Coping with Genetic Risk: Living with Huntington Disease (HD)

Rapid developments in genetics suggest that more and more people will be identified ‘at risk’ for common illnesses. Genetic discoveries have the potential to improve disease outcomes, but they also highlight gaps in our knowledge about patient-level factors such as how individuals respond to a genetic threat to their health and how they cope with that threat. There have been few empirical applications of psychological theories to understand genetic testing decisions and outcomes, although there have been calls for this approach. Drawing upon interviews with individuals at risk for (or with) Huntington disease (HD), this study adopts a stress and coping framework to explore how people cope with genetic illness in the family. Qualitative data analyses revealed that coping strategies were dynamic and varied but could be classified as 1) primary control coping, 2) secondary control coping and 3) social comparison strategies. Important distinctions were observed in coping strategies among those who had undergone genetic testing and received a test result, those who remained at risk, and those affected with HD, along with their caregivers. Implications for clinical practice and genetics health services are discussed.     

Dyadic Coping Among Couples with COPD: A Pilot Study

COPD (chronic obstructive pulmonary disease) is associated with psychological distress for patients as well as their partners. Dyadic coping can be negatively impacted by stressors. This study's objective was to compare the dyadic coping of couples in which one partner suffered from COPD with healthy couples of the same age. A total of 43 complete couples with COPD and 138 healthy couples participated in this pilot study. The surveys were sent by mail. The response rate of the COPD sample was 24.3%. In order to analyze the effect of gender and role (patient vs. partner) on dyadic coping, linear mixed models were calculated. To analyze the effect of gender and group (COPD group vs. normative comparison group) on dyadic coping, two-way analyses of variance were calculated for independent samples. COPD patients and their partners indicated that the patients received more support and were less able to provide support to their partners. This difference was also evident in comparison with the normative comparison group. In addition, couples with COPD perceived higher levels of negative coping and provided a considerably lower assessment of their positive dyadic coping. The dyadic coping of couples with COPD is unbalanced and more negative when compared to that of healthy couples. Interventions aimed at supporting COPD couples should seek to improve couples' dyadic coping in addition to individual coping strategies.     

Unemployment among women with multiple sclerosis: the role of coping and perceived stress and support in the workplace

Unemployment is high among individuals with multiple sclerosis (MS). Certain disease variables and demographics have been found to distinguish employed and unemployed individuals. However, these variables only account for 14–20% of the variance. Other factors, such as coping, perceived stress and social support, in the workforce have been proposed, but not yet fully examined. The purpose of the present investigation was to examine the role of known factors associated with unemployment in MS, as well as coping and perceived work stress and social support. Sixty-eight women with MS were asked about their employment status and reasons for leaving. They completed a comprehensive assessment including measures of cognition, disease symptoms, psychological functioning, coping and stress. Consistent with previous findings, certain disease and demographic variables were associated with being unemployed. In particular, women who left work due to their MS were found to be older, had a longer disease duration and progressive course, reported greater disability and fatigue, and performed worse on a cognitive measure. However, we also found that coping style distinguished those who were employed from those who left work due to their MS. In particular, those who left work reported utilizing maladaptive coping mechanisms such as behavioral disengagement and substance use. With regard to perceived work stress and support, individuals who were employed reported that job security and fellow co-workers were more of an uplift than a hassle in their lives, suggesting some benefit in employment. These findings suggest that further consideration be given to role of coping and perception of the benefit of employment among individuals with MS when making recommendations regarding work decisions.     

Perceived dyadic coping,anxiety, depression and satisfaction with life of women diagnosed with fibromyalgia

Women diagnosed with fibromyalgia face a wide range of challenges impacting multiple aspects of their lives, such as their relationship with their partner. This study aims to examine how women diagnosed with fibromyalgia manage stress in their own couple and to investigate the role of dyadic coping in anxiety and depression symptoms, and in life satisfaction. Seventy-three women diagnosed with fibromyalgia and 73 matched women filled questionnaires to examine dyadic coping, anxiety and depression symptoms, and life satisfaction. Results show that women diagnosed with fibromyalgia perceived themselves and their partner as using more negative dyadic coping, more delegated dyadic coping and less common dyadic coping. Moreover, negative dyadic coping predicted higher anxiety symptoms and poorer life satisfaction. Overall, our findings highlight the importance of dyadic stress management in understanding psychological adjustment better in women diagnosed with fibromyalgia and the need to develop better-adapted interventions to support them effectively.     

Participation and Attrition in a Coping Skills Intervention for Adolescent Girls with Inflammatory Bowel Disease

The current study examined factors associated with adolescent and parent participation in a coping skills intervention for adolescent girls with inflammatory bowel disease (IBD) and examined factors associated with attrition related to intermittent missing data. Thirty-one adolescent girls with IBD and their parents enrolled in the intervention. Psychosocial and disease factors related to participation in the 6-week web component of the coping skills intervention were examined as were baseline group differences between those who provided post-treatment data and those who did not. Adolescents experiencing more difficulties related to their disease and psychosocial functioning participated less in the web component of the treatment intervention. Families who attrited had higher baseline levels of parental catastrophic thoughts, parenting stress, and adolescent depression. Families experiencing greater levels of psychological and disease-related difficulties may be at risk for low participation and eventual dropout from pediatric IBD psychological treatment interventions.     

Fathers' parenting hassles and coping: associations with emotional expressiveness and their sons' socioemotional competence

The present study examined fathers' daily parenting hassles and coping strategies to (a) determine their association with fathers' emotional expressiveness and (b) predict their sons' development of socioemotional competence. Fathers of 148 preschool‐aged boys reported on their parenting hassles, coping strategies, and emotional expressiveness; mothers also reported on fathers' emotional expressiveness; and teachers reported on boys' socioemotional competence. Parenting hassles were associated with less rational, more emotional, and more avoidance coping as well as negative emotional expressiveness. More emotional and less rational coping responses were related to more negative expressiveness, whereas more rational, more emotional, and less coping were related to more positive expressiveness. Fathers' negative expressiveness was predictive of their sons being rated as more aggressive and disruptive by their teachers. In addition, fathers' parenting hassles and coping both predicted teacher ratings of their sons' aggressiveness. Implications of the findings are discussed. Copyright © 2007 John Wiley & Sons, Ltd.     

Adaptive Tasks in Multiple Sclerosis: Development of an Instrument to Identify the Focus of Patients' Coping Efforts

Objective : Adaptive tasks, referring to the subjective evaluation of disease-related stressors in relation to personal concerns, have been neglected in the extensive literature on coping with chronic disease. In this study, the development of an instrument for measuring adaptive tasks is described: the Questionnaire Adaptive Tasks in Multiple Sclerosis (QuAT-MS). Method : The QuAT-MS is based on a bottom-up categorization of patients' statements on the losses, threats, and challenges brought about by their disease, and employs 10 scales to measure the importance attached to particular disease-related stressors. Validity and reliability of this bottom-up categorization were established in a sample of MS patients ( N = 259) by examining their associations with related concepts relevant in adaptation to disease, such as coping (CISS), coping resources (LOT, self-efficacy), and quality of life (SIP). We also investigated whether patients' backgrounds and disease characteristics were related to adaptive tasks. Results : Adaptive tasks are more closely related with concepts relevant for adaptation (coping and coping resources) than with physical functioning (SIP) and disease-related characteristics (illness duration). Adaptive tasks are also associated with gender and level of education. Conclusion : It is concluded that adaptive tasks can be distinguished from related concepts like coping and quality of life. Furthermore, the QuAT-MS offers a reliable and patient-centred instrument for measuring the tasks which MS patients identify in their adaptation process.     

Coping with Work:

African-American women, who have faced the "double jeopardy" (Beale, 1970) of racism and sexism in the workforce, have had to develop coping strategies to enable their survival. African-Americans appear to use more diverse coping strategies than Caucasians (Barbarin, 1983; Gibson, 1982; Ramseur, 1989), as well as a more varied pool of informal helpers in their social networks and more flexible responses to stress (Gibson, 1982). Career counselors working with African-American women should be aware of decision-making factors other than individual preference, such as cultural norms and coping strategies necessary to survive in a discriminatory work environment. This paper examines the relationship between coping strategies used by African-American women and workplace realities, and makes recommendations for culturally sensitive career interventions with African-American women clients.     

Family Functioning and Coping Behaviors in Parents of Children with Autism

We analyzed family dynamics and coping behaviors of parents with a child with an autistic spectrum disorder. Previous research suggests that moderate levels of cohesion and adaptability are associated with higher levels of positive coping, and that the more coping strategies a family implements, the greater their satisfaction with family functioning. Using a family systems approach, the relationships among the familial variables of cohesion, adaptability, and social support were evaluated for their contributions to coping in the family unit. We also compared the responses of mothers and fathers. Surprisingly, for these parents of children with autism, those who rated their family as enmeshed implemented more positive coping strategies than did those from other cohesion styles. This finding suggests that the enmeshed style may be more adaptive for a family that encounters extreme challenges. Notably, mothers and fathers agreed on all variables except for perception of social support from family and friends. Mothers perceived more social support from family and friends. The results lead to several interesting suggestions for future research.     

Mothers' and fathers' coping with chronic childhood disease

Abstract

Mothers and fathers with a child with diabetes, asthma, cardiac conditions, epilepsy or leukaemia completed questionnaires to investigate their appraisal of disease-related difficulties and patterns of coping. There were differences both in appraised difficulties and coping patterns as a function of diagnostic group. In general, mothers who perceived more difficulties reported that it was helpful to cope by gaining disease-related knowledge. Fathers who perceived more difficulties reported it was more helpful to adopt strategies to enhance their own personal autonomy. Fathers who perceived more difficulties also reported that contact with medical staff was less helpful. Implications are discussed in terms of the differential implications of coping with chronic childhood diseases for mothers and fathers. Theoretical models need to take into account the differential demands of specific diseases in accounting for parents' stress appraisal and coping patterns.     

Racial and body image differences in coping for women diagnosed with breast cancer.

Although more White women develop breast cancer, African American women more frequently die of the disease (American Cancer Society, 2003). Despite higher morbidity among African American women, few studies have included racially diverse samples. The purposes of this study were to explore racial and body image differences in coping and self-efficacy in coping and racial differences in body image perceptions among breast cancer patients. The 92 participants ranged in age from 28 to 86 years (M=57.64, SD=12.48). Participants with higher body image perceptions had significantly higher self-efficacy in coping compared with participants with lower body image perceptions. There were no significant racial or ethnic differences in coping, self-efficacy in coping, or body image perceptions.     

Gender differences in the effectiveness of coping with dysphoria: A longitudinal study

This study examined whether men use more eflective means of coping with dysphoria on their own than do women. Forty-four male and female college students who reported feeling dysphoric were evaluated on their coping styles at three intervals in a six and a half week time span. The findings suggest that men and women do not use significantly different appraisal and coping techniques. For both sexes, problem-focused coping was associated with less dysphoria over time, whereas emotion-focused coping was associated with more dysphoria over time. Keeping anger in was associated with more dysphoria over time for women. In addition, the way in which the situation was appraised influenced the level of dysphoria over time for both sexes.     

Chinese teachers’ use of humour in coping with stress

The purpose of this study was to examine the mentality of Chinese teachers regarding their use of humour in coping with stress. Specifically, the study investigated their frequency of use of humour in coping with stress as compared to other coping styles and their perceptions about the relationship of humour with other coping styles. Data were collected from a sample of 789 Chinese teachers holding teaching posts at local Hong Kong secondary schools. Based on responses made to the COPE questionnaire, there was evidence that Chinese teachers had a lower frequency of use of humour as compared to other coping styles. As suggested by the results of a factor analysis, there was a perception among Chinese teachers that the use of humour was related more closely to escaping and/or avoidance as coping strategies, but more differentiable from problem‐focused/task‐oriented and emotional/social coping. It is interesting to find that the results of our study echoed those of a previous crosscultural comparison between Chinese and Canadian university students, in which the Chinese university students reported less use of humour in coping with stress than did their Canadian counterparts. These results have provided some empirical support for the notion that “humor has been traditionally given little respect in Chinese culture mainly due to the Confucian emphasis on keeping proper manners in social interactions” (Yue, 2010, p. 403). As teachers in Chinese societies are regarded as persons who are full of wisdom and capable of problem‐solving, it is expected that they should act as role models to their students. These social expectations on Chinese teachers could further mould their perceptions on the use of humour in coping with stress.     

An investigation of adult attachment and coping with exam-related stress

Students differ in how they cope with and manage stress associated with university life. This study investigates associations between adult attachment and coping strategies for exam-related stress. Fifty-seven students at a university in the north of England completed online questionnaires to assess attachment anxiety and avoidance, helpful and unhelpful coping strategies, and positive and negative affect. We found that students who were more avoidant in their attachment relationships were less likely to report using helpful problem-focused and emotion-focused strategies to cope with their exams. We also found that students who were more anxious in their attachment relationships reported using more dysfunctional coping strategies. We discuss the implications of the findings for university pastoral care and academic support systems.     

Religious orientation and coping with cancer

In this study we investigated the role of religious orientation in coping with stresses associated with cancer. A measure of daily coping and the Religious Orientation scale were administered to forty hematology-oncology patients in order to examine frequency of eight coping responses across religious orientations. It was found that proreligious and intrinsic participants used religion significantly more often than nonreligious and extrinsic types to cope with stresses associated with their cancer. We concluded that religious orientation and commitment influence the coping process, and suggest that religious commitment be included in studies of coping with cancer.     

Making the Best of a Bad Situation: Proactive Coping with Racial Discrimination

Proactive coping with racial discrimination takes three forms: self-focused coping, situation-focused coping, and avoidance. Overall, African Americans used self-focused coping more than situation-focused coping or physical avoidance, though there were interesting differences between retrospective recall of racial discrimination and daily reports. Relative to reports during the diary week, when recalling how they typically dealt with racial discrimination, African Americans overestimated their use of situation-focused strategies and underestimated their use of self-focused strategies. For both retrospective and daily reports, proactive coping was positively related to primary appraisals of harm but unrelated to secondary appraisals of resources. African American identification, but not stigma consciousness or optimism, was uniquely associated with proactive coping. We discuss the potential benefits and limitations of proactive coping with racial discrimination.     

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.     

Self-appraisal and coping in out-patients with chronic disease

Self-appraisal, coping efforts, muscle function, and activity and severity of disease were examined in out-patients with rheumatoid arthritis, osteoarthrosis or diabetes mellitus. Factor analysis of a 31-item self-appraisal and coping questionnaire yielded eight factors (self-appraisal, acceptance, minimization, planful problem-solving, avoidance, persistence, attribution of responsibility, and support seeking). For the factors of avoidance, minimization, and persistence, as well as for measures of activity and severity of disease, significant differences between the diagnostic groups were found. For patients with rheumatic arthritis, hierarchical regression analysis indicated disease duration to be associated with acceptance and with attribution of responsibility, and disability measures to be associated with self-appraisal. For patients with osteoarthrosis, they showed disability in muscle function to be associated with avoidance, and more negative self-appraisal as well as lower levels of support seeking to be associated with long disease duration. Results are discussed in terms of structural and adaptive defence forms and of adherence to a coping model ("medical model") which tends to foster acceptance and dependency.     

Illness perceptions and coping explain well-being in patients with Huntington's disease

This study sought to investigate the contribution of illness perceptions and coping mechanisms to the explanation of well-being of patients with Huntington's disease (HD). We investigated the Leventhal et al. assumption of the Self-regulation Model that coping mediates the relationship between illness perceptions and patients’ well-being. Illness perceptions, coping, and well-being in 77 HD patients were assessed with validated questionnaires; motor performance and cognitive performance were assessed with Huntington's disease-specific measures. The assumption that illness perceptions influence HD patients’ well-being via coping was not supported. The results indicate that both coping and illness perceptions made a major contribution to the explanation of variance in HD patients’ psychosocial well-being. Variance in their physical well-being was explained by illness perceptions mainly. The need to conduct further research on the interrelationships between illness perceptions, coping, and well-being in this patient category is discussed.     

Spontaneous Reports of Religious Coping by Patients with Chronic Physical Illness

Individuals undergoing the stress of physical illness often report the use of religious coping activities. This study compared the frequency of spontaneous reports of religious coping in three groups of patients including those with cancer preparing for a bone marrow transplant (n = 22), chronic pain (n = 36), and cardiovascular disease (n = 53). Participants were asked to respond to a written, open-ended question asking how they were coping with the challenges involved in their medical condition. The question asked them to list the resources, strategies, strengths, or behaviors that they found most helpful. No mention of religion or religious coping was included with the question. Of the 111 participants surveyed, 26.1% included religious coping in their responses. The relative percentage of religious coping was calculated by dividing the total number of coping responses by number of religious responses. Mean percentage of religious coping was highest in participants preparing for a bone marrow transplant (22.9%), followed by the cardiac group (5.7%), and the chronic pain group (3.8%).