Coping,psychological adjustment,and complementary and alternative medicine use in persons living with hiv and aids

Abstract

Many HIV-positive individuals dissatisfied with allopathic approaches to disease management have turned to complementary and alternative medicines (CAM). Although people use CAM for a variety of reasons (e.g., symptom management, holistic approach towards healthcare, improved immunity), the psychological benefits that these treatments may have are still not fully understood. The present study was designed to further previous research that demonstrated relationships between CAM use, stress appraisals, and coping behaviors. HIV-positive individuals (N= 127) completed measures assessing stress appraisals, coping, psychological adjustment, satisfaction with life, and immune functioning. After controlling for ethnicity and sexual orientation, stress appraisals and coping behaviors were found to be related to CAM use. Further, curvilinear relationships between CAM use and adjustment emerged, suggesting that some CAM use may be adaptive. Self-reported immune measures were unrelated to CAM use. In all, it appears that CAM use may be a complex form of coping that assists individuals in adjusting to a life-threatening illness. The implications of these findings with respect to adherence to highly active antiretroviral therapies (HAART) are also discussed.     

Religious Coping and Substance Use: The Moderating Role of Sex

The objectives of this study were to ascertain whether positive and negative religious coping are associated with substance use and to determine whether sex moderates this association. This study utilized a cross-sectional design and examined 349 undergraduate students (103 males and 246 females) at a midsize southeastern university. Participants completed a demographic questionnaire, the Brief RCOPE, and the Drinking and Drug Habits Questionnaire. Results revealed a positive association between negative religious coping and substance use only for males. While positive religious coping was significantly negatively associated with substance use, sex did not moderate this association. These results suggest that males may be especially vulnerable to engaging in substance use when utilizing negative religious coping. It may be important for university counseling centers to be cognizant of the types of religious coping used by students, as well as sex differences regarding the association between negative religious coping and substance use.     

汉区高校少数民族大学生压力对其学校适应的影响机制

在压力反应一般模式、应对交互作用模式、生态系统理论、风险缓冲模型和压力缓冲假说模型基础上构建了一个有调节的中介模型,探讨了压力、应对方式、文化智力和汉区高校少数民族大学生学校适应之间关系。采用了压力量表、应对方式问卷、文化智力量表和学校适应问卷对779名汉区高校少数民族大学生进行调查,结果显示：（1）压力影响汉区高校少数民族大学生学校适应;（2）应对方式部分中介了压力与汉区高校少数民族大学生学校适应间的关系;（3）文化智力调节了压力通过应对方式影响汉区高校少数民族大学生学校适应这一中介过程的前半路径和直接路径。研究结论对提高汉区高校少数民族大学生学校适应有重要的参考价值。     

Religion and the Use of Complementary and Alternative Medicine (CAM) Among Cardiac Patients

This study investigates the prevalence and predictors of using complementary and alternative medicine (CAM) among middle-aged and older patients prior to cardiac surgery. Additionally, it addresses the correlates of using 10 commonly used CAM therapies. The influence of religion on itemized CAM usage is also explored. Comprehensive data were collected from adult patients undergoing cardiac surgery through a preoperative survey 2 weeks prior to surgery, followed by a telephone interview the day before surgery. More than two-thirds of participants (80.9 %) indicated at least one CAM use. Income, religiosity, education, BMI, employment, and congestive heart failure predicted greater CAM utility. After multiple controls, major cardiac indicators were significantly positively associated with greater utility of CAM. There was also a significant positive association between religiosity and CAM use. Findings suggest considerable CAM use in this cardiac sample and certain associations among cardiac conditions, religiosity, and itemized CAM utilization. Future research is needed to investigate the potential joint therapeutic and adverse effects of drug and herbal remedies in cardiac patients.     

文化疏离感对汉区高校少数民族大学生幸福感的影响:应对方式的中介作用和文化智力的调节作用

采用文化疏离感量表、应对方式问卷、文化智力量表和幸福感问卷对670名汉区高校少数民族大学生进行调查,分析了文化疏离感、应对方式、文化智力和汉区高校少数民族大学生幸福感之间关系。结果显示:(1)应对方式部分中介了文化疏离感与汉区高校少数民族大学生幸福感间的关系;(2)文化智力调节了文化疏离感通过应对方式影响汉区高校少数民族大学生幸福感这一中介过程的前半路径和直接路径。     

Trauma and substance use: the role of defences and religious engagement

Substance use disorders commonly co-occur with posttraumatic stress disorder and are associated with greater impairment. There is some evidence to suggest that different coping strategies, including defence mechanisms and religious forms of coping, may buffer the relationship between trauma and SUDs. The purpose of this study was to evaluate the potential moderating roles of defence mechanisms and religious coping on the already-established relationship between trauma symptoms and substance abuse. Data were gathered from a sample of college students (N?=?380). Trauma symptoms were associated with increased substance use and abuse. The use of immature defences was significantly associated with trauma and substance use. Increased substance abuse was also associated with higher rates of negative religious coping. Individuals who endorsed trauma symptoms were also more likely to use positive and negative religious coping. Defences and coping did not moderate the relationship between trauma and substance use.     

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

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

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.     

Adolescent Adjustment and Coping Strategies

This study examines the relation between psychosocial adjustment and coping strategies among college freshmen. Three hundred thirty-one college students completed the Inventory of Psychosocial Development (IPD; Constantinople, 1969) and the Adolescent Coping Orientation for Problem Experiences (ACOPE; Patterson & McCubbin, 1987) inventory. Factor analysis of the ACOPE scales revealed two factors interpreted to represent the coping strategies of "salutary effort" and "stress palliation." For each subject a relative salutary effort score was calculated to reflect the proportion of coping efforts ascribable to mature, salutary coping efforts. Optimal adjustment was associated with adolescents whose reported means of dealing with tension reflected a high proportion of salutary effort. These findings, which support the notion of a covariation between styles of coping and psychological adjustment among adolescents, are discussed in light of psychosocial development, coping, and methodological issues related to research on coping and adjustment.     

Difficulties and coping strategies of Chinese,Japanese, and Korean immigrant students

An exploratory study was conducted to investigate mental health concerns and coping strategies in a sample of 274 Chinese, Japanese, and Korean immigrant junior high and high school students. Participants responded to two open-ended questions relating to difficulties associated with coming to the United States and attendant coping strategies. Data were coded into several categories, and chi-square and logistic regression analyses were conducted. Results indicated that the most common problem across all three Asian immigrant groups was communication difficulties. The most frequently reported coping strategy was the use of social support networks. In addition, Japanese students were more likely to experience interpersonal problems than were their Chinese and Korean counterparts. Korean students tended to utilize religious practices as a coping strategy more than did Chinese and Japanese students. The implications for research and counseling are discussed.     

Age and burnout syndrome in nursing professionals: moderating role of emotion-focused coping

This study examined whether the association between age and the three burnout dimensions (emotional exhaustion, depersonalisation and reduced personal accomplishment) depend on the extent of nursing professionals’ use of emotion-focused coping strategy. Participants were 283 nurses (Mage = 35 years, SD = 8.17, Range = 23–66 years) from a tertiary healthcare institution in south-eastern Nigeria. They completed self-report measures of relevant variables in paper and pencil form. Increased age was associated with reduced personal accomplishment for nurses with high emotion-focused coping, but not for those who were low or moderate in use of emotion-focused coping. Such moderation effects were not found for emotional exhaustion and depersonalisation. Findings clarify the conditions under which age may be associated with reduced sense of achievement at work among nursing professionals. The study adds to knowledge in combating burnout in nursing and could guide health managers in developing strategies that might prevent or ameliorate nurses’ burnout.     

Religiosity,Spirituality, Sexual Attitudes,and Sexual Behaviors Among College Students

The purpose of this study was to determine whether religiosity, spirituality, and sexual attitudes accounted for differences in sexual behaviors among college students. The sample included 960 college students enrolled at four northeastern colleges. Results indicated differences in sexual attitudes, religiosity, and spirituality by gender. Moreover, sexual attitudes, religiosity, and spirituality were associated with sexual behaviors among college students. Sexual behaviors among males were influenced by their sexual attitudes, religiosity, and spirituality, while for females, their sexual behaviors were mostly influenced by their sexual attitudes. College health professionals can use these findings when discussing sexual practices with students.     

Discriminative facility in the face of threat: Relationship to psychological distress

Abstract

This study explored whether discriminative facility in dealing with threatening situations is negatively associated with distress. Discriminative facility entails the ability to (1) “accurately” appraise the controllability of stressors and (2) use more problem-focused relative to emotion-focused coping with controllable stressors and at the same time more emotion-focused relative to problem-focused coping with uncontrollable stressors. We conducted a preliminary study to obtain “accurate” appraisals of the controllability of two stressors. In the main study, college students (N = 109) provided information regarding their appraisal of the controllability of the two stressors, how they coped with these two stressors, and their level of both stressor-specific distress and general distress. The relationship between coping strategy (problem- vs emotion-focused) and stressor-specific distress was found to be a function of the controllability of the stressor. Specifically, with controllable stressors, the high use of problem-focused coping was associated with less distress than the high use of emotion-focused coping. The opposite was found to be the case with uncontrollable stressors. More importantly, discriminative facility was negatively related to general distress. The results suggest that discriminative facility in the appraisal of and coping with stressors is an important mediator in the experience of psychological symptoms as a result of stress.     

Predicting problematic Internet use in men and women: the contributions of psychological distress, coping style, and body esteem

Problematic Internet use (PIU) is becoming a prevalent and serious problem among college students. Rates of PIU are higher in men, which may be due to psychological variables, such as comorbid psychological disorders and beliefs about one's body. We examined the ability of psychological distress, coping style, and body esteem to predict levels of PIU in men and women in a sample of 425 undergraduate students (46.8 percent male; mean age?=?19.0, SD?=?1.7). For men, phobic anxiety, wishful thinking, and overweight preoccupation were significant predictors of increased PIU. For women, depression, keeping to oneself, and decreased tension reduction were associated with increased PIU. The findings suggest that men and women may have different psychological reasons for excessive Internet use, including different types of psychological distress and coping styles. Unlike women, men may use the Internet because of weight concerns.     

Interpersonal Trauma and Physical Health Symptoms in College Students: Mediating Effects of Substance Use and Self-Blame

The present study examined the mediating effect of two coping mechanisms (substance use and self-blame) on the relationship between interpersonal trauma (IPT) exposure and self-reported physical health symptoms in college students. Participants included 365 trauma-exposed college students. We used multigroup structural equation modeling to test our hypothesized model and to determine whether the hypothesized relationships were moderated by gender. Results indicated that IPT exposure was associated with increased substance-use coping and self-blame. These two coping mechanisms, in turn, predicted increased physical health symptoms. The results of the moderation analysis indicated no significant gender differences in the hypothesized relationships.     

Putting the relationship between social anxiety and alcohol use into context: A daily diary investigation of drinking in response to embarrassing events

The goal of this study was to clarify mixed findings regarding the association between dispositional social anxiety and drinking among college students by using a daily diary method to examine whether a within-person social-contextual event moderated the relationship between social anxiety and alcohol use. College students (n = 476) completed a measure of dispositional social anxiety and then for 30 days reported whether they experienced an embarrassing event in public and the amount of alcohol they drank each day. We examined whether experiencing an embarrassing event moderated the relationship between dispositional social anxiety and alcohol use for same-day, same-evening, next-day, and next-evening drinking. While there was a positive relationship between dispositional social anxiety and alcohol use on evenings when an embarrassing event occurred earlier that day, this appeared to be driven by a reduction in drinking among those low in social anxiety. Individuals with high social anxiety drank in the evening regardless of embarrassing event occurrence. Results suggest that people with low social anxiety show an adaptive response to embarrassing events by lowering drinking on such evenings, while those with high social anxiety may drink to reduce their already high levels of anxiety independent of daily social events.     

Social anxiety and vulnerability for problematic drinking in college students: the moderating role of post-event processing

Socially anxious college students are at increased risk for engaging in problematic drinking (i.e. heavy or risky drinking) behaviors that are associated with the development of an alcohol use disorder. The present study examined whether post-event processing (PEP), repeatedly thinking about and evaluating one’s performance in a past social situation, strengthens the association between social anxiety and vulnerability to problematic drinking among college students. Eighty-three college drinkers with high or low social anxiety participated in a social interaction task and were exposed to a manipulation that either promoted or inhibited PEP about the social interaction. Among participants randomized to the PEP promotion condition, those with high social anxiety exhibited a greater urge to use alcohol after the social interaction and greater motivation to drink to cope with depressive symptoms over the week following the manipulation than did those with low social anxiety. These findings suggest that targeting PEP in college drinking intervention programs may improve the efficacy of such programs for socially anxious students.     

Introduction: novel therapies in developmental disabilities--hope, reason, and evidence

Complementary and alternative medicine (CAM) is used both alongside (complementary) and as a substitute for (alternative) conventional therapies. Although CAM use is reported to be high among children with typical development, reported rates for CAM use to address symptoms of children with developmental disabilities may be higher. Increased use in this population may relate to hope for amelioration of symptoms, concerns regarding side effects of conventional treatments, and a need on the part of families to participate in decision making regarding their child's care. Primary health care providers may find that the child's needs are best served when they maintain a dialogue with families to evaluate the evidence supporting novel therapies. Interventions need to be assessed in an evidence based fashion whether or not they are initially preceived as CAM. This issue of Mental Retardation and Developmental Disabilities Research Reviews contains reviews of CAM used to treat several developmental disabilities as well as some broader discussions related to the determinants of CAM use, current efforts to evaluate novel therapies, and how to consider the possibility of placebo effects.     

Active and Avoidant Coping and Coping Efficacy as Mediators of the Relation of Maternal Involvement to Depressive Symptoms among Urban Adolescents

Our study tested an extension of the social resource model in an urban sample of 129 African American and 114 European American adolescents. Maternal involvement was positively related to the use of active and avoidant coping strategies among youth of both ethnicities. Additionally, use of active coping strategies was related to greater coping efficacy, which, in turn, was associated with less depressive symptomatology. For African Americans, avoidant coping was related to greater coping efficacy, which, in turn, was associated with less depressive symptoms. For European Americans, avoidant coping was not significantly related to coping efficacy. Our findings underscore the importance of examining developmental models across ethnic/racial groups and suggest that adolescent mental health programs may benefit from culturally sensitive attention to coping beliefs and practices.     

Self-mutilation and coping strategies in a college sample

The goal of this study was to examine the use of specific coping strategies among self-mutilating college students. The self-mutilating group (n = 44) reported utilizing avoidance strategies more often than did a control group (n = 44) matched for general psychological distress but with no history of self-mutilation. In addition, female, but not male, self-mutilators endorsed using problem-solving and social support seeking strategies less often than nonmutilators. These findings suggest that coping strategies in general and avoidance-based strategies in particular may be important targets for the treatment of self-mutilative behaviors.