The role of coping styles as predictors of depressive symptoms among adolescents: a prospective study

The present study prospectively explored the main and interactive effect of approach and avoidant like coping styles, as well as school-related stress on depressive symptoms in a sample of 327 (167 females, 160 males) students in two Norwegian secondary schools. The results showed that seeking parental support as a coping style served as a negative predictor of later depression, and results give some support for aggressive coping styles being a risk factor for depressive symptoms. A significant interaction between aggressive coping style and stress in relation to depressive symptoms was found. We were also able to show that school-related stress at T(1) predicted depressive symptoms at T(2).     

Protective and vulnerability factors of depression in normal adolescents

The present study investigated the role of various protective and vulnerability factors in the development of depressive symptoms. A sample of normal adolescents (N=373) completed the Children's Depression Inventory and measures of a negative attributional style, parental rearing behaviour, coping styles, and perceived self-efficacy. In addition to computing the correlations between depression and these protective and vulnerability factors, the present data were also subjected to structural equations modelling to examine the correlational structure of the data. Depression was accompanied by high levels of parental rejection, negative attributions, and passive coping, and by low levels of active coping and self-efficacy. Furthermore, a model in which negative parental rearing behaviour and a negative attributional style featured as the primary sources of depression, while coping styles and self-efficacy played a mediating role in the formation of depressive symptoms, provided a reasonable fit for the data.     

Cross-sectional and Longitudinal associations in coping strategies and physical health outcomes among HIV-Positive youth

This study assessed whether coping styles had an influence on physical health outcomes either concurrently or longitudinally in a sample of HIV-positive youth. Coping styles were characterized as positive, passive, depressive withdrawal, and escapist. A cross-sectional latent variable analysis (N = 279) assessed associations among environmental stress, self-esteem, social support, coping styles, AIDS symptoms, and CD4 count. A more restricted longitudinal analysis (N = 174) tested associations among earlier environmental stress, self-esteem, coping styles, and AIDS symptoms at follow-up. CD4 count was not associated with coping styles in the cross-sectional analysis. Concurrent AIDS symptoms were significantly predicted by depressive withdrawal and environmental stress. A passive coping style modestly predicted more AIDS symptoms longitudinally. Correlates of perceived health and well-being of persons with HIV/AIDS are important to investigate in addition to more objective measures such as CD4 count that may not be amenable to change through coping style interventions alone.     

Predictors and mediators of treatment outcome in patients with binge eating disorder

A randomized controlled trial (N=52) was conducted comparing cognitive-behavioral therapy with a waiting list control group to identify mediators and predictors of treatment outcome. Reduction of weight concerns mediated abstinence of binge eating at post-treatment. Abstinence was marginally mediated by changes in eating and shape concerns, depressive symptoms and global severity of general psychopathology. Neither treatment outcome nor status at 1-year follow-up could be predicted by severity of eating disorder, comorbid psychopathology or maladaptive core beliefs at baseline or at post-treatment. The only predictor for abstinence at both post-treatment and 1-year follow-up was the coping style palliative reacting: higher scores predicted less favorable outcomes. Lower expression of emotions at post-treatment predicted more reduction of eating disorder psychopathology at follow-up. No other patient characteristics allowing treatment-patient matching could be identified.     

Why do Women get Depressed and Men get Drunk? An Examination of Attributional Style and Coping Style in Response to Negative Life Events Among Canadian Young Adults

Gender differences in alcohol consumption and depressive symptoms are well known. This study focused on the associations of gender with attributional style, coping style, and negative life events in explaining these differences. The association of gender with each of the predictor and outcome variables was examined. One hundred eight (51 men, 57 women) undergraduate university students, ages 18–21, completed validated measures of depression, alcohol consumption, attributional style, coping style, and negative life events. Participants reported mild-moderate levels of depressive symptoms, similar to comparable samples. In contrast, alcohol consumption was lower than expected. Depressive symptoms were associated with negative events and rumination among both men and women. Pessimism and wine consumption were correlated with depression among women only. Although men consumed more alcohol than did women, a gender difference in depressive symptoms was not found. Potential implications of these findings are discussed.     

Treating an HIV/AIDS Patient’s PTSD and Medication Nonadherence With Cognitive-Behavioral Therapy: A Principle-Based Approach

HIV/AIDS patients with medication adherence problems are vulnerable to developing drug resistance, immune system degradation, and opportunistic infections. Poor adherence to antiretroviral medication regimens can be aggravated by psychiatric problems, including depression and posttraumatic stress disorder. This article presents the case study of a patient with HIV/AIDS who was unable to adhere to his antiretroviral medication regimen primarily because of PTSD and depressive symptoms resulting from a sexual assault that had caused his seroconversion. Exposure-based cognitive-behavioral therapy was instrumental in helping the patient overcome his PTSD and depressive symptoms so that he could tolerate his HIV medications. The patient’s symptom relief was evidenced by improved scores on the Impact of Event Scale and Beck Depression Inventory. The article discusses the importance of accurate assessment, therapist flexibility, and principle-based treatment versus strict adherence to manual-based protocols.     

Psychologist as Mentor and Detective in the Mirror of the Soul

A case study is presented of a client, involved in business dealings and personal relationships with members of organized crime, who upon looking into his mirror one morning recognized for the first time that his life was quickly slipping away. Unless he broke free, he decided, by doing something bold and outrageous—in the style of his free-spirited and violent youth—he was doomed to a depressive existence for the remainder of his days. He stalked women by night. Disturbed by a series of frightening dreams of his involvement in the murder of a stalked and raped woman, he approached the author for psychological help. During the course of treatment it became apparent that the client lacked a sense of personal goodness. An exploration of the problematic nature of virtue and constructive behavior in psychotherapeutic theory is presented here, together with a rationale for the role of the therapist as mentor as well as therapist for people who lack early and present experiences with constructive role models.     

Understanding depressed mood in the context of a family-oriented culture

This study examined the contribution of individual and family variables to depressive symptoms among youths in a family-centered culture. Participants were 262 Mexican adolescents (mean age = 15.9 years). At the individual level, gender (being female) and higher levels of perceived stressfulness of life events and ruminative coping style were correlated with higher frequency of depressive symptoms. At the family level, higher levels of perceived parental warmth and acceptance and parental monitoring were correlated with lower levels of depressed mood, whereas higher levels of parent-adolescent conflict were associated with greater frequency of depressive symptoms. Regression analyses confirmed our prediction that both individual factors (gender, ruminative coping) and family factors (parental warmth and parental monitoring) would make unique contributions to depressive symptoms. The model comprised of individual and family variables accounted for 50% of the variance in depressed mood. Moreover, parental warmth and acceptance attenuated the impact of ruminative coping style on adolescents' depressive symptomatology. Findings are discussed in relation to previous research on adolescents in another family-centered culture (China), and directions for future research are proposed.     

Coping with dental treatment correlates of dispositional and domain specific monitoring and blunting

Abstract

Relations between coping style and several variables on an intermediary level were studied in a group of dentally anxious patients (N = 68) awaiting dental treatment. Monitoring was found to be positively related to the need of information: General dispositional monitoring was the best predictor of the need of information in case of more distant threat, whereas domain specific monitoring was the best predictor in case of imminent threat. Furthermore. dental trait anxiety was strongly related to early anticipatory tension, degree of anticipatory tension at several moments in time, and tension during treatment as perceived by the dentist, thereby overshadowing the weaker effects of coping style. Domain specific blunting was negatively related to desires for informational adaptations in the waiting room, and to question proneness as perceived by the dentist during treatment. It is concluded that, in order to study further effects of coping style, a sample homogeneous with respect to domain specific anxiety is needed.     

Traumatische Erfahrungen und Posttraumatische Belastungsstörung bei Journalisten

A questionnaire study on work-related trauma of journalists was conducted on the internet. 61 journalists (22 women) provided information about the type and frequency of highly stressful assignments and traumatic life events, symptoms of post-traumatic stress disorder (PCL-C), depression (CES-D) and coping style (emotional competence, FAPK, 3; sense of coherence, SOC). 46% of the participants lived in the USA, 41% in Europe; their mean age was 37 years and they had an average job experience of 13 years. They reported an average of 81 assignments in which they had been confronted with seriously injured, dying or dead persons or had worked at the risk of their own life. 13% had developed a full and 15% a partial post-traumatic stress disorder (PTSD). Compared to less disturbed individuals, the participants with (full or partial) PTSD reported significantly more often about violence in their original families, depressive symptoms and deficiencies in their emotional competence.     

Suicide and African American teenagers: risk factors and coping mechanisms

In this study we investigated whether locus of control, hopelessness, and depression were primary risk factors for suicide ideation and attempts in African American youth, and whether congruency between locus of control and religious coping style reduced suicide risk. The sample consisted of 176 African American high school students (115 females; 61 males). Multiple and logistic regression were used to determine relationships among study variables. Depression was found to mediate the relationship between hopelessness and suicidal behaviors. External locus of control led to greater risk for hopelessness and depression, with a trend in the predicted direction for suicide attempts. Religious coping style alone was not always associated with reduction of risk of suicidal behaviors, yet some evidence suggests that congruency between locus of control and religious coping style reduces risk. Results provide additional support for suicide interventions to target depressive symptoms. Results also highlight the importance of examining the role of culturally salient variables such as fatalism and religious coping style when developing intervention programs for suicide.     

The role of spousal relationships in fibromyalgia patients’ quality of life

Fibromyalgia (FM) is a chronic pain syndrome that includes debilitating symptoms such as widespread pain and tenderness, fatigue, and poor physical functioning. Research has shown FM patients’ choice of coping style and relationship quality with their spouse can impact their mental quality of life (QoL), but no known study has examined the protective nature of relationship quality and coping behaviors on both patient physical and mental QoL in the context of chronic pain. We examined 204 patients with FM on the (a) roles of coping styles and relationship quality on patient quality of life, and (b) moderating effect of relationship quality on the association between negative coping style and patient QoL. A series of multiple regressions found patients’ coping styles were not significantly associated with physical QoL, but were significantly associated with mental QoL. Patients’ relationship quality with their spouse was significantly associated with mental QoL, but not physical QoL and no significant interactions with negative coping style were found. Our results emphasize the importance of coping styles and relationship quality between patients and their spouses in the context of chronic pain. Clinicians can incorporate the patient’s relationship as part of a more holistic approach to care and improving outcomes.     

Relationship Between Religious Coping and Suicidal Behaviors Among African American Adolescents

This study investigated whether hopelessness and depression were risk factors for suicidal thoughts and behaviors in African American adolescents and looked at whether religious participation and religious coping protected these students from suicidality. Participants were 212 African American high school students (133 females, 79 males). The results of multiple and logistic regression analyses found that hopelessness and depression were risk factors for suicidal ideation and attempts. Religious coping style was significantly related to suicidal behaviors: Self-directed coping was related to increased hopelessness, depression, and suicide attempts, and collaborative coping was related to increased reasons for living. Gender differences were found in symptoms of depression, religious coping style and religious participation. Results provide additional support for suicide interventions to target hopelessness and depressive symptoms and highlight the importance of examining the role of culturally salient variables, such as religious participation and religious coping style, when developing intervention programs for suicide.     

The distribution of repressive coping styles among non-metastatic and metastatic breast cancer patients as compared to non-cancer patients

Abstract

Recent investigations have shown increased disease progression among breast cancer patients with a “repressive” coping style characterized as: passive, conforming, inclined to deny physical symptoms and emotionally unexpressive. The Millon Behavioral Health Inventory (MBHI) scales which delineate three discrete repressive coping styles include the: Introversive, Cooperative and Respectful. Forty-four women recently diagnosed (within four weeks) with non-metastatic (N=32) or metastatic (N=12) breast carcinoma, responded to the MBHI upon admission for treatment of their disease at a cancer treatment unit. All subjects received mastectomy as well as chemotherapy, radiation and/or endocrine therapy. These 44 Cancer patients were compared to 34 control subjects, comprising women who were seen at a colposcopy clinic for follow-up of a suspicious pap smear which was ultimately shown to be benign or consisted of mild dysplasia. Non-metastatic, metastatic and control subjects were compared with respect to coping style and psychological distress. The breast cancer patients were more likely to employ a repressive coping style as compared to non-cancer patients who utilized a “sensitizing” coping strategy predominantly. Cancer patients with the most severe prognosis (metastasis) were the only group within the study to attain a clinically significant mean base rate score on the respectful scale. Results suggest that the incidence of repressive coping styles may be disproportionately high among breast cancer patients.     

Cognitive-Behavioral Treatment of Depression with Comorbid Borderline Personality Traits

Personality dysfunction can influence the onset and maintenance of depressive symptoms. When both depression and personality dysfunction are present, it is important to develop an integrated treatment plan that addresses both conditions. A case example is used to illustrate how features of borderline personality disorder can influence the assessment and treatment of major depression. Specific challenges encountered by the therapist include: 1) differentiating borderline personality from depressive symptoms, 2) maintaining the therapeutic alliance, 3) managing impulsivity and self-destructive tendencies, 4) staying focused on long-term therapeutic goals, and 5) coping with noncompliance. Over the course of 27 sessions, the client was able to make positive changes in mood, self-image, and impulsive tendencies. Although the client's borderline personality traits complicated the course of treatment for depression, neglecting these personality problems would have left the client vulnerable to depressive relapse.     

Generalized expectancies for negative mood regulation predict change in anxiety and depression among college students

Negative mood regulation (NMR) expectancies, or the beliefs held by individuals that, when faced with various manifestations of stress and negative affect, they can successfully cope with such mood states, have proven to be a most useful construct in the context of better understanding self-regulatory processes. In the present prospective study, we examined the predictive utility of NMR expectancies with respect to its ability to predict residual change in both depressive and anxiety symptoms over an 8-week timeframe in a sample of 322 college students. Initial correlational analyses revealed that, as anticipated, NMR expectancies were negatively correlated with depressive and anxiety symptomatology, as well as with maladaptive coping style. Conversely, NMR expectancies were positively associated with self-reported adaptive coping. A series of hierarchical regression analyses revealed that, even when controlling for age, sex, baseline levels of affective distress (depression or anxiety), and coping styles, NMR expectancies predicted change in both depressive and anxiety symptomatology. Implications of the findings pertinent to theory building and testing are discussed.     

Psychological, cognitive, and interpersonal correlates of attributional change in adolescents

Examined the role of attributional style in adolescent's psychological functioning. Specifically, we examined the cross-sectional correlates of attributional style, as well as the correlates of changes in attributional style over time. A sample of 841 adolescents with either maladaptive or adaptive attributional styles completed a battery of self-report measures at 2 points in time, 1 year apart. Measures assessed depressive symptoms and suicidality, cognitive functioning (self-esteem, pessimism, coping skills), and interpersonal functioning (social competence, conflict with parents, social support from family and friends). Results indicated that attributional style is associated with multiple depression-related variables. In addition, youth experienced significant changes in their attributional styles over time (from adaptive to maladaptive and vice versa). Finally, changes in attributional style were associated with changes in psychological symptoms and other psychosocial variables. Results are discussed in terms of their implications for the prevention and treatment of adolescent depression.     

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.