger age. Emotional expression may be particularly affected by social influences related to gender and social receptivity. More research is needed to better distinguish constructive and unconstructive emotional processing.     

Psychological distress and well-being in advanced cancer: The effects of optimism and coping

This study examined the relations among optimism, coping, functional status, and psychological adjustment in 75 adults diagnosed with cancer. Both the positive and the negative aspects of psychological adjustment were assessed. All participants had been diagnosed with advanced stages of cancer (i.e., Stages II, III, and IV). Participants completed three assessments across a 4-month time period. Both optimism and coping were associated with psychological adjustment, even after controlling for functional status and prior adjustment. Additionally, optimism and coping were differentially related to distress and well-being. Optimism was strongly and positively associated with well-being and inversely related to distress. Escape-Avoidance coping was positively associated with distress and Accepting Responsibility coping was negatively associated with well-being. Comparisons between the current and prior studies indicated that individuals who are diagnosed with more advanced stages of cancer or who have survived bone marrow transplantation exhibit higher levels of optimism than do healthy individuals and individuals with early-stage disease.     

Religious Coping and Psychological Distress in Military Veteran Cancer Survivors

Research on the relationship between religious coping and psychological well-being in cancer survivors is limited. Forty-eight veteran cancer survivors completed measures of psychological distress, posttraumatic growth, and positive and negative religious coping. Negative religious coping was associated with greater distress and growth. Positive religious coping was associated with greater growth. Gender, race, and religious affiliation were significant predictors of positive and negative religious coping. Veteran cancer survivors who utilize negative religious coping may benefit from referral to clergy or a mental health professional. Assessment of religious coping may be particularly important for female, non-White, and Christian cancer survivors.     

Optimism, coping, psychological distress, and high-risk sexual behavior among men at risk for acquired immunodeficiency syndrome (AIDS).

In a cohort of gay men responding to the threat of acquired immunodeficiency syndrome (AIDS), dispositional optimism was associated with less distress, less avoidant coping, positive attitudes as a coping strategy, and fewer AIDS-related concerns. Men who knew they were seropositive for human immunodeficiency virus (HIV) were significantly more optimistic about not developing AIDS than men who knew they were seronegative for HIV. This AIDS-specific optimism was related to higher perceived control over AIDS and to active coping among seropositive men only and to health behaviors in both serostatus groups. There was no relation of optimism to risk-related sexual behavior. It is concluded that optimism is psychologically adaptive without necessarily compromising health behavior. It is also concluded that it is useful to distinguish between event-based optimistic expectations and dispositional optimism.     

Collaborative coping and daily mood in couples dealing with prostate cancer

Collaborative coping (i.e., spouses pooling resources and problem solving jointly) may be associated with better daily mood because of heightened perceptions of efficacy in coping with stressful events. The study examined the daily processes of collaborative coping (individuals' perceptions that the spouse collaborated), perceived coping effectiveness (ratings of how well they dealt with the event), and mood (i.e., Positive and Negative Affect Scale) across 14 days in 57 older couples coping with stressors involving the husband's prostate cancer and daily life in general. In hierarchical multivariate linear models, collaborative coping was associated with more positive same-day mood for both husbands and wives and less negative mood for wives only. These associations were partially mediated by heightened perceptions of coping effectiveness. Exploratory analyses revealed that collaborative coping was more frequent among wives who performed more poorly on cognitive tests and couples who reported greater marital satisfaction and more frequently using collaboration to make decisions. The results suggest that older couples may benefit from collaborative coping in dealing with problems surrounding illness.     

Stress processes in HIV-positive African American mothers: moderating effects of drug abuse history

This study examined the mechanism by which stressors, dissatisfaction with family, perceived control, social support, and coping were related to psychological distress in a sample of HIV-positive African American mothers. Additional analyses explored whether women who had a history of a drug abuse or dependence diagnosis differed either on levels of the study variables or the model pathways. The results indicated that HIV-positive African American mothers who had higher levels of stressors perceived their stressors as a whole to be less controllable. Coping resources, available social support and perceived control, were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictor of psychological distress. Furthermore, the effect of avoidant coping on psychological distress was stronger for mothers with a history of drug diagnosis. The implications of these findings for targeting interventions are discussed.     

Psychosocial correlates of emotional distress and risk behavior in african-american women at risk for hiv infection

We examined a model of stress and coping in 749 African-American women at risk for HIV infection. Women in the sample were either homeless, intravenous drug users (IVDUs) sexual partners of IVDUs, or prostitutes. A model was hypothesized based on stress and coping theory and research. Antecedents studied were personal resources, specifically self-esteem and available support. Mediators were threat appraisal and coping efforts. Outcomes studied were emotional distress and HIV risk behaviors. Structural equation modeling techniques were used to test hypothesized pathways between these variables. Forty-five percent of the variance in emotional distress in these women was explained by the model with self-esteem and avoidant coping the strongest predictors. Ten percent of the variance in risk behavior was explained by the model with emotional distress the strongest predictor. Direct and indirect pathways predicting risk behavior and distress are discussed. Implications of results for intervention and theory building are considered.