The role of coping humor in the physical and mental health of older adults

Objectives: This study examined the associations among coping humor, other personal/social factors and the health status of community-dwelling older adults.

Method: Survey questionnaires were completed with 73 community-dwelling older adults. Included were measures of coping humor, spirituality, self-efficacy, social support and physical and mental health status.

Results: Correlations across all variables showed coping humor to be significantly associated with social support, self-efficacy, depression and anxiety. Forward stepwise regression analyses showed that coping humor and self-efficacy contributed to outcome variance in measures of mental health status. Contrary to expectation, neither social support nor spirituality contributed to the total outcome variance on any of the dependant measures.

Conclusion: The importance of social support, self-efficacy and spirituality in determining the quality of life of older adults is well supported in the literature. Coping humor as a mechanism for managing the inevitable health stresses of aging has received less attention. This study shows that coping humor and self efficacy are important factors for explaining health status in older adults. Correlations among coping humor, self efficacy and social support suggest that a sense of humor may play an important role in reinforcing self-efficacious approaches to the management of health issues.     

Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury.

Kendall and Terry (1996) include many psychosocial predictors in their theoretical model that explains individual differences in psychosocial adjustment (Lazarus & Folkman, 1984). The model depicts appraisal and coping variables as mediating relationships between situation factors, environmental and personal resources, and multidimensional outcome. The aim of this study was to explore these theoretical relationships at very late stages of recovery from traumatic brain injury. A total of 131 participants who were more than 10 years post-injury (mean = 15.31 years) completed several psychosocial measures relating to outcome dimensions comprising employment, community integration, life satisfaction, quality of life (QoL), and emotion. There was no evidence that appraisal and coping variables mediated relationships between psychosocial and any of the outcome variables. However, when appraisal and coping variables were combined with psychosocial variables as direct predictors of outcome, every outcome except employment status was reliably predicted, accounting for between 31 and 46% of the variance. Personality significantly influenced all predicted outcomes. Self-efficacy contributed to the prediction of all outcomes except QoL. Data did not support for the theory of stress and adjustment as a framework for explaining the nature of predictive relationships between psychosocial variables and very long-term, multidimensional outcome after brain injury.     

Adolescent Humor and its Relationship to Coping,Defense Strategies,Psychological Distress,and Well-Being

Objective This study investigated the psychometric properties of the Humor Styles Questionnaire (HSQ) in measuring adolescent humor, including the relationship between humor and coping style, defense style, depressive symptoms, and adjustment in a non-clinical sample of adolescents. Method Humor, coping, defense strategies, depressive symptoms, and adjustment were investigated in 94 adolescents aged 12–15. Results The HSQ demonstrated adequate internal consistency. Inter-scale correlational patterns and scale means were similar for adolescents and adults. Convergent validity for the HSQ was supported by its relationship to: an adolescent-standardized humor defense scale; coping and defense strategies; and depressive symptoms and adjustment. Clinical utility of the HSQ was demonstrated by its unique contribution in predicting both depressive symptoms and adjustment above and beyond contributions from coping and defense composites. Discussion The HSQ appears to be a psychometrically sound and clinically useful measure to assess humor dimensions in adolescents.     

The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among veterans returning from Iraq and Afghanistan. Little research has examined variables that may mediate the relation between PTSD and aspects of social functioning, such as relationship satisfaction and family functioning. In this cross-sectional study, a total of 164 veterans who were seeking VA primary care or mental health care within one year after returning from Iraq and/or Afghanistan were screened for PTSD and completed a series of questionnaires that assessed social functioning, coping, and life satisfaction. Results showed that the 86 (52%) veterans who screened positive for PTSD reported greater difficulties in their relationships with romantic partners, less cohesion in their families, less social support, poorer social functioning, and lower life satisfaction compared to other treatment-seeking veterans. Less social support from the community, excessive worry, decreased acceptance of change, and lower availability of secure relationships mediated the association between PTSD and poor social functioning. The relation between PTSD and lower partner satisfaction was mediated by greater cognitive social avoidance and lower availability of secure relationships. These results suggest that psychotherapeutic interventions that address these mediating variables may help improve social functioning in treatment-seeking veterans with PTSD.     

Coping patterns as a valid presentation of the diversity of coping responses in schizophrenia patients

This study aimed to identify coping patterns used by schizophrenia inpatients in comparison with those used by healthy individuals, and to explore their association with selected clinical and psychosocial variables. The Coping Inventory for Stressful Situations (CISS) was used to assess coping strategies among 237 inpatients who met DSM-IV criteria for schizophrenia and 175 healthy individuals. Severity of psychopathology and distress, insight into illness, feelings of self-efficacy and self-esteem (self-construct variables), social support, and quality of life were also examined. Factor analysis, analysis of covariance and correlations were used to examine the relationships between the parameters of interest. Using dimensional measures, we found that emotion-oriented coping style and emotional distress were significantly higher in the schizophrenia group, whereas the task-oriented coping style, self-efficacy, perceived social support and satisfaction with quality of life were lower compared with controls. When eight CISS coping patterns were defined, the results revealed that patients used emotion coping patterns 5.5 times more frequently, and task and task-avoidance coping patterns significantly less often than healthy subjects. Coping patterns have different associations with current levels of dysphoric mood and emotional distress, self-construct variables, and satisfaction with quality of life. Thus, the identified coping patterns may be an additional useful presentation of the diversity of coping strategies used by schizophrenia patients. Coping patterns may be considered an important source of knowledge for patients who struggle with the illness and for mental health professionals who work with schizophrenia patients.     

Relationships between satisfaction with occupational factors and health-related variables in schizophrenia outpatients

  Background: The purpose of this study was to explore relationships between satisfaction with occupational factors, operationalized as occupational status and the total daily occupational situation, and health-related variables among people with schizophrenia. The health-related variables included quality of life, perceived control, sense of coherence, and psychopathology. Gender differences in these relationships were explored as well. Methods: A sample of 74 individuals, aged 20–55 years, from outpatient psychiatric services were recruited to the study. A variety of interviews and self-rating scales were used in the data collection. Results: When controlling for depressive symptoms, the results showed that satisfaction with employment status was of significance for health among patients with schizophrenia, but satisfaction with the total daily occupational situation seemed to be even more important to quality of life and other health-related aspects. In particular, satisfaction with daily occupations constituted an important dimension for self-rated quality of life. Some minor sex differences could be discerned in the pattern of associations. Conclusions: The strong association between satisfaction with daily occupations and self-rated quality of life adds a new dimension to the understanding of quality of life for this group of subjects, and suggests that helping to organise an individual's daily occupations ought to be a significant task in planning for psychiatric services. Accepted: 25 September 2000     

Well-being among older adults with OA: direct and mediated patterns of control beliefs,optimism and pessimism

Objectives: To assess the contribution of important psychological resources (i.e. optimism, pessimism, control beliefs) to the psychological well-being of older adults with Osteoarthritis (OA); to assess the direct and mediated association of these psychosocial resources to outcomes (depressive symptoms, life satisfaction, and self-esteem). These objectives are important because OA is a significant stressor, treatments are limited, and psychological functioning is at risk for those coping with the condition, even compared to other chronic illnesses. Method: A cross-sectional survey of 160 community-dwelling older adults with OA (81% women). Participants were not randomly selected, but nonetheless reflected the demographic makeup of the selection area. Results: Ordinary least squares regression analyses using the PROCESS macro revealed that optimism and pessimism were associated with higher depressive symptoms and lower self-esteem indirectly through constraints beliefs. The analysis of life satisfaction showed that optimism and pessimism were each partially mediated through mastery and constraints beliefs. Discussion: These results suggest that prior research, which has assessed these psychological resources as having singular relationships to outcomes, may have underestimated the importance of the relationship between these variables. We discuss possible points of intervention for older adults with OA who may experience increasing constraints beliefs over time.     

Happiness and congruence in older adulthood: a structural model of life satisfaction

The purpose of this study was to determine how health impairment, socioeconomic status, and social support relate to life satisfaction in later life. Using data from a sample of 320 older adults from The Georgia Centenarian Study, we constructed a structural model of life satisfaction. LISREL analysis was performed to test a two-factor model that included Happiness and Congruence and to determine the relationship of health impairment, socioeconomic status (SES), and social support to Happiness and Congruence, two measures of the Life Satisfaction Index-A (LSI-A). Data were found to provide a satisfactory fit of the model (GFI = 0.94; AFGI = 0.91). Social support and SES were found to have direct effects on health impairment. Health impairment was a key predictor and mediating variable of Happiness and Congruence. Findings also support a relationship between social resources and subjective well-being in later life. In particular, the association between social resources and life satisfaction was mediated through health impairment. These findings offer understanding relative to how health and social resources influence past and present assessments of subjective well-being among the elderly.     

Human Symbiosis

Abstract

Posttraumatic stress disorder (PTSD) is one of the most common psychiatric disorders among veterans returning tfrom Iraq and Afghanistan. Little research has examined variables that may mediate the relation between PTSD and aspects of social functioning, such as relationship satisfaction and family functioning. In this cross-sectional study, a total of 164 veterans who were seeking VA primary care or mental health care within one year after returning from Iraq and/or Afghanistan were screened for PTSD and completed a series of questionnaires that assessed social functioning, coping, and life satisfaction. Results showed that the 86 (52%) veterans who screened positive for PTSD reported greater difficulties in their relationships with romantic partners, less cohesion in their families, less social support, poorer social functioning, and lower life satisfaction compared to other treatment-seeking veterans. Less social support from the community, excessive worry, decreased acceptance of change, and lower availability of secure relationships mediated the association between PTSD and poor social functioning. The relation between PTSD and lower partner satisfaction was mediated by greater cognitive social avoidance and lower availability of secure relationships. These results suggest that psychotherapeutic interventions that address these mediating variables may help improve social functioning in treatment-seeking veterans with PTSD.     

The interplay of socio-psychological factors on school engagement among early adolescents

The study examined a conceptual model integrating existing knowledge on the linkages between life satisfaction, affect, purpose in life, and resilience with school engagement. This model posits direct relationships between all the social psychological variables and school engagement, and also indirect relationships between life satisfaction and school engagement as mediated by all the other variables in the study. The participants were 2381 students (1119 boys and 1262 girls) with average age of 15 years, from 40 national secondary schools in Malaysia. The findings supported the theoretical conceptualization. All variables were positively associated with school engagement. The strongest relationship was observed between overall life satisfaction and school engagement. The mediating model was partially supported. The study reiterates the adage that “it takes a village to raise a child”. Implications for practice and future research are discussed in the context of engagement in school learning.     

Life satisfaction and active coping style are important predictors of recovery from surgery

OBJECTIVE: The objectives of this study were to investigate the influence of psychological factors on the recovery of surgical patients and to explore whether there are any psychological variables other than anxiety that have a significant influence on recovery from surgery. METHODS: The participants were 112 adult patients undergoing a variety of surgical procedures. On the day prior to surgery, the Freiburg Personality Questionnaire, the State-Trait Anxiety Inventory, a coping schedule and the Questionnaire of Social Support were used to measure psychological parameters including personality, anxiety, coping and social support. The quality of the surgical outcome was rated by two independent and blinded surgeons by the length of hospital stay and analgesia and sedation requirements. The ratings controlled for the diagnosis, type of operation, intraoperative complications, postoperative medical problems and health limitations independent of the surgical procedure. RESULTS: Patients who had a complicated recovery were found to have reduced life satisfaction and lower situation-specific self-control expectations. Structural equation modeling revealed direct relationships between recovery from surgery and personality dimensions with the strongest correlations to life satisfaction, extraversion and attainment orientation. CONCLUSION: The data from this study suggests that valid predictions of the course of postoperative recovery need to take into account personality and coping behaviour orientated data as well as clinical variables. No direct influence on recovery could be predicted from preoperative state anxiety, but it seems likely that state anxiety may influence coping behaviour and that it is this that appears to have a significant impact to surgical recovery.     

Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury.

Demographic factors and cognitive impairment have been found previously to have associations with outcome after brain injury. Kendall and Terry (1996) suggest that preinjury psychosocial functioning, neurological factors, and cognitive impairment have a direct relationship with multidimensional psychosocial adjustment, but that cognitive impairment also has an indirect relationship by means of the mediation of appraisal and coping variables. The aim of this study was to explore these theoretical relationships at very late stages of recovery after brain injury. A total of 131 participants who were more than 10 years after injury (mean = 15.31 yr) completed a neuropsychological assessment, plus outcome measures that included employment status, community integration, life satisfaction, quality of life (QoL), and emotion. Results indicated that injury severity was predictive of life satisfaction; gender and relationship status predicted community integration; and age at injury predicted employment status. Impairment in working memory directly predicted all outcomes except QoL and anxiety. An indirect relationship was also evident between working memory, life satisfaction, and depression. Results partially support Kendall and Terry's model but the variables that significantly influence outcome seem to be determined by the outcome dimensions selected.     

Effects of faith and secular factors on locus of control in middle-aged and older cardiac patients

The complex relationships between faith factors and health locus of control were explored. Different from general expectancy, internal control was conceptualized as event-specific self-efficacy. Both control and faith are multidimensional phenomena and affect an individual's health and wellbeing. Yet, how faith and secular factors (e.g., demographic variables) are jointly related to personal control of patients in the face of medical crises remains empirically under-examined. Based on a comprehensive review of different aspects of perceived personal control, spiritual surrender, and faith factors, we presumed a multivariate association among them. Using data from two sequential interviews and the Society of Thoracic Surgeons' Adult Cardiac Database, the study examined the association between these faith factors and different health loci of control among 224 middle-aged and older patients 1 day prior to major cardiac surgery. Primary findings from multiple regression analyses generally supported our hypotheses. Greater internal control was positively related to using private prayer for coping, an event-specific "vicarious" control strategy, but negatively related to subjective religiosity, a general faith measure, after controlling for effects of other secular factors, especially cardiac-significant ones. Several factors in the medical history affected different loci of control. Older age and minority status were associated with greater external control.     

Attitude toward humor in patients experiencing depressive symptoms

Objective: This study measures the correlation between disposition to humor and level of depression to investigate openness to humorous interventions for the treatment of depression.Design, Participants, and Measurement: Individuals (n=200) with depression received questionnaires to assess their sense of humor and attitude toward humor using the Svebak's Humor Questionnaire and a disposition toward humor questionnaire. The correlation between Svebak's Humor Questionnaire scores and Quick Inventory of Depressive Symptomatology-Self Report scores was then measured. Results were further analyzed by race, age, and gender to assess any emerging trends within those groups.Results: Svebak's Humor Questionnaire mean scores remained high across gender, race, and age. However, there was not a statistically significant correlation between the level of depression and sense of humor (r=-0.22). The only significant relationship noted was between disposition toward humor and depression was for subjects aged 70 and older (r=-0.83).Conclusion: Though with certain limitations, these data provide preliminary support for the possibility that an appreciation of humor would persist despite symptoms of major depressive disorder. Clinicians could consider humor as part of an intervention in the treatment of depressive symptoms. The determination of the type of humor and manner of integrating it into therapy would require further study.     

Cognitive and Psychosocial Predictors of Subjective Well-Being in Urban Older Adults

Prior research indicates that physical health and social support have substantial influences on subjective well-being among older adults. However, little research has examined the influences of coping style and cognitive functioning on subjective well-being among older adults. This study investigated cognitive and psychosocial predictors of subjective well-being among 129 adults, ages 65-89 years. Canonical correlation indicated that subjective well-being was characterized by two dimensions: life satisfaction and affective balance (happiness). The use of emotion-focused coping strategies and poor perceived health were associated with diminished perceptions of life satisfaction, whereas task-oriented and avoidance-oriented coping were positively related to happiness. Cognitive functioning was positively related to life satisfaction and pleasant emotions independent of education and income.     

Cognitive and psychosocial predictors of subjective well-being in urban older adults

Prior research indicates that physical health and social support have substantial influences on subjective well-being among older adults. However, little research has examined the influences of coping style and cognitive functioning on subjective well-being among older adults. This study investigated cognitive and psychosocial predictors of subjective well-being among 129 adults, ages 65-89 years. Canonical correlation indicated that subjective well-being was characterized by two dimensions: life satisfaction and affective balance (happiness). The use of emotion-focused coping strategies and poor perceived health were associated with diminished perceptions of life satisfaction, whereas task-oriented and avoidance-oriented coping were positively related to happiness. Cognitive functioning was positively related to life satisfaction and pleasant emotions independent of education and income.     

What a difference a year makes: comparing relationships between stressful life events,mood and life satisfaction among older adults,and their working-age counterparts

ABSTRACT

Objectives: Stressful life events (SLEs) have been linked to depression, anxiety, and reduced life satisfaction. The inoculation hypothesis of aging suggests older adults may be less vulnerable to poor psychological outcomes following SLEs than working-age adults. The current study compared relationships between SLEs, mood and life satisfaction among older adults (65+), and adults aged 50–64, and investigated whether group identification and loneliness moderate these relationships.

Method: A community-based sample of 121 Scottish participants responded to measures of SLEs (modified Social Readjustment Rating Scale), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Index A), group identification (Group Identification Scale), and loneliness (UCLA Loneliness Scale).

Results: In the 50–64 age group, the number of SLEs was significantly associated with greater symptoms of depression and anxiety, and reduced life satisfaction. Group identification and loneliness did not moderate these relationships. There were no significant relationships in the older adult group.

Conclusion: The finding of relationships in working-age, but not older adults, supports the inoculation hypothesis of aging. Further research to better understand changes across the lifespan, and inter-relationships with related variables, would be valuable from both theoretical and clinical perspectives.     

A cross-sectional study on the health related quality of life of depressed Chinese older people in Shanghai

BACKGROUND: With an increasing life expectancy, there is a rapidly growing sector that is aging. Depression is the most prevalent functional mental disorder of older population. It is estimated that about 21% of the older population in Shanghai are suffering from depression. AIM: This study investigated the self-rated health related quality of life of community-dwelling older people diagnosed with depression in Shanghai, and to examine the relationships between this and mental and physical health, functional status and social support. METHODS: A cross-sectional survey was conducted in two community centres with a convenience sample of 71 participants. Measures included subjective perception of health related quality of life, level of depression, cognitive function, number of medical conditions, activities of daily living, functional abilities, and social support. The majority of the participants were female (n=52, 73.23%), and married (n=51, 71.8%). RESULTS: A higher level of depression was related to a poorer health related quality of life. Participants were least satisfied with their physical health. The level of depression, activities of daily living and satisfaction with social support were predictors of health related quality of life ratings. CONCLUSION: The study identified how depression affects the bio-psychosocial status of Chinese older people. Findings are discussed in light of the socio-cultural environment in Shanghai.     

Prediction of first episode of clinical depression in patients newly admitted to a medical long-term care facility: Findings from a prospective study

A cohort of 104 patients newly admitted to a medical long-term care facility was studied over 1 year for evolution of depression. Seven variables that were associated with level of depression were used in discriminant function analyses. Results showed that the variables had about 90% accuracy in predicting depressed versus non-depressed groups with good sensitivity and specificity. The variables measured: coping with admission; life satisfaction at admission; affective and non-affective symptoms at admission; clinical health status after admission; friends in hospital after admission; and changes in affective symptoms after admission before the onset of depression.     

Psychosocial variables and the life event/anxiety-depression link. A community study

Attention has shifted from the simple association between life events and psychological disturbance towards more complex models. Additional variables which may modify this simple association include personality factors, the nature and extent of social relationships, "vulnerability" factors and general coping skills. Four hypotheses concerning the influence of additional variables were described and their clinical relevance discussed. A general population study of 408 individuals was described. The influence of additional variables on the simple association between stressful life events and "anxiety-depression" was examined, using a hierarchical regression model. A range of demographic, personality, "vulnerability" and social relationship variables were considered in these analyses. The relevance of these results for our understanding of life events was discussed.