A comparison of coping strategies in patients with fibromyalgia,chronic neuropathic pain,and pain‐free controls

Patients suffering from chronic pain may benefit from learning adaptive coping strategies. Consensus on efficient strategies for this group of patients is, however, lacking, and previous studies have shown inconsistent results. The present study has examined coping strategies in two distinctly different groups of chronic pain patients and a group of healthy controls. Thirty neuropathic pain (NP) patients, 28 fibromyalgia (FM) patients, and 26 pain‐free healthy controls completed the Coping Strategy Questionnaire (CSQ‐48/27) and rated their daily pain. The results showed that FM and NP patients did not cope differently with pain. The only difference between the groups was that FM patients felt more in control of their pain than NP patients. Both patient groups used more maladaptive/passive coping strategies, but surprisingly also more adaptive/active coping strategies than healthy controls. However, FM patients with high levels of passive strategies felt less in control than FM patients with low levels of passive strategies. This was not seen in NP patients. An important implication for clinical practice is therefore that passive coping strategies should be restructured into active ones, especially for FM patients. Otherwise, the same psychological treatment model can be applied to both groups since they use similar coping styles.     

The role of optimism and pessimism in chronic pain patients adjustment

This study analyses the relationships between patients' dispositional optimism and pessimism and the coping strategies they use. In addition, the coping strategies repercussions on adjustment to chronic pain were studied. Ninety-eight patients with heterogeneous chronic pain participated. The assessment tools were as follows: Life Orientation Test (LOT), the Vanderbilt Pain Management Inventory (VPMI), the McGill Pain Questionnaire (MPQ), Hospital Anxiety and Depression Scale (HADS), and the Impairment and Functioning Inventory for Chronic Pain Patients (IFI). The hypothetical model establishes positive relationships between optimism and the use of active coping strategies, whereas pessimism is related to the use of passive coping. Active coping is associated with low levels of pain, anxiety, depression and impairment and high levels of functioning. However, passive coping is related to high levels of pain, anxiety, depression and impairment and low levels of functioning. The hypothetical model was empirically tested using the LISREL 8.20 software package and the unweighted least squares method. The results support the hypotheses formulated regarding the relations among optimism, pessimism, coping and adjust of chronic pain patients. By analysing optimism among chronic pain patients, clinicians could make better predictions regarding coping and adjustment.     

Coping in context: the role of stress, social support, and personality in coping

Personality and social relationships play an important role in almost every aspect of stress and coping. Daily process methods are particularly useful in elucidating how these factors might influence both responses to and outcomes of stress. Our work has linked both dimensions of personality, particularly the Big Five, and aspects of social relationships, particularly social support, to the likelihood of engaging in certain coping strategies and the effectiveness or outcomes of these coping strategies. In addition, we have found the effect of personality on coping and stress outcomes to vary by the situational context in which stress occurs. We review findings from our recent daily process studies of stress, coping, and social support. Further, we discuss the costs and benefits of the daily process methodology for addressing these questions, highlighting the clinical utility of findings gleaned with the use of this approach. Finally, we discuss future directions and applications of daily process methods to the study of stress and coping.     

Consumer Personality and Coping: Testing Rival Theories of Process

This research examines the effect of consumer dispositions on the relationships between stress‐related appraisals, consumption emotions, and the coping process. We comparatively tested rival models of these relationships. Our data show that the consumer personality traits of consumer assertiveness and marketing maven and the general personality trait of extraversion interact with cognitive appraisals to influence consumers’ choice of coping strategies. The research contributes to existing knowledge of how these consumer personality traits motivate consumer behavior, and it enriches existing models of the relationship between personality influences and coping.     

Acculturation strategies, coping process and acculturative stress

Using structural equation modeling, this study examines the influences of motivational factors (Need for Cognitive Closure--NCC--and Decisiveness), coping strategies and acculturation strategies on levels of acculturative stress. Two groups of immigrants in Rome (Croatians n= 156 and Poles n= 179) completed a questionnaire that included scales for the various factors. Although our initial hypothesized model was not confirmed, a modified model showed that the motivational factors of NCC and Decisiveness indirectly influence acculturative stress. The modified model with good fit indices indicated that the relationship between NCC and Decisiveness are mediated by coping strategies and acculturation strategies. Specifically, NCC is associated positively with avoidance coping, which in turn is negatively associated with the host group relationships and positively with the original culture maintenance. The last two dimensions predicted lower levels of acculturative stress. Decisiveness was positively associated with the problem-oriented coping and, negatively, with emotional and avoidance coping.     

The Accuracy of the DSM-IV Pain Disorder and the ICD-10 Persistent Somatoform Pain Disorder in Chronic Pain Patients

Objectives. In this investigation we studied the relationships between different psychological relevant subgroups and the presence of different psychosomatic symptoms in a sample of chronic pain patients, testing the accuracy of the DSM- and ICD classification systems.Results. We found no evidence for a “pure” pain syndrome according to the DSM- and ICD systems. On the contrary, we found highly significant evidence of a mixed psychosomatic condition.Conclusion. The results suggest a broad somatoform classification, with subgroups based on personality characteristics taking a stress—coping model into account, including interpersonal attachment behaviour. An alternative model of a diagnostic approach is presented.     

Individual differences,mood, and coping with Chronic pain in Rheumatoid Arthritis: a daily process analysis

This study examines individual differences in coping and associated health outcomes as they unfold across time. Twice daily for one week, 71 individuals with Rheumatoid Arthritis reported their pain, coping efforts, and negative mood via structured daily records. The five factor model of personality (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) and disease status were also assessed. Multi-level statistical models examining within and between person variability indicated significant temporal associations from coping to pain and bi-directional associations between mood and pain within days. Furthermore, findings suggest that coping use and coping effectiveness were moderated by personality. Implications for models of coping with chronic pain, as well as clinical applications, are discussed.     

Coping strategies and perceived social support in fibromyalgia syndrome: Relationship with alexithymia

Fibromyalgia (FM ) is a chronic pain syndrome characterized by high levels of psychological distress and alexithymia, a personality disposition affecting emotional self‐awareness. The main aim of the present study was to investigate for the first time the relationship between alexithymia and coping strategies on the one hand, and alexithymia and perceived social support on the other, in a sample of FM patients. To reach this aim, 153 FM patients completed a battery of tests assessing coping strategies, perceived social support, alexithymia, psychological distress and pain intensity. Four regression analyses were performed to assess whether alexithymia was still a significant predictor of coping strategies and perceived social support, after controlling for psychological distress. High levels of both psychological distress and alexithymia were found in our sample of FM patients. Regarding coping strategies, FM patients reported higher scores on problem‐focused coping, with respect to the other two coping strategies. The regression analyses showed that the externally‐oriented thinking factor of alexithymia significantly explained both problem‐ and emotion‐focused coping, while the difficulty‐describing feelings factor of alexithymia proved to be a significant predictor of perceived social support. Only the variance of dysfunctional coping ceased to be uniquely explained by alexithymia (difficulty identifying feelings factor), after controlling for psychological distress, particularly anxiety. These results highlight a negative relationship between alexithymia and both the use of effective coping strategies and the levels of perceived social support in FM patients. An adequate assessment of both alexithymia and psychological distress should therefore be included in clinical practice with these patients.     

Children's Coping with Recurrent Headache

We investigated the relationships among perceptions of control over pain, gender, and coping responses in 57 school-aged children receiving services at a specialized pediatric headache clinic. Perceptions of control and gender interacted to predict frequency of active and negative coping responses. A wide range of coping strategies was reported, but only minimal gender or perceived control differences were found in the frequency and helpfulness of individual coping strategies. Results are discussed within the context of recent stress and coping models within the pediatric chronic illness literature.     

Psychological adjustment to gynaecological cancer: Patients’ illness representations,coping strategies and mood disturbance

This study examined associations between illness representation dimensions specified by the self-regulation model, coping and mood in recently diagnosed gynaecological cancer patients. Participants were 61 patients recruited from a specialist outpatient gynaecology clinic. Patients completed a survey measuring their cognitive illness representations (IPQ-R), coping strategies (COPE) and mood (POMS-SF). Consistent with research into other illnesses, the study found theoretically congruent cross-sectional associations between illness representations and mood disturbance. Support was found for a possible path whereby higher denial and avoidant coping might mediate the relationships between cyclical timeline and illness coherence representations and more negative mood. There were no mediational relationships for other coping strategies. Mediation of the relationship between illness representations and mood by avoidant coping has important theoretical and practical implications. These are discussed, as are direct relationships between illness representations and mood.     

Relationships between individual-level factors and burnout: A meta-analysis of Chinese participants

We meta-analytically tested the relationships between job burnout dimensions (emotional exhaustion, depersonalization, and reduced personal accomplishment) and five factor model personality traits, personal resources, and coping strategies in Chinese participants. It showed that most of the variables considered were significantly related to job burnout dimensions in the expected direction. A comparison of the results of this study with Alarcon’s meta analysis showed that the correlations of burnout with individual level factors were in the same direction, but the magnitudes of the effect sizes differed to a certain extent. Implications of the findings and future research directions were discussed.     

Personality and coping: A context for examining celebrity worship and mental health

The adaptational‐continuum model of personality and coping suggests a useful context for research areas that emphasize both personality and coping. The present paper used Ferguson's (2001) model integrating personality and coping factors to further conceptualize findings around celebrity worship. Three hundred and seventy‐two respondents completed measures of celebrity worship, personality, coping style, general health, stress, positive and negative affect and life satisfaction. Celebrity worship for intense‐personal reasons is associated with poorer mental heath and this relationship can be understood within the dimensions of neuroticism and a coping style that suggests disengagement. Such findings suggest the utility of examining the relationship between celebrity worship and mental health within both personality and coping variables, which have practical implications for understanding and addressing mental health problems that may occur as the result of engaging in celebrity worship for intense‐personal reasons.     

Barriers perceived by teachers at work, coping strategies, self-efficacy and burnout

This study examines the relationships among stressors, coping strategies, self-efficacy and burnout in a sample of 724 Spanish primary and secondary teachers. We understood stressors as barriers perceived by teachers that interfere with their work meeting learning objectives and which cause them stress and burnout. An analysis of teacher responses using hierarchical regression revealed that pedagogical barriers had significant positive effects on the burnout dimensions. Furthermore, the results show not only the moderator role played by coping strategies in the pedagogical barriers-burnout dimensions relationship, but also the association between self-efficacy and the coping strategies used by teachers. Practical implications are discussed.     

Coping with interpersonal stress: role of big five traits

Seventy-one couples living in a stepfamily context reported interpersonal family stressors and related coping strategies daily for 1 week in a daily process study. The role of personality and of the stressful context in each of the spouse's coping was examined. Personality was assessed via the Five-Factor Model (Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness). Two types of stressors emerged as primary dimensions of stepfamily stress: marital conflict and child misbehavior. These were treated as contextual factors in multilevel modeling analyses examining the independent and interactive effects of personality and situation on coping. Nine subscales of coping were examined based on three main functions of coping: problem-, emotion- and relationship-focused. Both the situational context and the five dimensions of personality examined were significantly and independently related to coping-strategy use. Moreover, there were significant personality-by-context interactions. The present study highlights the importance of considering personality in context when examining coping behaviors.     

Personality and stress

Recent years have witnessed an upsurge of interest in how personality affects the stress process. This paper reports on a broad spectrum of findings on the relationships between personality and stress, taking transactional stress theory as the point of departure. A first part outlines the different approaches stress research has taken within personality psychology as opposed to research based on transactional stress theory and discusses the debate between these two paradigms. The second part gives an overview of empirical findings, with a focus on the Big Five personality factors, in order to demonstrate that personality affects the stress process in every aspect. The discussion suggests that we address unresolved problems of transactional stress research in the framework of interactionist personality psychology. Special attention ought to be given to developing a better understanding of situational characteristics, stress-producing mechanisms, and the functions of situational choices and coping strategies for personality.     

How do I cope with pain? Let me count the ways: awareness of pain coping behaviors and relationships with depression and anxiety

Patients with chronic pain are often undertreated with medications alone and need alternative ways of coping. Identifying pain coping skills patients use may be beneficial; however, no research has investigated whether patients are aware of their coping skills. The purpose of this study was to determine whether patients are aware of their pain coping skills, whether certain patient characteristics were related to using coping strategies, and whether coping strategies were related to psychiatric symptoms. Chart reviews were conducted on seventy-eight chronic pain patients who completed a semi-structured psychological interview. Patients endorsed using more coping strategies on the measure compared to the verbal self-report. Identifying with certain patient demographics was related to higher use of some coping strategies. Symptoms of anxiety and depression were also related to the use of some coping strategies. Anxiety was negatively related to ignoring the pain and using self-talk coping statements and positively related to catastrophizing. Depression was negatively related to the use of distraction, ignoring the pain, and using self-talk coping statements. Depression and pain severity were both positively related to catastrophizing and prayer. Results suggest that clinicians may need to help patients become aware of adaptive coping strategies they already use and that the use of certain coping strategies is related to lower levels of depression and anxiety.     

中学生人格特质、主观应激与应对风格之间的关系

旨在构建中学生的人格特质、主观应激与应对风格之间的关系模型。采用问卷的方法,被试来自成都的四所中学,共607人。探索性因素分析和路径分析结果表明：中学生的应对风格可以分为主动应对和被动应对;不同类型的主观应激之间可能存在潜在关系;主动的应对风格只受到人格特质（外向/内向性、责任心）直接作用;被动的应对风格除了受人格特质的直接和间接作用外,还受到主观应激的影响。     

Post-Traumatic Growth After a Myocardial Infarction: A Matter of Personality,Psychological Health,or Cognitive Coping?

The aim of the present study was to focus on the relative contributions of personality, psychological health and cognitive coping to post-traumatic growth in patients with recent myocardial infarction (MI). The sample consisted of 139 patients who had experienced a first-time acute MI between 3 and 12 months before data assessment. Multivariate relationships were tested by means of Structural Equation Modeling. The results showed that besides the contribution of personality and psychological health, a significant amount of variance in growth was explained by the cognitive coping strategies people used to handle their MI. As cognitive coping strategies are generally assumed to be mechanisms that are subject to potential influence and change, this provides us with important targets for intervention.     

癌症患者人格类型及其与应对策略、社会支持的关系

该研究旨在调查和分析癌症患者人格类型及其与应对策略、社会支持的关系。采用艾森克人格问卷简式量表、社会支持评定量表、医用应对问卷等测查工具对205名癌症病人进行调查。结果显示:1.癌症患者可以聚类为两类人格:温和健康型和身心障碍型;2.身心碍型患者的屈服应对显著高于温和健康型患者;3.身心障碍型患者的客观社会支持和主观社会支持都显著低于温和健康型患者。研究表明,癌症患者可分为温和健康型和身心障碍型两种人格类型。身心障碍型患者采用更多的屈服应对,同时获得的社会支持也更少。     

The role of pain anxiety, coping, and pain self-efficacy in rheumatoid arthritis patient functioning

Anxiety about pain is increasingly recognized as one factor contributing to increased pain perception and pain behavior [McCracken, L. M., Faber S. D., & Janeck A. S. (1998) Pain-related anxiety predicts nonspecific physical complaints in persons with chronic pain. Behavior Research and Therapy, 36, 621-630; McCracken L., & Gross R. (1995). The pain anxiety symptoms scale (PASS) and the assessment of emotional responses to pain. Innovations in clinical practice: a source book, 14, 309-321]. To assess this emotional reaction to pain in chronic pain patients, McCracken, Zayfert and Gross [McCracken, L., Zayfert, C., & Gross, R. (1992). The Pain Anxiety Symptom Scale: development and validation of a scale to measure fear of pain. Pain, 50, 67-73] developed the Pain Anxiety Symptom Scale (PASS) composed of four subscales: Cognitive Anxiety, Fearful Appraisal, Escape Avoidance and Physiological Anxiety. The present study extended previous work by examining the relationship among pain anxiety dimensions, use of active and passive coping strategies and arthritis self-efficacy as predictors of functional status in 154 rheumatoid arthritis (RA) patients. Functional status was assessed using the Five-Factor Model of the Arthritis Impact Scale, 2nd ed., (AIMS2): Physical Functioning, Affective Experience, Symptoms, Social Interaction and Role Function. Hierarchical multiple regression analysis on each of the AIMS2 criterion variables showed that pain anxiety, pain and symptom self-efficacy, health status and coping strategies were able to explain between 9 and 38% of the variance in the five AIMS2 variables. The present results support the hypothesized role of pain anxiety along with previously established contributions of self-efficacy and coping strategies, in affecting physical, social, emotional and role functioning in chronic RA patients.