Coping Strategies in Adolescents

Children and adolescents report that they experience stress in their lives and that they attempt to cope with that stress. Although most research on stress and coping has focused on adults, recent attention to adolescents suggests there are developmental changes in coping during adolescence and that particular coping strategies vary with gender and the type of stressors adolescents experience. This study examined coping strategies used by male and female students in early, middle, and late adolescence when they were coping with two different types of stressors: daily hassles and major life events. Older adolescents used a greater variety coping strategies and used methods that directly reduce the impact of the stressor and involved a cognitive component (e.g., planful problem solving; reappraisal) more often than younger adolescents. Adolescents in all age groups varied their strategies in relation to the type of stressor, but there were no significant gender differences. The findings suggest that significant changes during a relatively short period during adolescence may affect adaptive processes and have implications for intervention efforts aimed at reducing the negative effects of stress during this period of development.     

The psychological cost of waiting

The study of any problem involving waiting situations invariably assumes that people dislike having to wait. The analysis of queueing problems usually prescribes that some costs should be associated with the time people spend waiting to be served. These are usually considered to be of an economic nature, though the existence of other costs of a psychological nature is accepted. It is generally accepted that after having to wait for a certain amount of time, anxiety and stress start to build up in an individual, due both to the sense of waste and the uncertainty involved in a waiting situation. This work provides a theoretical basis for analysing this building up process as it occurs during the waiting period. It is proved that, under very general conditions, the resulting psychological stress accumulated during the process is a marginal increasing function of the waiting time, and some strategies to minimise it are developed. The results obtained give theoretical support to the usual assumptions underlying the development of systems to provide “real time” information to people in waiting situations. This is especially important in the operation of public transportation systems. The results also provide theoretical support to the “convex” treatment usually given to the waiting cost function in queueing problems.     

Waiting for the next Shoe to Drop: The Experience of Parents of Children with Fanconi Anemia

Fanconi Anemia (FA) is a rare genetic disease that generally affects children and results in bone marrow failure requiring blood or marrow transplantation for survival. A unique feature of the condition is the long, often many years, waiting period between genetic diagnosis and treatment. This qualitative study looked at the lived experience of parents confronting their child’s diagnosis of FA. We aimed to describe factors which parents found helpful or detrimental during the waiting time period and to recommend strategies to support families who will have these experiences in the future. Categories that emerged were: parents’ emotional responses, thoughts about FA (which occurred daily for most parents), sources of stress, mechanisms of coping, family dynamics and responses that were supportive and non-supportive. We found that most parents experience stress, uncertainty, and active surveillance throughout the course of the illness. Healthcare professionals, and especially physicians, were agents of both the most and least supportive experiences of parents. Parents described family centered team care as helpful throughout the illness and health professional education as a priority need.     

Cognitive strategies in coping with expedition stress

Expeditions provide a valuable opportunity for studying processes of coping with a stressful situation. An expedition to India organized by the British Schools Exploring Society has already been reported as being accompanied by positive changes on self-report personality scales. This paper is concerned with detailed cognitive coping measures completed throughout the 6 weeks of the expedition. It needs to be noted that the results relate to young adults and to those who provided detailed coping information; the generalizability of the result is a matter for future research. The expedition presented a mixture of physical and social stresses. Men enjoyed the physical experience more than women, but women enjoyed the social experience more than men. There was generally greater reliance on personal resources than on social support in coping with stress. This was particularly true for men in coping with physical stress and women in coping with social stress. In general, the physical stresses had been better anticipated than the social ones. Positive reformulations were much more widely used as coping strategies than avoidance/resignation strategies, especially so for physical stresses. However, use of avoidance/resignation strategies was the better predictor of outcome, with those who used them being least likely to show positive personality change as a result of the expedition. The results are related to current research on stress and coping.     

Meaningful coping with chronic pain: Exploring the interplay between goal violation,meaningful coping strategies and life satisfaction in chronic pain patients

Trying to cope with chronic pain is a highly demanding and challenging task and pain patients often need to reformulate goals or aspirations due to their pain condition. This goal violation is often related with experienced distress and requires coping processes in order to decrease the distress and stimulate a healthy adaptation. Some scholars, however, argued that in so‐called unsolvable or irreparable stressors such as chronic pain, conventional coping strategies like problem‐focused coping might not be the most adaptive option. In these situations, meaningful coping strategies attempting to transform the meaning of the stressful experience would be more accurate. In this study, we aim to test if goal violation triggers meaningful coping strategies over time and whether engagement in these meaningful coping strategies result in improved life satisfaction, as an indicator of adaptation. A longitudinal three wave study in a sample of paint patients (n = 125) tests whether goal violation triggers positive reappraisal and downward comparison, two possible meaningful coping strategies. The study furthermore tests if engagement in these strategies results in a better adaptation to the pain condition, reflected in higher life satisfaction. Results partially supported our hypotheses by pointing to the benevolent role of downward comparison on life satisfaction via decreased goal violation of pain patients. Our findings however did also show that positive reappraisal predicted lower life satisfaction via increased levels of appraised goal violation which questions the role of positive reappraisal as a genuine meaningful coping strategy. Implications and limitations are discussed.     

Spécificité des stratégies de coping des patients en rémission de la maladie de Crohn : une étude qualitative

IntroductionCrohn's disease (CD), a chronic inflammatory bowel disease, has strong psychological and social repercussions related to the specificity of the symptomatology. To better understand how patients cope with the disease, coping strategies have been studied but without taking into account the specificity of the CD experience.ObjectiveOur objective is to identify the perceived coping strategies used by patients in relation to their illness experience.MethodUsing a qualitative approach, semi-structured interviews and thematic content analysis with 33 CD patients in remission were conducted.ResultsOur results highlight that some of the coping strategies used are not taken into account by the coping scales frequently used in the literature. Indeed, the illness experience appears to be fundamental in the establishment of new strategies based on the experiential knowledge patients use to reduce the stress induced by a potential relapse. Moreover, coping strategies based on positive emotions are also implemented, and they enable patients to make sense of the disease.ConclusionThe coping strategies, i.e., “experiential knowledge” and “positive emotions”, may shed more light on the complexity of the illness experience of CD patients and allow us to make recommendations concerning the psychological support of patients.     

How do I cope with pain? Let me count the ways: awareness of pain coping behaviors and relationships with depression and anxiety

Patients with chronic pain are often undertreated with medications alone and need alternative ways of coping. Identifying pain coping skills patients use may be beneficial; however, no research has investigated whether patients are aware of their coping skills. The purpose of this study was to determine whether patients are aware of their pain coping skills, whether certain patient characteristics were related to using coping strategies, and whether coping strategies were related to psychiatric symptoms. Chart reviews were conducted on seventy-eight chronic pain patients who completed a semi-structured psychological interview. Patients endorsed using more coping strategies on the measure compared to the verbal self-report. Identifying with certain patient demographics was related to higher use of some coping strategies. Symptoms of anxiety and depression were also related to the use of some coping strategies. Anxiety was negatively related to ignoring the pain and using self-talk coping statements and positively related to catastrophizing. Depression was negatively related to the use of distraction, ignoring the pain, and using self-talk coping statements. Depression and pain severity were both positively related to catastrophizing and prayer. Results suggest that clinicians may need to help patients become aware of adaptive coping strategies they already use and that the use of certain coping strategies is related to lower levels of depression and anxiety.     

Coping with Job Loss and Reemployment: A Two-Wave Study

Using a national sample, this study investigated the effects of unemployed workers’ coping resources and coping strategy use on reemployment after a three-month period. Based on previous research, it was expected that (1) three types of coping resources (self-esteem, social support, and financial resources) would be positively related to problem-focused coping with job loss, (2) coping resources would be negatively related to emotion-focused coping with job loss, (3) problem-focused coping would be positively related to reemployment, (4) problem-focused coping would be more strongly related to reemployment than emotion-focused coping, and (5) coping strategies would mediate the relationship between the availability of coping resources and obtaining reemployment. Results provided support for the direct effects of coping resources (self-esteem, social support, and, to some extent, financial resources) on coping strategies, and a direct effect of problem-focused coping on reemployment 3 months later. Self-esteem and social support were each indirectly related to subsequent employment status, mediated by problem-focused coping. In other words, individuals with higher levels of self-esteem and social support were not only more likely to engage in problem-focused coping, but having a higher level of self-esteem and social support was also associated with a higher likelihood of being reemployed three months later. Findings are pertinent for the design of more effective interventions that mitigate adverse effects of unemployment and facilitate a successful return to the workforce.     

Evolutionary autonomous agents and the naturalization of phenomenology

The phenomenological goal of grounding the content of conceptual thought in the background understanding of everyday, skillful coping was approached using evolutionary autonomous agent (EAA) methodology. The behavior of an EAA evolved to perform a specified motor task was identified with skillful coping. Changes in the dynamics of the EAA controller occurred when the EAA encountered an unexpected obstacle with loss of longer time scale components in its hierarchical temporal organization. These temporal changes are consistent with the phenomenological changes which we experience with breakdown during equipment use with our adoption of a more immediate, determinate stance. Since this latter experience is the basis of conceptual thought, the EAA paradigm goes some way in providing a naturalized explanation for the grounding of the content of conceptual thought in everyday, skillful coping in a manner that is physiologically plausible and phenomenologically accurate.     

Monitoring/Blunting and Social Support: Associations with Coping and Affect

The present study examined the associations of personal factors and social resources with coping and affective reactions to simulated stressful encounters. The study tested coping strategies and assessments of affect in the context of 'health' and 'work' threats described in 2 vignettes in a sample of 147 community residents. They also completed the Monitor-Blunter Style Scale (MBSS) and a perceived social support scale. The results showed positive associations between active coping and positive affect, and negative associations between avoidant coping and negative affect, replicating previous findings. Most interestingly, neither monitoring/blunting nor social support were directly related to either negative or positive affect, but were differentially related to coping strategies. Monitoring and social support were positively correlated with active coping and support-seeking in both vignettes, while blunting was related positively to avoidant coping, and social support was related negatively to this coping strategy. These results suggest that personal factors and social resources affect the use of coping strategies, rather than the affective reactions to threats, and contribute to our understanding of the stress and coping process.     

Effects of waiting times within simple problems: an analogy to waiting times in human-computer interaction

The impact of forced intra-task waiting periods was evaluated in a laboratory study designed in analogy to forced waiting periods in human-computer interaction. Each task consisted of two lines of grouped capital letters (so-called Sterzinger lines) that had to be processed individually, separated by the experimental waiting period. The final response to both lines was taken after removal of the second line. The experiment was conducted according to a within-subjects design with the order of the two factors "duration" (2 s vs. 8 s) and "variability of the waiting periods" (constant vs. variable) controlled. The dependent variables were performance indices, heart rate, electrodermal activity, and subjective measures of mood and physical complaints. The results showed effects of the duration of waiting periods for the performance and the physiological variables, and effects of the variability factor for the subjective variables. Shorter waiting periods were associated with higher scores of heart rate and skin resistance responses, variable waiting periods seemed to confuse the subjects more than constant ones. The results are discussed with respect to the effects of the two experimental factors. With respect to dialog structures in human-computer interaction, the results lead to the conclusion that response interference could be avoided by giving the user the possibility to immediately input problem solutions. Partial and preliminary inputs should be permanently kept visible during the whole task cycle by the software.     

Perceived sources and levels of stress,general self-efficacy and coping strategies in clinical dental students

The aims of this study were to identify sources of stress among clinical students and to evaluate the students’ perceived levels of stress, general self-efficacy and effective coping strategies in a private dental school environment. The study group consisted of 130 undergraduate clinical dental students in a Turkish private dental school, during the academic year 2014–2015. The students were surveyed using modified version of the dental environment stress (DES) survey, the perceived stress scale, the general self-efficacy scale (G-SES) and the brief coping scale. Age, sex, year of study, history of psychiatric treatment and factors that affected the choice of dentistry were also recorded. Final year and female clinical dental students, who were found to be the most stressful students, had moderate to high perceived stress scores. Total and ‘Faculty and administration’ related DES scores increased with the year of study. Stressors related to ‘Workload’ and ‘Clinical training’ affected females more than males. G-SES scores were higher in male students and students, who had no history of psychiatric treatment. The most and the least common coping strategies were ‘Planning’ and ‘Substance abuse’, respectively. ‘Religion’ was found to be one of the main coping strategies. Stress factors affecting Turkish clinical dental students studying at private dental school differed from the previously reported stress factors affecting students studying at a governmental dental school. Advanced year and female students experienced more stress than the other students.     

Need for cognitive closure and coping strategies

This study investigated the hypothesis that the process of coping may be motivated by an interaction of directional motivational factors represented by job satisfaction/dissatisfaction and by non‐directional or epistemological motivational factors represented by the level of Need for Cognitive Closure. Need for Cognitive Closure is based on two general tendencies: the urgency tendency (“to seize”) and the permanency tendency (“to freeze”). The urgency tendency reflects the desire to attain closure as quickly as possible (“to seize”) whereas the permanence tendency refers to the inclination to maintain closure for as long as possible along with a desire to preserve or “freeze on” past knowledge and to safeguard future knowledge. The urgency and permanence notions both rest on the assumption that people under a heightened need for closure experience its absence as aversive. In relation with this, we predicted that if job satisfaction is low, the increased need for closure is related to the choice of problem‐oriented coping strategies. Alternatively, we hypothesized that with high job satisfaction an increased need for closure is related to use of avoidance coping. Questionnaires pertaining to need for cognitive closure, to coping strategies and to a measure of job satisfaction were completed by a group of 146 Croatian immigrants living in Italy. Results of the analyses confirmed that when subjects were highly satisfied with their job, their primary concern was to preserve their position. So, here the high need for closure enhanced the tendency to freeze and induced the choice of avoidance coping strategies. On the other hand, our results confirmed that when persons are not satisfied with their job, high need for closure increases the desire for change and improvement. Immigrants increased the tendency to seize manifests itself in extensive and quickened information processing relative to the use of problem‐oriented coping strategies.     

The psychosocial impact of multiple sclerosis: exploring the patient's perspective.

This study examined subjective patient experiences of the psychosocial consequences of multiple sclerosis (MS). Fifty patients were interviewed regarding the effects MS had on their lives and interpersonal relationships. These statements were collated and administered with a 5-point Likert scale to 94 MS patients. The responses were subjected to factor analysis. Three areas of subjective patient experience of the psychosocial consequences of MS emerged: demoralization, benefit-finding, and deteriorated relationships. Of particular interest was benefit-finding, which included a deepening of relationships, enhanced appreciation of life, and an increase in spiritual interests. Although benefit-finding was related to adaptive coping strategies such as positive reappraisal and seeking social support, it was unrelated to depression and was related to higher levels of anxiety and anger. These findings indicate that benefit-finding is a substantial and poorly understood part of the illness experience for MS patients.     

Life strains,coping, and emotional well-being: A longitudinal study of recently separated and married women

The stress and coping paradigm was used as the framework for a longitudinal study of recently separated and married women. Data were gathered at three different interviews over a period of 18 months. Comparing the two groups of women, it was found that life strains in the areas of financial concerns and spouse relations were related to both income level and marital status, with low-income and separated women experiencing the highest levels of these strains. Also, the separated women used coping strategies emphasizing personal change and reported more positive changes related to their family, work, and material conditions. Regression analyses on the entire sample showed that life strains were inversely related to emotional well-being and that coping served a stress-buffering function. It was concluded that the emotional well-being of separated and married women must be considered in the context of stress, coping, and change processes.     

The Role of Attachment in Predicting Spiritual Coping with a Loved One in Surgery

Research has examined the relationship between spiritual coping and adjustment and found that individuals employ spirituality in coping in various ways. However, the reasons that individuals choose certain strategies remains unclear. The current project examined whether spiritual coping mediates the relationship between attachment to God and adjustment for individuals (N = 155) waiting for a loved one undergoing inpatient surgery. Results from the present study indicated that attachment to God was differentially related to spiritual coping activities and styles. In turn, spiritual coping was associated with the adjustment to the surgery vigil. Data were analyzed through path analysis of models for each of the outcome variables (Religious Outcome, General Outcome, Stress-Related Growth, and General Health Questionnaire). Attachment to God was predictive of spiritual coping, which, in turn, was predictive of adjustment. Attachment to God provides a useful framework for understanding why individuals choose particular coping strategies.     

Hearing Impairment, Coping Strategies, and Anxiety Sensitivity

The aim was to study coping strategies among hearing-impaired individuals by using a validated coping instrument—The Ways of Coping Questionnaire (WOCQ; S. Folkman & R. Lazarus, 1988)—and to relate the use of coping with anxiety sensitivity and experience of hearing impairment. A questionnaire booklet was sent out to the members of the local branch of the Swedish Hard of Hearing Association. Ninety-four members responded to the questionnaire, yielding a 53% response rate. Primary outcome measures were the WOCQ, the Anxiety Sensitivity Index, and visual analogue scale rating of discomfort from hearing impairment. Repeated measures analysis of WOCQ subscales showed that the participants used planful problem solving and self-controlling coping strategies whereas escape/avoidance responses were less frequently used than the other coping strategies. Anxiety sensitivity was associated with escape/avoidance coping (r = .63, p < .0001). In conclusion, hearing-impaired individuals do not use escape/avoidance coping more than other coping strategies. However, escape/avoidance coping is associated with anxiety sensitivity, suggesting that sensitivity to anxiety sensations is an important associated factor. Coping strategies were not associated with discomfort from hearing impairment in any meaningful way.     

Exploring the Recovery of Non-offending Parents after a Child’s Sexual Abuse Event

A variety of factors influence a child’s recovery from a child sexual abuse (CSA) event including the non-offending parent’s role in the healing process of their child. The purpose of this study was to gain a better understanding of how non-offending parents recuperate from a CSA occurrence. By better understanding non-offending parents’ perspectives related to the healing process, health professionals can provide effective supports, programs, and services. We recruited and conducted in-depth qualitative interviews with 16 non-offending parents to explore their risk factors, protective factors, stressors, coping strategies, and perceptions of healing following their child’s sexual abuse event. We also invited parents to contribute specific ideas to improve programs and services offered to families of sexual abuse served by a child advocacy center located in an urban pediatric hospital. Our findings included five themes: (1) a variety of emotions are present; (2) family context influences recovery; (3) coping is different for everyone; (4) navigating the justice system is frustrating; and (5) healing is a process. The results of our study revealed that the non-offending parents that were managing their child’s sexual abuse event more productively were further along in the healing process (as compared with their counterparts) and had successfully processed their emotions, described less chaos in their family unit, employed positive coping strategies, and had found a way to move forward and accept a “new normal”. The findings of our study can be used to promote recovery and provide better services to non-offending parents following a CSA event.

     

Expanding coping goodness-of-fit: religious coping, health locus of control, and depressed affect in heart failure patients

The goodness-of-fit coping hypothesis posits that problem-focused (PF) coping is particularly helpful under high controllability conditions, while emotion-focused (EF) coping is more helpful in low controllability situations. However, little research has examined whether the goodness-of-fit hypothesis applies to religious coping, a distinct set of coping resources and efforts. Further, little goodness-of-fit research has been conducted in the context of life-threatening illness. We tested coping goodness-of-fit for PF and EF as well as religious coping resources and strategies in 202 congestive heart failure (CHF) patients. Multiple regression analyses examined the extent to which each type of coping, health locus of control (HLOC) regarding their CHF, and their interactions related to subsequent depressed affect. Neither religious coping efforts nor religious resources were related to depressed affect. However, when examined in conjunction with internal HLOC, active coping and organized religious commitment were related to less depression for those higher in internal HLOC, while daily spiritual experience was related to less depression for those lower in HLOC. These results partially support the goodness-of-fit hypothesis and indicate a need to consider the perceived controllability of situations when examining the associations of religious coping resources and activities on depressive symptoms in the context of illness.