Psychological distress of caregivers: moderator effects of caregiver resources?

Personal psychological, social and health resources of informal caregivers are often assumed to attenuate or increase caregiving stress. This hypothesis was tested by investigating the effect of caregivers' resources on the relationship between their appraisal of the caregiving situation and psychological distress. Caregiver resources measured were: problem-focused and emotion-focused coping, neuroticism, received emotional and instrumental support and physical functioning. Results show that none of these caregiver resources has moderator effects, neither for all caregivers together (n = 166), nor for subgroups of caregivers. These subgroups were: spouses, non-spouses, males, females, caregivers of minimally and mildly demented people and of moderately and severely demented people, respectively. The absence of moderator effects on caregiving stress suggests that caregivers of demented elderly people may need attention and support when they perceive pressure, regardless of their personal resources.     

Relations between social support, appraisal and coping and both positive and negative outcomes in young carers

This study examined a stress/coping model of adjustment in early caregiving. It was hypothesized that better adjustment would be related to higher social support and approach coping, and lower stress appraisals and avoidant coping. One hundred young carers aged 10-25 years completed questionnaires. Predictors included choice in caregiving, social support, stress appraisal and coping. Dependent variables were global distress and positive outcomes (life satisfaction, positive affect, benefits). Correlations supported all hypothesized relations between the stress/coping predictors and adjustment outcomes. Regression analyses showed social support as the strongest predictor of adjustment, whereas coping and choice in caregiving emerged as weaker predictors and stress appraisal was unrelated to adjustment. The stress/coping framework and findings have the potential to inform interventions designed to promote well-being in young carers.     

Job strain and psychological distress among employed pregnant Thai women: role of social support and coping strategies

Most Thai women continue to work throughout their pregnancy; however, little is known about job strain and its relation to psychological distress. This study aimed to examine: (1) the direct effects of job strain, perceived workplace support, perceived family support, and coping strategies on psychological distress and (2) the moderating effect of perceived workplace support, perceived family support, and coping strategies on the relationship between job strain and psychological distress. Lazarus and Folkman’s transactional model of stress and coping guided this cross-sectional study. Full-time employed pregnant women (N?=?300) were recruited from three antenatal clinics in Thailand. Thai versions of the following instruments were used: the State-Anxiety Inventory and Center for Epidemiological Studies—Depression Scale (psychological distress), the Job Content Questionnaire (job strain and perceived workplace support), the Medical Outcome Study Social Support Survey (perceived family support), and the Ways of Coping Checklist—Revised (coping strategies). Job strain with other predictors explained 54 % of the variance in psychological distress. In the separate hierarchical multiple linear regression models, two types of coping strategies, seeking social support and wishful thinking, moderated the effects of job strain on psychological distress. Perceived family support had a direct effect in reducing psychological distress. Job strain is a significant contributor to psychological distress. The average levels of seeking social support and wishful thinking were most beneficial in moderating the negative impact of job strain on psychological distress. Since perceived workplace and family support did not have moderating effects, stress management programs for decreasing the levels of job strain should be developed.     

Effects of effort and distress coping processes on psychophysiological and psychological stress responses.

The purpose of this study was to investigate the effects of coping processes on psychophysiological and psychological responses in stressful settings. In particular, we focused on the effects of a combination of active and avoidant coping processes. Subjects were 40 healthy undergraduate male students (mean=19.80, S.D.=0.97) who were randomly divided into four groups: (a) an effort coping group in which a subject faced a controllable stressor mobilizing an effortful and active coping behavior for a reward; (b) a distress coping group in which a subject faced a distressful stressor mobilizing an avoidant coping behavior for threat of punishment; (c) an effort-distress coping group in which a subject faced an ambivalent stressor mobilizing active coping behavior for a reward and avoidant coping behavior for threat of punishment; and (d) a control group. Initially, the effects of effort coping, distress coping, and effort-distress coping on psychophysiological and psychological responses were investigated. It was found that effort coping and effort-distress coping intensified cardiovascular responses, particularly blood pressure, and that distress coping and effort-distress coping intensified skin conductance level (SCL). Secondarily, the relationships between effort coping process, distress coping process, psychophysiological responses, and psychological responses were investigated. As a result of cluster analysis, the changes of heart rate and blood pressure were correlated to the change of the effort score, and the changes of SCL and psychological responses were correlated to the change of the distress score. These findings suggest that active coping processes and avoidant coping processes independently affect different response systems.     

初中生应激生活事件、社会支持、应对方式与心理症状关系的结构模型

目的:构建初中生应激生活事件、社会支持、应对方式与心理症状的关系模型.方法:对1009名初中生分别采用应激生活事件问卷、应对方式问卷、社会支持问卷和症状自评量表进行测量,进而用结构方程模型的方法构建了潜变量之间的关系模型.结果:应激生活事件、社会支持、积极应对、消极应对对症状总分有直接影响(权重分别是0.565、-0.064、-0.172、0.377),应激生活事件、社会支持、消极应对对症状总分有间接影响(权重分别是0.161、-0.042、-0.115).结构方程分析表明,女生的社会支持、消极应对对症状总分的影响比男生组更大(女生权重为-0.142和0.292,男生权重为-0.097和0.198).结论:应激生活事件、社会支持、应对方式对心理症状的作用得到结构方程模型的有力支持.     

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.     

Brief report: pediatric cancer, parental coping style, and risk for depressive, posttraumatic stress, and anxiety symptoms

OBJECTIVE: According to the stress and coping goodness of fit model, parents' risk for psychological symptoms was hypothesized to decrease as a function of using emotional regulation and problem appraisal strategies more frequently, and to increase as a function of using problem-solving and avoidant behaviors more frequently to cope with an uncontrollable stressor--pediatric cancer diagnosis. METHODS: Parents (N = 150) completed measures of depression, PTSD, anxiety, and coping style. RESULTS: Regression analyses revealed that symptoms decreased as a function of using problem appraisal and an emotional regulation strategy (social support) more frequently; and increased as a function of using problem-solving strategies, avoidant coping (substance use), and another emotional regulation strategy (negative self-blame) more frequently. CONCLUSIONS: The findings provide some support for the model but suggest that the method of coping (e.g., social support) might be considered in addition to the focus of the coping strategy (e.g., emotional regulation).     

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.     

Predicting the impact of child sexual abuse on women: the role of abuse severity, parental support, and coping strategies.

Female Navy recruits (N = 5,226) completed surveys assessing history of childhood sexual abuse (CSA), childhood strategies for coping with CSA, childhood parental support, and current psychological adjustment. Both CSA and parental support independently predicted later adjustment. In analyses examining whether CSA victims' functioning was associated with CSA severity (indexed by 5 variables), parental support (indexed by 3 variables), and coping (constructive, self-destructive, and avoidant), the negative coping variables were the strongest predictors. A structural equation model revealed that the effect of abuse severity on later functioning was partially mediated by coping strategies. However. contrary to predictions, the model revealed that childhood parental support had little direct or indirect impact on adult adjustment.     

Psychological well‐being across 1 year with rheumatoid arthritis: Coping resources as buffers of perceived stress

Objectives. Using the transactional model of stress and coping, the present study investigated whether specific coping resources act as buffers of the relationship between perceived stress and psychological well‐being among rheumatoid arthritis (RA) patients. Design. A longitudinal observational study was carried out with assessments at baseline, 6 months and 1 year. Methods. Measures of perceived stress, coping resources (optimism/pessimism, social support and explicit active coping strategies) and psychological well‐being (anxiety, depression and life satisfaction) were completed by 134 RA patients. Demographics, RA duration, pain, fatigue, functional disability, antidepressant use and physical comorbidities were recorded and statistically controlled for. Results. Perceived stress had the strongest relationship with psychological well‐being at baseline, and affected anxiety after 6 months. Optimism and pessimism predicted psychological well‐being across 1 year. Active behavioural coping buffered an association of stress with depression at baseline, while baseline active cognitive coping buffered the effect of baseline stress on life satisfaction after 6 months. Conclusion. Patients with RA under greater perceived stress who do not use active coping strategies appear to be at risk of psychological comorbidity and may therefore benefit from interventions teaching specific active coping strategies. Larger observational studies and interventions are required to confirm and extend these findings.     

Psychological distress and the impact of social support on fathers and mothers of pediatric cancer patients: long-term prospective results

OBJECTIVE: To explore the effects of social support on psychological distress of parents of pediatric cancer patients using a prospective design over a 5-year period. METHODS: Parents of children diagnosed with cancer participated at diagnosis (T1), 6 months (T2), 12 months (T3), and 5 years later (T4). Instruments The General Health Questionnaire and the Social Support List (SSL) measuring amount of support, (dis)satisfaction with support, and negative interactions were administered. RESULTS: Psychological distress and amount of support received decreased significantly from diagnosis to T4. No significant change in (dis)satisfaction with support and negative interactions was found. Social support variables did not show any concurrent or prospective significant effect on mothers' distress at T4. Dissatisfaction with support showed a significant unique concurrent effect on fathers' distress at T4 and negative interactions had a prospective unique effect. CONCLUSIONS: Dissatisfaction with support and negative interactions that fathers experienced significantly affected their levels of psychological distress. No such effect was found for mothers.     

The Role of Illness, Resources, Appraisal, and Coping Strategies in Adjustment to HIV/AIDS: The Direct and Buffering Effects

This study examined the utility of a stress and coping model of adjustment to HIV/AIDS. A total of 114 HIV-infected gay or bisexual men were interviewed and they completed self-administered scales. Predictors included illness variables (disease stage and number of symptoms), coping resources (optimism and social support), appraisal (threat, challenge, and controllability), and coping strategies (problem- and emotion-focused). Adjustment outcomes were depression, global distress, social adjustment, and subjective health status. Results from hierarchical regression analyses indicated that better adjustment was related to an asymptomatic illness stage, fewer HIV-related symptoms, greater social support, challenge and controllability appraisals, problem-focused coping, and lower threat appraisals and reliance on emotion-focused coping. There was limited support for the stress-buffering effects of optimism. Findings support the utility of a stress and coping model of adjustment to HIV/AIDS.     

Meaning of illness and psychological adjustment to HIV/AIDS

The authors explored the relationship between meaning of illness and psychological adjustment in persons with symptomatic HIV disease and AIDS. A group of 203 participants completed self-report questionnaires measuring meaning of illness, problem-focused coping, social support, psychological well-being, and depressed mood. Positive meaning was associated with a higher level of psychological well-being and a lower level of depressed mood. Further, meaning contributed significantly to predicting both psychological well-being and depressed mood over and above the contributions of problem-focused coping and social support. These findings have implications for HIV coping and adjustment models and for HIV-related psychotherapy.     

Asthma in relation to personality traits, life satisfaction, and stress: a prospective study among 11,000 adults

BACKGROUND: While patients' personality has been thought to affect allergic diseases, the association of asthma and psychological factors is still debated. Stress is believed to predispose to asthma, but no clear evidence of causality has been found. We have studied the role of psychological factors in prevalent as well as in incident asthma cases among the adult population. METHODS: A total of 11540 adults initially aged 18-45 years responded to three questionnaires in 1975, 1981, and 1990, respectively. The association of psychological factors (including extroversion and neuroticism scales, subjective stress, and life satisfaction) and prevalent asthma was studied, as well as the predisposing effect of these factors on the risk of adult onset asthma. Logistic regression was used for risk calculations. RESULTS: Low life satisfaction was associated with asthma prevalence (age- and sex-adjusted OR=2.27: 1.04-4.93 for prevalent asthma among those with low life satisfaction compared to those with high life satisfaction), as was neuroticism (age and sex-adjusted OR=1.78:1.12-2.84 for those with a high neuroticism score compared to those with a low score). A high extroversion score was significantly associated with the risk of adult onset asthma among women (age-adjusted OR=2.72: 1.44-5.12 for new asthma among those with high score compared to those with a low extroversion score). CONCLUSION: No specific personality type is associated with adult onset asthma, but there is a significant sex difference in the effect of psychological factors in asthma risk. A high extroversion score is a strong predictor of incident asthma among women. Prevalent asthma decreases life satisfaction and is associated with a high neuroticism score.     

Coping and Adjustment in Children with Cancer: A Meta-Analytic Study

The current meta-analysis assessed the efficacy of coping strategies on psychological and physical adjustment in children with cancer (n = 1230). Coping strategies were operationalized in accordance with two coping taxonomies; the first is based on the general orientation of the child's coping attempts (approach or avoidance), and the second is based upon coping efforts to regulate the stressor and/or feelings of distress attributed to it (problem-focused and emotion-focused). Approach, avoidance, and emotion-focused coping were unrelated to overall adjustment. A small-to-medium but negative association was found between problem-focused coping and adjustment, indicating more use of the strategies that compose this dimension are associated with poorer adjustment. However, homogeneity analyses also indicated significant variation for all of these effect sizes. Follow-up moderator analyses found coping-adjustment relations were both dependent upon time since diagnosis and the particular stressor the child was dealing with during treatment.     

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.     

Stress,psychological distress,psychosocial factors,menopause symptoms and physical health in women

Objectives

Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women.

Methods

One hundred and sixteen women aged 45–55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health.

Results

Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping.

Conclusions

Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.     

大学生心理应激模型的初步构建

目的：探讨大学生的心理应激过程并初步构建大学生心理应激模型。方法：以880名高校大学生为研究对象，采用结构方程模型技术（SEM）建立生活事件、应对方式、社会支持、个性特征、自我效能等因素对心身健康的作用途径。结果：①生活事件既对大学生心身健康直接产生作用，又通过应对方式、社会支持、个性特征、自我效能这砦中介因素间接产生作用，并且从路径系数上反映出间接作用大于直接作用。②自我效能是重要的心理中介因素，与应对方式、社会支持、个性特征相比，在生活事件和大学生心身健康之间似乎起着更为直接的中介作用。结论：研究为揭示大学生心身健康的作用机制、有效开展大学生心理卫生工作和更好地增进大学生心身健康水平提供r初步的理论依据。     

AIDS-related grief and coping with loss among HIV-positive men and women

AIDS-related grief was examined and its association with coping among HIV-positive men and women explored. AIDS-related grief, psychological distress and coping were examined among a sample of 268 HIV-infected individuals, diverse with respect to gender, ethnicity, and sexual orientation. Participants exhibited elevated scores on measures of grief reaction and psychological distress including depressive symptoms, anxiety, and traumatic stress related to their losses. Hierarchical regression analyses revealed that severity of grief reaction was associated with escape-avoidance and self-controlling coping strategies, type of loss, depressive symptoms, and history of injection drug use. Interventions are needed to enhance coping and reduce psychological distress associated with the unique bereavement experienced by people living with HIV- and AIDS-related grief.     

Attachment style and coping in relation to posttraumatic stress disorder symptoms among adults living with HIV/AIDS

Research indicates that a significant proportion of people living with HIV/AIDS report symptoms of posttraumatic stress disorder (PTSD). Moreover, attachment style has been associated with psychological and behavioral outcomes among persons living with HIV/AIDS. Attachment style may influence the ability to cope with traumatic stress and affect PTSD symptoms. To examine the association between attachment style and coping with PTSD symptoms, we assessed 94 HIV-positive adults on self-report measures of posttraumatic stress, coping, and attachment style. In multiple regression analysis, avoidant attachment and emotion-focused coping were positively and significantly associated with greater PTSD symptomatology. Support was also found for the moderating effects of avoidant and insecure attachment styles on emotion-focused coping in relation to greater PTSD symptoms. Taken altogether, these results suggest that interventions that develop adaptive coping skills and focus on the underlying construct of attachment may be particularly effective in reducing trauma-related symptoms in adults living with HIV/AIDS.