A biopsychosocial model for depressive symptoms following acute coronary syndromes

A partial latent structural regression analysis was used to evaluate the influence of perceived stress and coping resources on depression following acute coronary syndromes (ACS) in a sample of 113 participants (25 females and 88 males with a mean age of 57.61 years (SD = 12.63). Out of them, 55 participants were Australian born and 48 were born elsewhere, with 53 of the patients scoring in the mild to high depression range on the Beck Depression Inventory and the Cardiac Depression Scale. Perceived stress and coping resources, after controlling for age and smoking explained 89% of the variance in the latent variable depression. Higher perceived stress levels and fewer coping resources predicted higher levels of depression. Higher levels of perceived stress predicted fewer coping resources and fewer coping resources predicted higher levels of depression. There was a significant direct and indirect effect of perceived stress through coping on depression. Cognitive and physical coping resources were the best predictors of the depression construct. These results have potential implications for the treatment of depression post-ACS. In particular, cognitive and physical coping mechanisms and perceived stress reduction need to be addressed when treating depression post-ACS.     

Profiles of middle school teacher stress and coping: Concurrent and prospective correlates

This study examined the stress and coping patterns of middle school teachers. A final teacher sample of 102 and student sample of 1450 agreed to participate in the study. We conducted a latent profile analysis of the teachers' self-reported levels of stress and coping at the beginning of the school year and used the resulting profiles to predict teacher practices and student outcomes over time. Nearly all teachers were characterized by high stress and high coping (66%) or high stress and low coping (28%). Based on concurrent ratings and observations, the High Stress/Low Coping profile had higher burnout and lower self-efficacy, higher rates of observed reprimands, and higher student-reported depression in comparison to the other classes. The most adaptive profile, Low Stress/High Coping (6% of sample), had lower burnout, greater parent involvement and higher student prosocial skills in comparison to the other groups. Profiles also predicted the maintenance of most of these effects and the increase of some effects over the school year. Examining stress and coping in combination can inform efforts to improve teacher well-being and have a positive influence on student learning environments.     

Social Support and Postdeployment Coping Self-Efficacy as Predictors of Distress Among Combat Veterans

This study evaluated the indirect effect of received social support on distress severity (i.e., posttraumatic stress and depression symptom severity) among 89 combat veterans. Through integrating the social support deterioration deterrence model and the enabling hypothesis, mediating roles of perceived social support and self-efficacy specific to postdeployment adaptation were investigated. Results showed that (a) received social support and perceived social support were not related, and (b) both received and perceived social support indirectly predicted distress severity (posttraumatic stress and depression symptom severity) through postdeployment coping self-efficacy. Specifically, high received and perceived social support independently predicted high postdeployment coping self-efficacy, and high postdeployment coping self-efficacy predicted lower distress severity levels. Theory enhancement and future research needs are discussed.     

Coping with Gulf War combat stress: mediating and moderating effects

The authors examined relationships between method of coping with combat-related stress and psychological symptoms among Gulf War Army personnel (N = 1,058). Participants were surveyed on return from the Gulf region (Time 1) with the Coping Responses Inventory (R. Moos, 1990) and a measure of combat exposure. Outcomes were symptom measures of posttraumatic stress disorder (PTSD) and depression. At Time 2 (18-24 months) participants completed the same symptom measures and an index of postwar stress. Higher proportions of approach-based coping in the war zone were related to lower levels of psychological symptoms. Combat exposure moderated the effects of coping on Time 1 PTSD. Coping predicted changes in symptoms of depression but not PTSD. Combat exposure affected changes in depression through postwar stress but had a direct negative effect on PTSD.     

The Role of Coping Styles and Self-efficacy in the Development of Dysphoric Mood Among Nursing Students

Coping styles and self-efficacy have been recognized as important determinants of dysphoric mood. The objectives of this study were to determine the influence of these two factors on depression and anxiety in Japanese students. A set of questionnaires, including the Hospital Anxiety and Depression (HAD) Scale, the Coping Inventory for Stressful Situations (CISS), and the Self-efficacy Scale (SES) was distributed to 146 nursing students. Structural equation modelling was conducted to specify the relationships between measured variables. The HAD depression and anxiety scores were predicted by emotion-oriented coping. The HAD depression alone was predicted by avoidance-oriented coping. Self-efficacy scores predicted the emotion-oriented coping and HAD depression scores. Students’ dysphoric moods were influenced by emotional-oriented coping that mediated the effects of low self-efficacy, and self-efficacy also had a direct effect on depression.     

Predictors of anxiety and depression among newly diagnosed people living with HIV: A longitudinal study

This longitudinal study examined whether past resilience and internalized stigma predicted anxiety and depression among newly diagnosed Spanish-speaking people living with HIV (PLWH). We also analyzed whether coping strategies mediated this relationship. Data were collected at two time points from 119 PLWH. Approximately a third of participants had scores indicative of anxiety symptoms, the same result was found for depressive symptoms. Structural equations modeling revealed that 61% of the variance of anxiety and 48% of the variance of depression 8 months after diagnosis was explained by the proposed model, which yielded a good fit to data. Anxiety and depressive symptoms were significantly and negatively predicted by positive thinking, thinking avoidance, and past resilience, and positively predicted by self-blame. Additionally, anxiety was positively predicted by internalized stigma. Past resilience negatively predicted internalized stigma, self-blame, and thinking avoidance and it positively predicted positive thinking. Internalized stigma positively predicted self-blame. Moreover, internalized stigma had a significant indirect effect on anxiety symptoms through self-blame, and past resilience had significant indirect effects on anxiety symptoms and depressive symptoms through internalized stigma and coping. The results point to the need for clinicians and policy makers to conduct systematic assessments and implement interventions to reduce internalized stigma and train people living with HIV to identify and use certain coping behaviors.     

父母冲突、青少年应对策略及其与青少年社会适应的关系

以736名小学、初中、高中学生为被试,着重探讨了父母冲突内容、青少年应对策略和青少年社会适应之间的关系。研究发现:(1)父母冲突中指向孩子和指向父母自身的冲突普遍较少,但指向孩子的冲突显著地多于指向父母自身的冲突。指向孩子的冲突存在显著的性别和年级主效应;(2)青少年所使用的间接应对策略要显著地多于直接应对策略,直接应对和间接应对策略均存在显著的性别和年级主效应;(3)青少年的不良行为存在显著的性别主效应,学习问题、抑郁和主观幸福感存在显著的年级主效应;(4)父母冲突多的青少年和使用应对策略少的青少年出现的不良行为、学习问题和抑郁要显著地高于父母冲突少、使用应对策略多的青少年,但前者感受到的主观幸福感要显著地少于后者;(5)指向孩子的冲突和直接应对策略可以显著地预测青少年的不良行为,指向孩子和指向父母自身的冲突可以显著地预测青少年的学习问题。间接应对策略和指向父母自身的冲突可以显著地预测青少年的抑郁情绪,同时,间接应对策略可以显著地影响青少年的主观幸福感。     

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).     

Purpose in life and reasons for living as mediators of the relationship between stress,coping, and suicidal behavior

Positive psychological factors that help protect vulnerable persons from suicidal behavior are vital in understanding resiliency and suicide prevention. The purpose of the current study was to examine whether positive factors (including purpose in life, reasons for living, and coping styles) mediate the relationship between stressful life events and suicidal behaviors among 416 college student volunteers. Reasons for living inversely predicted suicidal behavior and thoughts directly as well as indirectly via an inverse relationship with depression. Purpose in life indirectly predicted suicidal behavior and thoughts via an inverse effect on depression, whereas emotion-focused coping indirectly predicted suicidal behavior and thoughts both through an effect on depression and an inverse effect on reasons for living. In addition, avoidant coping indirectly predicted suicidal behavior via a direct, positive effect on reasons for living. Reasons for living and emotion-oriented coping had the largest effects in the model. Results of this study underscore the importance of augmenting reasons for living and purpose in life among suicidal or potentially suicidal persons.     

Psychological adjustment in breast cancer: processes of emotional distress.

The process of psychological adjustment to breast cancer was examined at diagnosis and at 3- and 6-month follow-ups in a sample of 80 women with Stage I-Stage IV breast cancer. At diagnosis, symptoms of anxiety/depression were predicted by low dispositional optimism, and this path was partially mediated by use of emotion-focused disengagement coping. Younger age also was predictive of anxiety/depression symptoms at time of diagnosis, and this relationship was fully mediated by magnitude of intrusive thoughts. At 3 months, changes in anxiety/depression symptoms were predicted only by intrusive thoughts. At 6 months, low dispositional optimism reemerged as a significant predictor of changes in anxiety/depression and again was partially mediated by the use of emotion-focused disengagement coping. Independent effects for problem-focused engagement and disengagement and emotion-focused engagement coping were also found at 6 months. Implications of these data for psychosocial interventions with breast cancer patients are highlighted.     

流动儿童压力应对方式与抑郁感、社交焦虑的关系:一项追踪研究

为了探讨流动儿童压力应对方式与抑郁感、社交焦虑的变化特点及其动态关系,本研究通过整群抽样法从5所北京市公立学校和1所打工子弟学校选取1164名流动儿童,采用问卷调查的形式对其进行为期一年的追踪测查,追踪时回收有效数据680份.对前、后测均参加调查的680名被试的数据进行分析,结果发现:(1)经过一年的城市适应,流动儿童整体的积极应对增多,消极应对减少,抑郁感下降,但社交焦虑水平无明显变化;(2)流动儿童个体在压力应对、抑郁感、社交焦虑的发展上均表现出两极分化的现象,年龄越小、来京时间越短、低年级及女生流动儿童群体的发展趋势更为良好;(3)流动儿童压力应对方式与抑郁感、社交焦虑间存在相互作用的动态关系,前测压力应对方式、抑郁感、社交焦虑均能显著预测后测相应变量的水平,前后测压力应对方式对抑郁感、社交焦虑均有即时预测作用,而前测抑郁感和社交焦虑对后测压力应对方式有不同的延时性影响.     

Parent Stress and Coping: Waiting for a Child to Receive a Kidney Transplant

The current study examined the degree of parent stress and depression among mothers and fathers of children with end-stage renal disease (ESRD) listed for a kidney transplant, to determine whether demographic factors, stress, and coping would predict parent depression. Eighty-six mothers and 58 fathers of children with ESRD preparing for a kidney transplant completed standardized measures of parent stress related to the child’s chronic illness (PIP), coping style (Brief Cope), and depression (BDI-II). Information about the disease was obtained from the medical record. Maternal depression was predicted by having a lower family income, higher degree of parent stress associated with the child’s illness, and the use of avoidant coping strategies. Paternal depression was only predicted by higher parent stress. Illness related variables did not contribute significantly to the understanding of parent outcomes. Pre-transplant evaluations should screen for elevated levels of stress and depression, and develop interventions to help parents cope with their child’s renal disease.     

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.     

Probability learning and coping in dysphoria and obsessive-compulsive tendencies

The processing of stress-relevant categorical events and their contributions to subsequent probability judgments were examined among subjects who were psychometrically categorized as dysphoric, obsessive-compulsive, or “control.” stress-relevant symptomatology of depression was considered to be characterized by a deficit of active counterstress coping activity and obsessive-compulsiveness by ritualistic efforts which have little or no direct effect on stress occurrence. Subjects were presented with a sequence of stressful (loud white noise) and benign (illumination of a green light) events in association with a series of discrete stimuli (alphabetic letters) in three conditions of counterstress activity. Results generally supported the predicted tendency to learn probability information primarily in conditions which reflected the subjects' characteristic ways of responding to stress. Obsessive-compulsives acquired the information primarily in a “ritualistic” context, controls in an active coping context, and dysphorics in both a coping deficit context and unexpectedly in an active coping context. The role of enhanced stressor predicability in maintaining typical stress response patterns of the three groups was discussed.     

Stress and Health in Spanish Women1

This study examines the relationship between stress and health in a sample of 1,566 women aged between 18 and 65 years. Multiple regression analyses were conducted using the scaled version of the General Health Questionnaire (GHQ‐28) scales as the dependent variables, and 21 personal and social variables as predictors. The women with more severe depression, anxiety, and somatic and social dysfunction symptoms were those who had a more emotional coping style and greater work role dissatisfaction. Moreover, depression, anxiety, and social dysfunction symptoms were predicted by low self‐esteem, while depression, anxiety, and somatic symptoms were predicted by chronic stress. The women with more symptoms of anxiety and depression were those who have experienced more life events and have low perceived social support. Women with Type‐A behavior patterns were found to suffer more anxiety and somatic symptoms. Women who exercise more hours per week had fewer somatic symptoms, and those with a more rational coping style suffered less social dysfunction.     

Depression and Social Anxiety in Children: Differential Links with Coping Strategies

Strategies that children use for coping with stressors are known to be related to emotional adjustment, but not enough is understood about specific links with social anxiety and depression. The present investigation tested differentiated associations of social anxiety and depression with specific types of coping strategies, and evaluated the direction of these associations over time. In Study 1, 404 children aged 8–13 years completed a coping scale modified from Kochendefer-Ladd and Skinner (Developmental Psychology 38:267-278, 2002) in order to evaluate factor structure and subscale internal consistency. In Study 2, 270 8–11-year-old children completed depression and social anxiety scales, a sociometric survey, and the coping scale from Study 1, with a follow-up timepoint 9 months later. In Study 1, factor analysis revealed six internally consistent coping subscales. In Study 2, social anxiety and depression were found to have distinctive longitudinal associations with subsequent coping strategies. Decreased problem-solving, social support-seeking, and distraction were uniquely predicted by depression but not by social anxiety. Internalising coping was a stronger outcome of social anxiety, and increased externalising was uniquely predicted by depression. There was also some evidence for a moderating role of peer relations. However, none of the coping strategies predicted changes in depression or social anxiety over the two timepoints. These results highlight the impact that emotional adjustment may have on children’s coping strategies, and clarify important distinctions between social anxiety and depression in relation to coping.     

压力对大学生抑郁的影响机制:领悟社会支持与应对方式的中介作用

基于心理应激理论、素质-压力三模式以及社会支持主效果模型考察领悟社会支持、积极应对方式和消极应对方式在压力与抑郁关系中的链式中介效应,使用压力量表、领悟社会支持量表、应对方式量表和抑郁量表对抽取的641名大学生进行调查。研究显示:(1)领悟社会支持中介了压力对大学生抑郁的影响;(2)积极应对方式、消极应对方式中介了领悟社会支持对大学生抑郁的影响。因此,领悟社会支持以及应对方式在压力与大学生抑郁之间起链式中介作用。     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

Coping and psychological distress for men with substance use disorders

Coping with stress is a major focus for chemically dependent persons in relapse prevention programs. The relationships among coping and psychological distress were investigated in 71 men with substance use disorders, at both pre—and post-treatment. It was predicted that low task-oriented coping, high emotion-oriented coping, and high avoidance-oriented coping would predict psychological distress (e.g., anxiety and depression). It was also expected that use of task-oriented coping would increase following treatment and that use of emotion-oriented coping and avoidance-oriented coping, and reported levels of psychological distress would all decrease following treatment. Participants completed the Coping Inventory for Stressful Situations and the General Health Questionnaire, took part in an intensive treatment program (e.g., relaxation, drug education, stress management) and completed these questionnaires again following treatment. Results indicated that high emotion-oriented coping predicted hypochondriasis, anxiety and depression. Task-oriented and avoidance-oriented coping did not predict psychological distress, although task-oriented coping was negatively related to hypochondriasis, anxiety and depression. The results regarding change in coping styles and levels of psychological distress were as hypothesized, except that avoidance-oriented coping did not significantly change following treatment. Theoretical and practical implications of the research are discussed.     

The role of coping, anxiety, and stress in depression post-acute coronary syndrome

Depressive symptoms are common and can affect prognosis following acute coronary syndromes (ACS). This study examined the psychological factors, coping, anxiety, and perceived stress associated with depression following ACS. Psychological variables were assessed in 15 females and 66 males (M = 57 years, SD = 12). Repeated measures at 2, 12, and 24 weeks post-ACS compared depression, anxiety, perceived stress, and coping resources as determined by the Cardiac Depression Scale, Beck Depression Inventory-II, State Trait Anxiety Inventory, Perceived Stress Scale, and Coping Resources Inventory. Depression, anxiety, and perceived stress remained high in the depressed group across time. Coping scores at 2 weeks post-ACS predicted depression scores at 24 weeks post-ACS. It appears that trait anxiety and coping resources are related to depressive symptoms post-ACS.