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.     

Employee adjustment to stress: The role of coping resources, situational factors, and coping responses

Abstract The present study was designed to examine further the stress-adjustment relationship in employees. Specifically, the relations among employees' coping resources (self-esteem, generalized control beliefs, neuroticism, and social support), their appraisals of a recent stressful event experienced at work (appraised stress, self-efficacy, and situational control beliefs), the coping strategies (problem- and emotion-focused coping) used to deal with the event, and levels of employee adjustment (psychological well-being and job satisfaction) were examined. Data were collected from 153 male and female employees in a public sector department, employed in a range of middle-management administrative activities. The data provided support for a modified version of a model that proposed that both situational appraisals and coping strategies are mediating processes in the stress-adjustment relationship. There was evidence that employees' coping responses to the recent stressful event experienced at work were related to concurrent levels of adjustment. As predicted, the use of problem-focused coping, in general, had positive relationships with the measures of adjustment, whereas the effects of emotion-focused coping were generally negative (there was, however, some evidence that the effects of coping were dependent on event controllability). There was also evidence that coping resources had both direct and indirect effects (via coping and via situational appraisals) on employee adjustment. The latter effects were most marked for generalized control beliefs and self-esteem. Situational appraisals (in particular, efficacy expectancies) also had indirect effects on employee adjustment, through their effects on coping responses.     

Coping strategies of mother carers of children living with chronic illness and disease in a rural South African community

The present study explored the coping strategies used by mother carers of children living with chronic illness and disease (CID) in a rural South African community. Ten mothers (age range = 30 to 56 years) were selected through snowball sampling to participate in the present study. They provided care to their children, a majority (50%) of whom had epilepsy, followed by asthma (20%) and other conditions. Data on the coping strategies used by mothers of children living with CID were collected using semi-structured interviews and analysed thematically. The results showed that mother carers tended to use three types of coping strategies, namely: appraisal-focused, problem-focused and emotion-focused strategies. Appraisal-focused was commonly used by mother carers whose children had epilepsy, whilst mother carers of children with asthma tended to use problem-focused coping strategies. All mother carers were found to use emotion-focused strategies to varying degrees in coping with the chronic diseases of their children.     

The effectiveness of expatriate coping strategies: the moderating role of cultural distance, position level, and time on the international assignment

On the basis of the stress and coping literature, the authors examined the diverse coping strategies used by expatriate managers in response to the problems encountered while on international assignments. It was hypothesized that although problem-focused coping strategies may be more effective than are emotion-focused coping strategies in affecting cross-cultural adjustment and intention to remain on the international assignment, the relationship is moderated by contextual factors such as hierarchical level in the organization, time on the assignment, and cultural distance. Coded semistructured interview responses from 116 German expatriates on assignment in either Japan or the United States were analyzed with moderated regression analyses. The results suggest that the effectiveness of problem-focused coping strategies in predicting cross-cultural adjustment is moderated by cultural distance and position level but not by time on the assignment. The use of problem-focused coping strategies was not related to expatriates' intention to remain on the assignment.     

The Role of Family Processes and Coping Strategies in the Relationship Between Parental Chronic Illness and Childhood Internalizing Problems

Sixty-nine families (father, mother, and one child) in which the father had hemophilia, approximately half of whom were HIV positive, were assessed in an examination of the relationship between parental chronic illness, family functioning, child coping strategies, and child adjustment. Latent variable path analyses with partial least-squares estimation procedures (PLS) were used to test a model of the relationship between parental chronic illness, family process variables, child coping strategies, and child internalizing behavior problems. The severity of the father's illness predicted family process variables, which predicted the coping style of the child. The use of more avoidant coping strategies was associated with more internalizing problems.     

Do allogeneic bone marrow transplant candidates match coping to controllability of pre-treatment stressors?

According to the Person x Situation theoretical framework, people adjust their coping to address the unique challenges of encountered stressors. Whether their strategies fit or appropriately address these stressor challenges influences adjustment. We examined the fit between pre-treatment stressors reported by hematological cancer patients awaiting allogeneic bone marrow transplantation (alloBMT) and their coping responses. Stressors were categorized as controllable versus uncontrollable; coping responses were categorized as problem- versus emotion-focused versus mixed (i.e., elements of both coping types). We hypothesized that patients would employ coping responses that fit the controllability of stressors (i.e., a match between stressor and coping response): problem-focused coping for controllable stressors and emotion-focused coping for uncontrollable stressors. In qualitative interviews, pre-BMT patients (10 men, 7 women) described encountered stressors and how they coped with them. Every reported stressor was linked with its associated coping response, resulting in a stressor-coping pair. We determined the proportion of total stressor-coping pairs in which the coping response matched the controllability of its linked stressor. Most stressor-coping pairs involving uncontrollable stressors showed the hypothesized match with emotion-focused or mixed coping. Contrary to hypotheses, fewer stressor-coping pairs that involved controllable stressors matched with problem-focused or mixed coping. Rather, these pairs were more likely to link controllable stressors with emotion-focused coping (i.e., mismatch between stressor controllability and type of coping). AlloBMT candidates may appraise the pre-treatment stage, globally, as permitting very little control. Coping efforts may consequently emphasize regulation of negative emotions (i.e., emotion-focused coping).     

Dispositional and situational coping and mental health among Palestinian political ex-prisoners

We examined, first, differences in dispositional and situational coping, and psychological distress between political ex-prisoners and their matched controls, and second, coping effectiveness in protecting mental health from impacts of imprisonment and military trauma. Thirdly, we tested the hypothesis that compatibility ("goodness of fit") between dispositional and situational coping would predict low psychological distress. Participants were 184 men recruited from a Palestinian community sample, 92 were former political prisoners and 92 non-prisoners. The dispositional coping was assessed as a general response style to hypothetical stressors and situational coping as responses to their own traumatic experiences. Psychological distress was measured by SCL-90-R, and posttraumatic stress disorder, depression and somatoform symptoms by scales based on CIDI 2.1 diagnostic interview. The results showed that, compared to non-prisoners, the political ex-prisoners employed less avoidant, denying, and emotion-focused coping strategies. Military trauma was associated with avoidant and denying coping only among non-prisoners. The ex-prisoners showed more mental health and medical problems, especially when exposed to military trauma. None of the coping styles or strategies were effective in protecting the mental health in general or in either groups. However, main effect results revealed that the high level of active and constructive and low level of emotion-focused coping were associated with low levels of psychiatric symptoms and psychological distress.     

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.     

Mind over matter: cognitive - behavioral determinants of emotional distress in multiple sclerosis patients

Given the high incidence and unique symptomatology of depression in multiple sclerosis (MS) patients, the current study examined the role of cognitive and behavioral variables in predicting psychosocial adjustment in this population, in order to suggest psychotherapeutic interventions tailored specifically to MS patients. Data from 329 MS patients indicated that problem solving coping, acceptance coping, and challenge appraisals were associated with positive psychological adjustment (i.e., high life satisfaction, low depression and anxiety), whereas variables measuring disease severity (i.e., illness duration, subjective health status, and self-reported disability) were not associated with adjustment. These findings suggest that MS patients' psychological outcomes are more related to controllable cognitive and behavioral factors than to the physical effects of the disease. Consequently, it is expected that interventions that target these specific coping strategies and cognitive appraisals will be effective in treating the emotional effects of MS.     

MARITAL SATISFACTION AMONG MOTHERS OF INFANTS WITH CONGENITAL HEART DISEASE: THE CONTRIBUTION OF ILLNESS SEVERITY,ATTACHMENT STYLE,AND THE COPING PROCESS

This study examined the contribution of illness severity and attachment style to marital satisfaction among mothers of infants with Congenital Heart Disease (CHD) as well as the mediating role of cognitive appraisal and ways of coping with motherhood tasks. Eighty-five mothers of newborns with CHD rated their attachment style 2 weeks after the infant's CHD diagnosis and two physicians rated the severity of the disease. One year later, mothers completed self-reports scales tapping marital satisfaction, appraisal of motherhood tasks, and ways of coping with these tasks. The severity of infant's disease and mothers’ attachment anxiety and attachment avoidance were related to less marital satisfaction. Moreover, whereas illness severity and attachment anxiety had direct effects on marital satisfaction, the negative effects of attachment avoidance were mediated by the appraisal of motherhood in threatening terms and the reliance on emotion-focused coping. The interconnections between attachment style, the process of coping with the stress of a chronic illness, and marital satisfaction were discussed.     

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

Abstract

The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.     

Impact of emotional approach coping and hope on PTSD and depression symptoms in a trauma exposed sample of Veterans receiving outpatient VA mental health care services

The present investigation evaluates the relationship between coping style, dispositional hope, and posttraumatic stress disorder (PTSD) and depression symptom severity in a trauma-exposed Veteran sample. Specifically, we evaluated the adaptive value of emotional avoidant and approach coping strategies and perceptions of hope in a sample of 209 trauma-exposed Veterans receiving outpatient mental health care at a VA facility. Participants completed a life events questionnaire and inventories assessing coping, dispositional hope, and PTSD and depression symptom severity. Hierarchical regression analyses were conducted controlling for relevant demographic variables. Greater levels of emotional avoidance and lower levels of emotional expression were significantly associated with increased PTSD and depression symptom severity. Dispositional hope was positively associated with depression symptoms only and perceptions of hope moderated the association between emotional avoidance coping and depression symptoms. Findings highlight the value of emotional coping strategies and perceptions of hope in posttraumatic adjustment. Specifically, employing coping techniques that encourage emotional expression may promote improved adjustment among trauma-exposed individuals, while reduced perceptions of hope and the use of avoidant coping strategies may place individuals at greater risk for depression following exposure to traumatic events.     

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.     

Illness Perceptions,Coping, Benefit Finding,and Adjustment in Individuals with Hepatitis C

Objective

To investigate the ability of illness perceptions, adaptive, and maladaptive coping strategies, and benefit finding to predict physical and psychosocial adjustment among individuals diagnosed with the hepatitis C virus (HCV), within an expanded self‐regulatory model of illness (SRM).

Method

A total of 126 participants with HCV completed an online questionnaire assessing illness perceptions, coping, benefit finding, and four adjustment outcomes, depression, physical functioning, life satisfaction and positive affect.

Results

Illness perceptions made significant contributions to the variance in adjustment outcomes across the four psychosocial and physical adjustment areas. At an individual level, personal control, identification with HCV symptoms, perceptions related to illness duration, illness coherence, and emotional responses to HCV made significant contributions to the prediction of adjustment. Similarly, the combined contributions of adaptive and maladaptive coping strategies explained significant variance across the four adjustment areas. Greater adoption of maladaptive coping strategies predicted poorer physical health, higher reported depression, greater life satisfaction, and positive affect outcomes, while increased engagement with adoptive coping strategies predicted higher positive affect. Increased benefit finding predicted greater positive affect, life satisfaction, and higher depression.

Conclusion

Results demonstrate the ability of the SRM features of illness perceptions and coping, and benefit finding to predict physical and psychosocial adjustment outcomes within the context of HCV.     

Impact of symptoms and aging attribution on emotions and coping

Two experimental studies and a large field study were designed to examine how symptom severity, symptom duration, symptom ambiguity, and the association of symptoms with aging affected emotional responses and coping with illness threats. In Study 1, 280 respondents from the surrounding community reported the emotional and coping responses they would manifest to scenarios that varied the severity, duration, and ambiguity (i.e., labeled vs. unlabeled) of a common set of symptoms. Severity had more of an impact on coping strategies than did duration or illness label; severe symptoms elicited stronger emotional upset and a higher incidence of both self-care behaviors and seeking of medical care. Symptoms of longer duration also resulted in increased seeking of medical care. Responses of the 334 adults participating in Study 2 replicated and extended these findings: A closed-ended item asking participants whether the symptoms could be attributed to aging showed that attribution of symptoms to aging increased with age, was more frequent for mild symptoms, and was associated with reduced emotional response to symptoms and a tendency to delay seeking treatment. Participants in the field study (168 patients seeking medical care for a variety of symptoms) completed interviews tracing symptom processing and emotional and coping reactions. The results provided evidence for the external validity of the scenario studies, as the attribution of symptoms to aging was greater for older than younger patients and resulted in a significant tendency to delay seeking medical care. Results of these studies suggest that symptom experience and symptom interpretation must be considered in the study of coping responses to illness threats.     

Emotional intelligence, personality, and task-induced stress

Emotional intelligence (EI) may predict stress responses and coping strategies in a variety of applied settings. This study compares EI and the personality factors of the Five Factor Model (FFM) as predictors of task-induced stress responses. Participants (N = 200) were randomly assigned to 1 of 4 task conditions, 3 of which were designed to be stressful. Results confirmed that low EI was related to worry states and avoidance coping, even with the FFM statistically controlled. However, EI was not specifically related to task-induced changes in stress state. Results also confirmed that Neuroticism related to distress, worry, and emotion-focused coping, and Conscientiousness predicted use of task-focused coping. The applied utility of EI and personality measures is discussed.     

Sex differences in relationships among anger, depression, and coping strategies of Japanese students

This study investigated sex differences in the relationships among an ger, depression, and coping strategies. Undergraduate students, 77 men and 130 women, 3 not identified by sex, voluntarily participated. Participants made ratings on a self-report about anger, depression, coping strategies, and mental health. Analyses showed that women who reported themselves as angry tended to cope with stress by optimistic and active strategies, while women who reported themselves as depressed tended to cope with stress by withdrawn and passive strategies. Men who reported being depressed tended to select emotion-focused cognitive coping, while men who reported being angry selected no specific coping. Adoption of engaged emotion focused coping strategies were related to mental health only for women.     

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.