Coping with Abortion

Abstract

This study evaluated individual differences in coping style in response to an abortion procedure. The 55 subjects displayed a wide range of responses, although the average level of distress was fairly high. These women were quite similar to other stressed populations in their response to the Impact of Event Scale, providing evidence for a generalized stress response syndrome. When divided into groups based on coping style, “avoiders” were found to experience more distress that “nonavoiders,” and “approaches” decreased in distress over time while “nonapproachers” did not. The implications of these findings are discussed in the context of the interaction between coping styles and counseling strategies.     

Coping with gastrointestinal endoscopy: self-efficacy enhancement and coping style.

Forty-eight men scheduled for endoscopy were assessed for preferred coping style and assigned to one of four preparation conditions: (a) relaxation plus coping self-efficacy (SE) enhancement, (b) relaxation only, (c) procedural information, and (d) no preparation. It was hypothesized that increases in SE would be associated with better behavioral and self-report assessments of coping with endoscopy, and that coping style would moderate effects of SE enhancement. Hypotheses were largely confirmed. Ss in SE enhancement preparation experienced greater increases in coping SE and greater decreases in distress before and during endoscopy than did other Ss. Changes in coping SE were negatively correlated with changes in anticipatory anxiety, and SE ratings were significantly related to distress during endoscopy. Ss classed as monitors fared most poorly with no-preparation, whereas blunters did most poorly with procedural information.     

The Buffering Effects of Active Coping on the Relationship Between SES and Cortisol Among African American Young Adults

Abstract

Cortisol levels have consistently been related to socioeconomic status (SES). Possible moderators for this relationship are coping styles that are known to moderate relationships between cardiovascular factors and SES. The authors examined whether coping style moderated a relationship between resting Cortisol levels and various measures of SES in a sample of urban, African American young adults. Those scoring low on coping style had high Cortisol levels if they were currently students or unemployed. This effect, however, differed for men and women. The authors suggest that coping style may play an adaptive role regarding salivary Cortisol measures in young adults when they are students or unemployed. Active coping may help protect against stress among young African American adults.     

Reducing Distress During Invasive Medical Procedures: Relating Behavioral Interventions to Preferred Coping Style in Pediatric Cancer Patients

The hypothesis that matching childrens' preferred coping styles(repression, sensitization) with behavioral interventions (distraction,sensory information) during invasive medical procedures willreduce self-reports of fear and pain, anticipatory heart rate,and observable signs of distress was tested in 28 children withcancer. A significant coping style by intervention interactionfor the self-report of experienced pain was found. However,those groups using an intervention that matched their preferredcoping style actually reported higher experienced pain ratings.Trends for differences between coping style on factors indicativeof the chronicity of the disease were found. Chronicity, whichreflects the degree of past experience with invasive medicalprocedures, may be a more important factor than preferred copingstyle in pain management of these patients.     

Association of Coping Styles with Quality of Life in Cancer Patients

Methods:The study was performed on 150 cancer patients (71 females and 79 males) admitted to the hospitals affiliated with Kermanshah University of Medical Sciences. Endler and Parker Coping Inventory for Stressful Situations, and World Health Organization''s Quality of Life Questionnaire were used to evaluate their coping style and QOL, respectively.Results:The Present study showed in cancer patients being male, single, having higher salary and education, and lower age are related to higher QOL. Furthermore, in general, QOL of cancer patients was positively correlated with avoidant coping style (P < 0.05, r : 0.170) and negatively associated with emotion-focused coping styles (P < 0.01, r : −0.378).Conclusion:The results suggested that focusing on a patient''s coping style, predominantly on an emotion-focused coping style, is essential to improve patient''s QOL, and that patients possibly to employ a more emotion-oriented coping style should receive enough notice, particularly before discharge.     

Managing uncertainty and responding to difficult emotions: Cancer patients’ perspectives on clinician response during the COVID-19 pandemic

ObjectivePatients undergoing cancer treatment during the COVID-19 pandemic have experienced stress and uncertainty with respect to disruptions in cancer care and COVID-19 related risks. We examined whether clinicians’ responsiveness to patients’ uncertainty and difficult emotions were associated with better health and well-being.MethodsPatients were recruited from cancer support communities and a market research firm. Respondents assessed clinicians communication that addressed uncertainty and difficult emotions. Health status measures included mental and physical health, coping during the pandemic, and psychological distress.Results317 respondents participated in the study. Patients’ perceptions of their clinicians responsiveness to patient uncertainty and negative emotions were associated with better mental health, physical health, coping, and less psychological distress (all p-values <0.001). Respondents with greater self-efficacy and social support also reported better health.ConclusionEven when controlling for patients’ personal and health-related characteristics, clinicians’ communication addressing patients’ uncertainty and difficult emotions predicted better health, better coping, and less psychological distress. Access to social support and self-efficacy also were associated with better health status.Practice implicationsClinicians’ communication focused on helping with uncertainty and difficult emotions is important to cancer patients, especially during the pandemic. Clinicians should also direct patients to resources for social support and patient empowerment.     

Coping style,cognitive hardiness,and health status

This study investigates the effects of coping style and cognitive hardiness on physical and psychological health status. Measures of coping styles (intrusive positive thoughts, intrusive negative thoughts, avoidance, problem-focused coping), cognitive hardiness, stress, health habits, psychological distress, and physical illness were collected for 194 professional employees. Multiple regression analyses revealed that intrusive negative thoughts and avoidance coping approaches significantly contributed to predictions of psychological distress and physical illness outcomes, respectively. Cognitive hardiness significantly contributed to predictions of psychological distress but not physical illness outcomes. Health habits were significantly related to both measures of health status. Two coping approaches, intrusive positive thoughts and problem-focused coping, did not significantly contribute to predictions of either physical or psychological health status.     

Preparation for oral surgery: Evaluating elements of coping

Third-molar extraction patients (N=231) underwent one of five preparatory interventions offering different levels of relaxation, control, and self-efficacy to evaluate the relative importance of each of these elements of coping in the context of an acute stressor. Prior to surgery subjects completed measures of monitoring and blunting. Results indicated that relaxation, perceived control, and self-efficacy were each significant, and roughly equivalent, contributors to coping, and operated in an additive way. Intervention type, and the interaction of intervention type with blunting score, significantly predicted distress prior to and during surgery. It was concluded that no single element is crucial to effective coping and that interventions that provide more coping elements are generally superior. Additionally, the interaction of coping style with intervention is as strong a contributor to coping outcome as the other factors. Those who prefer to distract themselves may benefit most from interventions that require the least possible personal investment of effort and attention.     

Introduction

ABSTRACT

Response style is an important issue that is often not addressed when assessing or treating patients with posttraumatic stress disorder (PTSD). In this paper, various response styles are discussed along with their relevance to clinical work and research with PTSD patients. Two of the most prevalent measures of response style, the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and Structured Interview of Reported Symptoms (SIRS) scales are evaluated for use in assessing for PTSD. In addition, the Trauma Symptom Inventory's potential for use in evaluating response style is briefly discussed. Implications for future work and directions for future investigation are outlined.     

Coping and distress as predictors of glycemic control in diabetes

This study attempts to identify the relative contribution of coping styles (task-, emotion-oriented and avoidance) and anxiety and diabetes-related distress to glycemic control in IDDM (Insulin Dependent Diabetes Mellitus) patients. Recent research suggests that coping and distress may as well be determinants as consequences of certain characteristics of the illness and subject. This points to the need to control some of these variables in diabetic research. Ninety seven IDDM patients from an outpatient unit were included. Measures were self-report questionnaires (CISS, STAI-Y, PAID) and biological data (HbA1C i.e. metabolic control). When potential confounds were controlled for (current age, age at onset, gender, presence of complication), three main predictors of metabolic control could be isolated through hierarchical regression analysis: (1) presence of complications; (2) task-oriented coping style; and (3) diabetes-related distress. Three steps were included in predictors: illness and subject variables (step 1); coping styles (step 2); and negative emotions (step 3). Each step contributed to a significant increase in variance. Emotion-oriented coping style appeared as redundant with distress measures. Results suggest that the relations between psychological predictors and metabolic control would be closer in women. These results partly replicate other findings, and advocate for a better consideration of emotional factors in the prediction of blood glucose control in this disease.     

Effects of Prolonged Stress on Coping Style in Terminal Renal Failure Patients

Abstract

Fifty-nine patients with terminal renal failure and 59 comparison subjects matched on age, sex, origin, education and marital status were administered the Shanan Sentence Completion Test at the onset of hemodialysis, to test the hypothesis that 1) prolonged stress reduces the tendency to cope actively and that 2) the extent of reduction would vary according to the patients' background. Findings provided massive support for the first hypothesis; in nearly all aspects of coping style investigated, hemodialysis patients obtained significantly lower scores, indicative of passivity, negative self perception and of tendencies to withdraw by denial from the harsh reality.

Findings on the second hypothesis were equivocal. Only sex and education showed interaction with illness and coping. Women appeared to be more vulnerable than men. The effects of education on coping were reduced as a consequence of the illness. Findings are discussed in terms of their implications for stress research and for the advancement of preventive measures in hemodialysis treatment.     

Preoperative preparation for surgery: an analysis of the effects of relaxation and information provision

The two objectives of this study were: (1) to replicate previous findings on the effects of relaxation in the preparation for surgery, and (2) to analyse the interaction effect between type of intervention (i.e., relaxation and information provision) and coping style (i.e., high versus low monitoring) on patients' pain level and the return to normal daily activities. Ninety cholecistectomy patients, who accepted participation in the study, were randomly assigned to one of three groups. Patients in the first group received complete sensory and procedural information. Those in the second group were trained in relaxation, while individuals in the third group acted as an attention control group. All patients were assessed for preferred coping style. The results demonstrated, again, the positive effects of relaxation training in the preparation of low monitoring patients. That is, low monitors trained in relaxation experienced less surgical pain through the recovery process and performed at a higher activity level at follow‐up, compared to low monitor controls. Moreover, individuals who were exposed to any of the interventions experienced, in general, less pain, and reported a higher activity level during leisure time, than control patients. On the other hand, however, no ‘interaction effect’ was observed when the interaction between coping style and type of intervention was studied. Copyright © 1999 John Wiley & Sons, Ltd.     

A Snapshot of Terror: Acute Posttraumatic Responses to the September 11 Attack

SUMMARY

This paper reports on acute posttraumatic reactions and forms of coping to the September 11 attack. We conducted a survey within three weeks of the attack on a nationwide, representative sample of individuals 13 years or older (N= 3,134). Measures included the Stanford Acute Stress Reaction Questionnaire (SASRQ), the brief version of the COPE, and questions about demographics and attitudes toward the attackers. Results show that residents of New York City-women, young adults (but not teens), and people recently immigrated into the country-experienced more distress about the attack. There was a positive linear association between hours of watching TV news related to the attack and distress, and a small positive association between hostility toward the perpetrators, TV watching, and distress. Income, religion, education, and ethnicity did not have an effect on distress. Maladaptive coping strategies and TV watching explained considerably more variance than did demographics. Reactions to acute trauma seem to depend on the lack of appropriate coping strategies. The curvilinear relationship between age and posttraumatic distress suggests caution when interpreting previous findings about age and posttraumatic reactions. The association between media exposure, coping styles, and acute distress among teens extends previous findings and deserves further investigation.     

Preferences for notification of imaging results in patients with metastatic cancer

ObjectiveThis study examines the preferences of patients with metastatic cancer regarding notification of imaging results, as well as distress surrounding the process.MethodsOn imaging day, preferences for notification, expectations of results, health literacy, and social support were measured. After receiving results, patients reported on actual delivery methods. At both times, patients were screened for overall distress, anxiety, and depression.ResultsThe majority of patients preferred notification within 2 days and during a face-to-face visit with their oncologist. Although levels of distress, anxiety, and depression were low, patients with higher anxiety, depression, and social isolation had higher distress. There was no correlation between absolute distress levels and agreement between notification preferences and actual delivery methods. Receiving results from a preferred provider was associated with a decrease in distress from imaging day to follow-up. Face-to-face delivery of results was more important to people with lower health literacy.ConclusionsWhile distress regarding the receipt of results was low, it was higher for some groups of patients. Attending to the preferences of these subgroups may help to minimize distress.Practice implicationsReceiving results from preferred personnel and diminishing patients' sense of social isolation might provide psychological benefit during the period surrounding imaging.     

Matching intra-procedural information with coping style reduces psychophysiological arousal in women undergoing colposcopy

This study assessed the combined effects of coping style and intra-procedural information on indices of distress (physiological measures, observed distress, self-report measures of anxiety and affect) among a group of patients undergoing colposcopy. High and low monitors were exposed to one of three interventions: high information (live video feed of colposcopy); low information (complete audiovisual distraction); and control. Results revealed a 2 (monitoring style) × 3 (information level) × 2 (time) interaction for systolic blood pressure (SBP), F(2, 111) = 3.55, p = .032. Among low monitors, patients in the low-information group exhibited significant SBP reductions during colposcopy, while those in the high-information group exhibited SBP increases. Among high monitors, patients in the high-information and control groups exhibited SBP reductions. Further, significant differences in observed signs of distress were found between groups with high monitors in the low-information group faring best overall, F(2, 111) = 4.41, p = .014. These findings indicate that tailoring information to suit individual coping style may maximize the apparent efficacy of interventions aimed at reducing stress during medical examinations.     

Psychological adjustment in caregivers of school-age children infected with HIV: stress, coping, and family factors

OBJECTIVE: To assess for significant differences in psychological functioning between caregivers of HIV-infected children and caregivers of healthy children, and to examine the utility of applying a stress and coping model to caregivers of children with HIV disease. METHODS: Participants included caregivers of HIV-infected children (n = 36) and caregivers of a demographically matched control group of healthy children (n = 32). During their child's pediatric clinic visits, caregivers completed measures of psychological adjustment, stress, coping style, and family resources and support. They also completed a measure of their child's psychological adjustment. RESULTS: Caregiver psychological distress scores did not significantly differ between the HIV and control groups, and clinically significant rates of psychological distress were reported by more than a third of caregivers in both groups. Hierarchical multiple regression analyses revealed that independent of their child's illness status, stress and coping style were significant predictors of caregiver's psychological adjustment. In addition, caregiver psychological distress was a significant predictor of children's maladjustment. CONCLUSIONS: High rates of psychological distress were observed in caregivers of children with HIV disease; however, similarly high rates of psychological adjustment problems were found in caregivers of healthy children. Caregivers who reported high levels of daily stress and emotion-focused coping styles tended to report more psychological distress. Further, caregivers who reported more psychological distress also reported more internalizing and more externalizing behavior problems in their children, regardless of the child's illness status. These findings reflect the impact of poverty and environmental stress on caregivers' adjustment.     

Psychological and neuropsychological predictors of coping patterns by patients with multiple sclerosis

To determine the relative contribution of psychological and neuropsychological (NP) variables to the prediction of patterns of coping with disease-related stressors and satisfaction with their coping efforts, 56 patients with multiple sclerosis (MS) were administered the Ways of Coping Checklist, the Symptom Checklist-90-Revised, and a battery of NP tests chosen for their sensitivity to MS. Higher levels of psychological distress were associated with greater use of emotion-focused coping strategies and reduced perceived effectiveness of the coping strategies employed. Psychological distress was not related to the use of problem-focused strategies and NP variables did not predict coping style or effectiveness. MS patients who display heightened psychological distress may be good candidates for psychotherapeutic interventions aimed at improving perceived coping effectiveness.     

Negative affectivity and repressive coping: pervasive influence on self-reported mood, health, and coronary-prone behavior.

Negative affectivity (NA) and repressive coping (REP) are coping styles characterized by a disposition to either experience or avoid distress. This study investigated the potential influence of NA and REP on self-reported distress and coronary-prone behavior among 178 male cardiac patients undergoing rehabilitation. Based on their STAI-Trait and Marlowe-Crowne Scale scores, subjects were categorized as high NA (N = 72), low NA (N = 44), or REP (N = 62) individuals. With respect to subjective distress, high-NA individuals reported more negative mood states and health complaints than both low-NA and REP individuals (p less than 0.0001). In contrast, no association was found between coping style and cardiovascular fitness as measured by exercise stress testing (p = 0.87). Hence, it seems that (a) high-NA individuals overreacted to physical problems and (b) REP individuals warded off distress. These differences in coping style were stable over a period of 3 months. With respect to coronary-prone behavior, the current findings were largely inconsistent with previous research. NA was associated with Type A interview-rating (p less than 0.001), but not with Type A self-rating. REP individuals, however, had a significantly lower score on the Jenkins Activity Survey and the Cook-Medley Hostility Scale than both high-NA and low-NA individuals (p less than 0.0001). Supposed associations, therefore, between NA and self-rated coronary-prone behavior may in fact originate from the repressive coping style that characterizes some individuals low in NA. In summary, it may be stated that the findings of the current study suggest the use of NA and REP markers in research, so that the potential influence of these coping styles can be identified in the study of stress-health relationships.     

Psychological Distress, Coping, and Disease Progression in HIV-positive Homosexual Men

The objectives of the study were (1) to examine the role of coping styles in disease progression in models controlling for initial CD4+ cell counts, distress, and health behavior in a sample of HIV- positive homosexual men (n = 65), and (2) to investigate the relationship between coping styles and distress (e.g. depression, anxiety, negative ruminations). A consistent association between planful problem-solving coping and disease progression was demonstrated. Distress was positively correlated with indicators of passive-defensive coping style (e.g. self- controlling, escape-avoidance), and negatively correlated with planful problem-solving and positive reappraisal. The results suggest that coping styles may merit a specific focus in future research of psychological factors in HIV infection, particularly as they may relate both to medical outcome and to the social/emotional aspects of being HIV-infected.     

Hiding Worries from One's Spouse: Associations Between Coping via Protective Buffering and Distress in Male Post-Myocardial Infarction Patients and Their Wives

The relationship between protective buffering, a style of coping in which the individual hides his/her concerns from spouse, and level of distress was studied among post-myocardial infarction (MI) patients and their spouses. Forty-three male married MI survivors and their wives completed measures of psychological distress and protective buffering at 4 weeks and 6 months post-hospital discharge. At both time periods, a greater propensity for protective buffering by the patient was related to higher levels of patient distress. Protective buffering by wife was also associated with higher levels of wife distress. In addition, patient buffering at 4 weeks predicted increased patient distress at 6 months. The results suggest that male MI patients who conceal their worries from their spouses adjust more poorly over time.