A Longitudinal Study of Coping Strategies and Quality of Life Among People with Multiple Sclerosis

The current study was designed to examine the role of coping strategies on quality of life (QOL) of people with multiple sclerosis (MS) over a period of 12 months. Respondents were 321 people with MS and 239 people from the general population who completed measures of QOL on two occasions, 12 months apart. People with MS also completed measures of how they coped with their illness. The results demonstrated that people with MS experienced lower levels of QOL at both points in time. For people with MS, QOL domains strongly predicted other QOL domains at both time 1 and time 2. The coping strategies of social support, focusing on the positive and wishful thinking were consistent predictors of physical QOL, psychological QOL, social QOL and environmental QOL. These findings indicate that coping strategies play an important role in predicting the QOL of people with MS.     

Adjustment to multiple sclerosis: application of a stress and coping model.

This study examined the use of a stress and coping model of adjustment to multiple sclerosis (MS). A total of 122 MS patients were interviewed and completed self-administered scales at Time 1 and 12 months later, Time 2 (n = 96). Predictors included stressful life events, illness (duration, severity, and disability), social support, appraisal (threat and control/challenge), and coping (problem focused and emotion [wishful thinking, self-blame, and avoidance] focused). Adjustment outcomes were Time 2 depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that after controlling for the effects of Time-1 adjustment, better Time-2 adjustment was related to less disability, greater reliance on problem-focused coping, and less reliance on emotion-focused coping. There was limited support for the stress buffering effects of coping and social support. Findings offer some support for the use of a stress and coping model of adaptation to MS.     

The Relationship Between Religion, Spirituality, Psychological Adjustment, and Quality of Life Among People with Multiple Sclerosis

The present research was comprised of two studies that aimed to explore the role of religious and spiritual variables in the psychological adjustment and quality of life of people with Multiple Sclerosis (MS). In study 1, religious behavior and objective levels of spirituality and religiosity were not significantly related to psychological adjustment or quality of life among people with MS. Positive religious coping was negatively related to psychological adjustment and quality of life. In study 2, Intrinsic religious orientation and Quest religious orientation were related to poor psychological adjustment. Implications of the present research for people with MS and other chronic illnesses are discussed.     

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.     

Optimism and coping as determinants of psychosocial adjustment to rheumatoid arthritis

Psychosocial adjustment in 66 patients with chronic rheumatoid arthritis, with a mean duration of 12 years with the disease, were evaluated in a prospective design, with 62% of the sample followed up 16 months later. It was predicted that dispositional optimism would predict adjustment over time and that perceived support and perceived control would be related to psychosocial adjustment at the time of concurrent measurement. At Time 1, psychosocial adjustment was associated with greater optimism and perceived support and less disability. Optimism at Time 1 was the only significant predictor of changes in adjustment at Time 2 controlling for Time 1 adjustment and Time 2 disability. It was found that optimism temporally precedes increases in psychosocial adjustment. In terms of coping strategies, wishful thinking was related to poorer social adjustment, whereas problem-focused coping was marginally related to positive adjustment. Neither coping strategy predicted adjustment across time. Optimism at Time 1 did predict problem-focused coping at Time 2. Perceived social support regarding a specific circumstance at a given point in time enables one to persist in solving a task. Interventions to enhance the quality of life of individuals coping with progressive deteriorative disease must look at the influence of their behavior and attitude on those who provide care for them.     

Development of a Measure of Coping with Multiple Sclerosis Caregiving

Development of a self-report measure of coping specific to multiple sclerosis (MS) caregiving is needed to advance our understanding of the role of coping in adaptation to caring for a person with MS and to contribute to a lack of empirical data on MS caregiving. A total of 213 MS caregivers and their care recipients completed a Coping with MS Caregiving Inventory (CMSCI) and measures of adjustment (psychological distress), appraisal and illness. A subsample ( n = 64) also completed the Ways of Coping Checklist (WCC) and additional adjustment measures (depression, caregiving impact, dyadic adjustment, and relationship conflict and reciprocity). Factor analyses revealed 5 factors: Supportive Engagement, Criticism and Coercion, Practical Assistance, Avoidance, and Positive Reframing. Subscales had internal reliabilities comparable to similar scales and were empirically distinct. Preliminary construct validation data are consistent with recent MS caregiving research that links passive avoidant emotion-focused coping with poorer adjustment, and relationship-focused coping caregiving research that links greater reliance on positive relationship-focused coping and less reliance on criticism with better adjustment. Results extend this research by revealing new relations between coping and adaptation to MS caregiving. Convergent validation data suggest that although the inventory differs from the WCC, it does share certain conceptual similarities with this scale.     

Social comparison,coping and depression in people with spinal cord injury

The present study among 70 people with spinal cord injury examined the prevalence and correlates of identification (seeing others as a potential future) and contrast (seeing others in competitive terms) in social comparison as related to coping and depression. The most prevalent social comparison strategy was downward contrast (a positive response to seeing others who were worse-off), followed by upward identification (a positive response to perceiving better-off others as a potential future), downward identification (a negative response to perceiving worse-off others as a potential future), and upward contrast (a negative response to seeing others who were better-off). Those with less severe lesions reported the highest levels of upward contrast, coping through blaming others, and depression. Downward contrast was particularly related to constructive coping, and upward identification to wishful thinking. The less adaptive social comparison strategies, i.e., upward contrast and downward identification, were quite strongly related to wishful thinking and blaming others. Particularly upward contrast, i.e., feeling bad as response to seeing that others are better-off, was related to depression.     

Coping and sensitivity to aversive events

To test further the sensitivity to aversive events hypothesis, males and females varying in level of depressed mood listened to positive, negative, and neutral social scenes while psychophysiological measurements were obtained. In addition, the relations among response styles, coping strategies, and psychological adjustment were examined. Results indicated that only dysphoric females responded in ways consistent with the sensitivity hypothesis, exhibiting greater electrodermal responses to negative social scenes compared to nondysphoric females. No differences in psychophysiological sensitivity were found between dysphoric and nondysphoric males. Dysphoric students engaged in more ruminative type responses in reaction to their depressed mood and reported using more avoidant coping strategies in response to stress. In particular, females utilized more ruminative strategies in response to a depressed mood and more emotion-focused coping strategies in response to stressful events in general. The implications for these results are discussed within a diathesis-stress framework.     

Multiple Sclerosis and Economic Well-Being: Role of Health, Age, and Duration of Illness

This study used quantitative and qualitative techniques to examine the role of health, age, and duration of illness among people with multiple sclerosis (MS) in their economic well-being. Participants were 113 adults (31 males and 82 females) with MS who lived in urban and rural regions of Australia. The results demonstrated that health and age had a significant impact on both the economic well-being and psychological adjustment of people who contract this disorder. Different health variables predicted different aspects of economic well-being. Fatigue was the major health variable that predicted costs of MS and economic pressure, with age also predicting economic pressure, whereas income levels were predicted by cognitive confusion and mobility problems. Duration of illness, gender, and urban/rural location were not significant predictors of the economic variables. These results demonstrate the importance of obtaining multiple measures of economic well-being, as well as a broad range of health-related measures, in determining the impact of MS on the economic well-being of people with this disorder.     

Levels of Social Support and Coping Strategies in Adult Survivors of Child Sexual Abuse

The study examined the effects of levels of social support and types of coping strategies on the psychological adjustment of adult survivors of childhood sexual abuse. Five hundred students from two universities in the Limpopo Province of South Africa participated in this study (males =115, females = 383). Mixed methods were used for the collection and data analysis. Higher the level of social support received correlated with superior psychological adjustment. The specific types of coping styles adopted did not affect psychological adjustment in the survivors.     

Cognitive,Behavioral and Goal Adjustment Coping and Depressive Symptoms in Young People with Diabetes: A Search for Intervention Targets for Coping Skills Training

The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for young people with Type 1 (T1) diabetes. A wide range of coping techniques was studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 78 young people with T1 diabetes participated. They were contacted through a social networking website, several Internet sites, and flyers. A wide range of coping techniques appeared to be related to depressive symptoms. Especially the cognitive coping strategies self-blame, rumination, refocus positive, and other-blame, together with goal adjustment coping, were of importance. A large proportion of the variance of depressive symptoms could be explained (65 %). These findings suggest that these specific coping strategies should be part of coping skills trainings for young people with T1 diabetes.     

Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat

How do people cope with a threat when they do not plan to adopt an adaptive, protective response? We explored this question by examining the effects of information about a health threat and two aspects of coping ability, self-efficacy and response efficacy, on two adaptive and five maladaptive coping strategies (e.g., avoidance, wishful thinking). The results disclosed that the high-threat condition energized all forms of coping; it did not differentially cue specific coping strategies. The critical factor in determining the specific strategies used was the coping information. The high-response-efficacy and high-self-efficacy conditions strengthened adaptive coping and did not foster any maladaptive coping. A supplementary path analysis revealed an intriguing pattern of relations, including the finding that the most maladaptive strategy was avoidant thinking, which simultaneously reduced fear of the threat and weakened intentions to adopt the adaptive response.     

The relationship of appraisal and coping to chronic illness adjustment

There is evidence that adaptation to chronic illness may be affected by psychological factors, especially how patients appraise and cope with the stress of their illness. The purpose of the present study was to examine the relationship of stress appraisal and coping responses to multiple behavioral indices of illness adjustment among patients with diverse chronic medical conditions. One hundred and one patients admitted to a multidisciplinary medicine/psychiatry unit completed measures of functional impairment, depression, symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical regression analyses indicated that emotion-focused coping was positively related to poor psychosocial adjustment and depression after controlling for physician rated disease severity. Appraising chronic illness as holding one back predicted greater emotion-focused coping responses and poorer adjustment to illness. The use of problem-focused coping strategies was generally unrelated to illness adjustment. These findings suggest the presence of an emotion-focused coping triad consisting of wishful thinking, self blame, and avoidance, all of which appear to be maladaptive strategies when coping with chronic medical conditions. Implications for coping skills training and the need for longitudinal research is discussed.     

Optimism and Traumatic Stress: The Importance of Social Support and Coping1

This study examined the effects of optimism following traumatic stress and pathways through which optimism may act. Rescue and recovery workers at the crash site of US Air Flight 427 (n= 159) were studied 2, 6, 9, and 12 months after the crash to examine optimistic outlook, social support, coping, and stress. As predicted, a more optimistic disposition was associated with less self‐reported distress, less use of avoidant and wishful‐thinking coping strategies, greater use of problem‐focused and seeking‐social‐support coping, and greater availability of social support. Contrary to expectations, coping did not account for the relationships observed between optimism and stress responding. Social support explained some of the effects of optimism on coping and stress, but these mediational effects varied over time. Findings suggest that optimism affects stress and coping directly and indirectly by affecting how much social support is available.     

Women's Reactions to Miscarriage: The Role of Attributions,Coping Styles,and Knowledge1

This study examined 72 women's retrospectively reported reactions to miscarriage, including depression, stress, and anxiety. The buffering role of women's attributional explanations for the event, the significance of the loss of the baby, coping strategies, and women's knowledge of miscarriage were also assessed. Correlational analyses revealed that women's attributions were tied to their reactions, in that the more women blamed their own character or doctor, the more severely they reacted. Coping strategies accounted for a large portion of the variance (64%), whereby women who used cognitive restructuring as a strategy suffered less adverse reactions than did those who used social withdrawal or wishrul thinking. Women's knowledge before miscarriage, rather than after, accounted for 6% of the variance in their reactions. Examining the interrelations of these variables revealed that the amount of women's knowledge before miscarriage was related to less wishful thinking, and their knowledge after the event was related to less problem avoidance. Women's attributions were also related to their coping strategies: Blaming one's character, behavior, or doctor were positively related to self-criticism and social withdrawal, and negatively related to support from doctors and significant others. The implications of these findings for interventions to facilitate adjustment to miscarriage and future research are discussed.     

A Comparison of Mood and Quality of Life Among People with Progressive Neurological Illnesses and Their Caregivers

The current study was designed to investigate differences in mood and a range of QOL domains among 423 patients and 335 caregivers of people with motor neurone disease (MND), Huntington’s disease (HD), Parkinson’s, and multiple sclerosis (MS). Patients and caregivers completed an anonymous questionnaire that evaluated their mood (anxiety, depression, fatigue, confusion) and QOL (physical, psychological, social, environment). The results demonstrated that caregivers of people with MND and HD experienced most problems with their mood and QOL compared to caregivers of people in the other illness groups. There were few differences in mood or QOL between patients and caregivers. Patients generally showed greater confusion, physical impairment, and psychological maladjustment. The findings suggest that educational and intervention programs need to be developed to help both patients and their caregivers to adjust and cope with these illnesses, particularly caregivers of people with MND and HD.     

The effect on coping of monitoring, blunting, and the ability to achieve cognitive structure.

The effects of monitoring and blunting on individuals' choices of coping strategies and their effectiveness were examined. In addition, the authors explored the effect of the ability to achieve cognitive structure (AACS), defined as either or both of the following: (a) the ability to avoid information that either cannot be categorized or clashes with the individual's existing knowledge; (b) the ability to organize knowledge to fit an already existing cognitive structure. The results showed that in addition to the main effects of monitoring on problem-focused coping and social support seeking behaviors and of blunting on the use of wishful thinking, AACS was found to moderate blunting's influence on problem-focused coping as well as the effectiveness of distancing and avoidance coping. Finally, the results showed that the combination of high monitoring and high blunting sometimes contributes to coping effectiveness.     

Coping, Conflictual Social Interactions, Social Support, and Mood Among HIV-Infected Persons

This study considers the interrelationships among coping, conflictual social interactions, and social support, as well as their combined associations with positive and negative mood. Research has shown that each of these variables affects adjustment to stressful circumstances. Few studies, however, examine this full set of variables simultaneously. One hundred forty HIV-infected persons completed a questionnaire containing measures of coping, social support, conflictual social interactions, and positive and negative mood. Factor analyses showed that perceived social support and conflictual social interactions formed separate factors and were not strongly related. Compared to perceived social support, social conflict was more strongly related to coping behaviors, especially to social isolation, anger, and wishful thinking. Conflictual social interactions were more strongly related to negative mood than was perceived social support. Coping by withdrawing socially was significantly related to less positive and greater negative mood. The findings point to the importance of simultaneously considering coping, supportive relationships, and conflictual relationships in studies of adjustment to chronic illness. In particular, a dynamic may occur in which conflictual social interactions and social isolation aggravate each other and result in escalating psychological distress.     

Adolescent Girls' Coping With Relational Aggression

This study was designed to examine coping strategies for relational aggression. Ninety-eight female middle- and high-school students completed the Revised Ways of Coping Scale (Folkman & Lazarus, 1985) and reported characteristics of a relational aggressive act of which they were the victim and characteristics of their friendship before and after the act. We explored the relationship between characteristics of the relationally aggressive act and the method of coping. Results of the study indicate that the more hurt the girl was by the aggression, the more likely she was to use passive and avoidant coping strategies, such as wishful thinking. The girls who felt closer to their friends after the aggressive act were the girls who coped by seeking social support significantly more often than any other type of coping strategy.     

The effects of cystic fibrosis on couples: marital satisfaction, emotions, and coping strategies

An earlier diagnosis and better overall multidisciplinary care enable people suffering from Cystic Fibrosis (CF) to have a life expectancy of 40. Consequently, new populations and questions about the development of the life of couples have arisen. This study by questionnaires takes a first look at marital adjustment, anxiety, depression, and emotion focused, social support focused, and problem focused coping strategies in 16 CF patients and their partners. As a whole, the couples' marital adjustment level was good; it was higher for men who were patients than men who were partners, and vice versa for women. Anxiety was high for at least one partner in 10 of the couples; depression, for at least one partner in seven of them. The participants seem to use coping strategies to a lesser extent than the general population. The results are discussed in terms of how the quality of life as a couple with one partner suffering from CF is affected by the proper mutual adjustment of the partners.