Differential effects of coping in mental disorders: A prospective study in psychiatric outpatients

The present follow-up study investigated the differential effects of dispositional coping styles on change in nine clinical syndromes of the Axis I spectrum of the DSM-III-R. Subjects were 155 psychiatric outpatients who were examined 6 and 7 years after their enrollment in the study. Coping accounted for up to 9% of the variance of symptom change over 1 year. As hypothesized, the effects of different coping styles varied considerably across the clinical syndromes. Active goal-oriented coping improved symptoms of the anxiety and the dependency spectrum; seeking social support had beneficial effects on symptoms of the depressive spectrum. The effects of the coping styles distraction, use of alcohol and other drugs, and focusing on and venting of emotions were detrimental, but again in a specific way. The results suggest that the differentiation of outcome criteria for coping is important. © 1996 John Wiley & Sons, Inc.     

Coping style of substance‐abuse patients: Effects of anxiety and mood disorders on coping change*

The authors studied the coping style of substance‐abuse patients during clinical cognitive‐behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential‐drug‐abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient‐substance‐abuse treatment, and more‐adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non‐anxiety patients. Presence of a mood disorder had no impact on coping‐style improvement. The results indicate that more attention should be focused on anxiety disorders during substance‐abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology. © 2003 Wiley Periodicals, Inc. J Clin Psychol, 2003.     

A factor analytic study of coping styles and the MMPI‐2 content scales*

The relationships among coping styles and psychopathology were examined with the MMPI‐2 content scales and a reliable and valid coping measure—the Coping Inventory For Stressful Situations (CISS). Subjects were 167 higher‐functioning normal adult males. The results are consistent with previous research that employed the CISS; a strong positive association was found between emotion‐oriented coping strategies and various measures of psychopathology. Task‐oriented coping strategies were found to be unrelated to these measures. Results are discussed in the context of a potential model for understanding the various relationships among coping styles and psychopathology. © 2003 Wiley Periodicals, Inc. J Clin Psychol, 2003.     

心理干预对老年痴呆患者亲属应付方式的影响

目的探讨心理干预对老年痴呆照料者应付方式的影响。方法对30例老年痴呆照料者,通过对疾病知识及应付技能的心理干预并应用应付方式问卷进行干预前后的评价与分析。结果心理干预后老年痴呆照料者退避及自责的消极应付方式减少,求助和解决问题的积极应付方式增加,差异均有显著性意义（P〈0．05）。结论心理干预能促进老年痴呆照料者的心理健康水平,改变消极的应付方式。     

Cognitive mediational deficits and the role of coping styles in pedophile and ephebophile Roman Catholic clergy

This study was designed to examine hypothesized differences between sex offending and nonoffending Roman Catholic clergy on cognitive mediation abilities as measured by the Rorschach Inkblot Test (H. Rorschach, 1921/1942). This study compared 78 priest pedophiles and 77 priest ephebophiles with 80 nonoffending priest controls on the Inkblot test using J. E. Exner's (2003) Comprehensive System. The three groups were compared on seven variables that constitute Exner's Cognitive Mediation cluster. Additionally, the groups' coping styles were compared to examine the interaction of coping style and cognitive mediational abilities. We found interactions between coping style and offending status across most of the cognitive variables indicating impairment in the mild to pathological ranges. Moreover, significantly higher unusual thinking styles (Xu%) and significantly lower conventional thinking styles (X+%) in offenders compared to nonoffenders. Those with an Extratensive style (n=31) showed significantly higher distorted thinking when compared to the Introversive (n=81), Ambitent (n=73), and Avoidant (n=50) coping styles. This study suggests that offenders display significantly higher distorted thinking styles than do nonoffenders. Possible reasons for these discrepancies and the role of coping styles in abusive behaviors were discussed.     

Life stress and clinically elevated MMPI scales: gender differences in the moderating influence of coping

Coping styles were evaluated as moderators of life stress-psychopathology relationships. Five hundred twenty-one undergraduates (271 females and 250 males) completed the Life Experiences Survey, the Coping Strategies Inventory, and the MMPI. To assess maladaptive coping styles, groups were constructed for each of 8 clinical scales (Hs, D, Hy, Pd, Pa, Pt, Sc, and Ma) composed of all subjects with a clinically significant elevation on that scale. The coping styles of these "clinical" groups were compared to the coping styles of "normal" groups, made up of subjects whose life stress scores were approximately the same but whose corresponding MMPI scale scores were within normal limits. To assess adaptive coping styles, a group of effective copers (with high life stress but normal MMPI profiles) was compared to a group of less effective copers (with high life stress but with at least one scale outside of normal limits). All groups were constructed separately for gender. The predicted gender differences and specific coping style-psychopathology relationships were, by and large, found. Coping style differences between the effective and less effective copers were also found. These findings suggest that several coping styles are important moderators of life event stress-psychopathology relationships.     

Depersonalization,fantasies, and coping behavior in clinical context*

The main purpose of the present study was to determine the relation between specific dissociative experiences (depersonalization, fantasies) and self‐reported coping behavior in a clinical (depression, anxiety, schizophrenia) and nonclinical sample (normal adults). Dissociative experiences were assessed with the Questionnaire of Experiences of Dissociation (QED) of Riley (1988) and coping behavior with the Stress‐Process Questionnaire (SPQ; Janke, Erdmann, & Boucsein, 1985). A factor analysis of the QED items revealed a two‐factor extraction: Factor 1 “depersonalization” and Factor 2 “fantasies/daydreams.” The clinical group scored higher on the QED factor “depersonalization” and had more passive forms of coping behavior (resignation, social isolation, self‐compassion, self‐blame) than the normal adults. Similar correlation patterns were found for both groups: The QED factor “depersonalization” correlated highly with the coping behaviors “resignation,” “social isolation,” “self‐blame,” “self‐compassion,” and “rumination.” No correlation between Factor 2 “fantasies/daydreams” and the coping behavior was found. Finally, correlations between depersonalization, trait anxiety, and personal need for structure were reported. © 2003 Wiley Periodicals, Inc. J Clin Psychol, 2003.     

Stress and coping among children of alcoholic parents through the young adult transition

The transition to young adulthood is both a time when risky health behaviors such as substance misuse peak and a time of opportunity for growth and development through the acquisition of adult roles. In this transition, coping styles include responses to the stressors and opportunities associated with the emergence of adulthood. The extent to which such coping styles are skillfully employed in part determines adjustment into adulthood. The current study used a high-risk, longitudinal design to examine the development of coping styles over adolescence, continuity in these coping styles from adolescence to adulthood, the impact of coping on adult stress and substance misuse, the ability of coping to buffer effects of stress on substance use, and differences in coping between at-risk youth (i.e., children of alcoholics [COAs]) and their peers. A sample of 340 adolescents completed four assessments over ages 11-23. We used latent trajectory models to examine interindividual and intraindividual change in coping over time. Evidence for both change and continuity in the development of coping from adolescence to adulthood was found, although adolescent coping had limited impact on stress and substance use in adulthood. Support was also found for complex stress-buffering and stress-exacerbating effects of coping on the relations between major life events and adult drug use and between stress associated with the new roles of adulthood and heavy alcohol use. Implications of these findings for development and adjustment in the transition to adulthood are discussed.     

Testing the psychometric properties of the Ways of Coping Questionnaire (WCQ) in Turkish university students and community samples

Ways of Coping Questionnaire (WCQ) has been extensively used to assess coping styles in the clinical or non‐clinical context. The present study investigates the psychometric properties of WCQ in Turkish culture and attempts to get its shorter version by using three separate and independent samples (two groups of university students and one community sample). The constructive study was conducted with a sample of full‐time university students (N = 472) and it indicated that the most relevant factor structure was seven‐factor model. The factors were planful problem‐solving, seeking refuge in supernatural forces, keep to self, seeking social support, seeking refuge in fate, escape/avoidance and accepting responsibility. After that, confirmatory factor analysis was performed to test the adequacy of these factors with two different samples. Study 1 was conducted with a sample of university students (N = 485) and Study 2 was conducted with a sample of community (N = 416). Results demonstrated that seven‐factor solution revealed better results in both samples in terms of goodness of fit indexes in confirmatory factor analysis. The results of reliability and validity analysis revealed that psychometric properties of WCQ were acceptable. In addition to getting shorter version of WCQ, the present study enhances cross‐cultural information that increases awareness about the coping styles in a non‐western culture. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioners Message: ? Ways of Coping Questionnaire (WCQ) is a feasible measure especially for non‐native clinicians to understand the client's coping styles by exploring and being sensitive to his/her cultural values in order to establish therapeutic alliance throughout the therapy assess. ? Turkish version of WCQ includes specifi c dimensions of seeking refuge in fate and supernatural forces. ? Clinicians can assess behavioural as well as cognitive responses of coping behaviours by WCQ. ? WCQ can be used to identify focal point of the therapy when dealing with depression, negative affect and self esteem problems of Turkish clients.     

沙盘游戏创新实验对大学生独生子女应对方式的影响

目的:探索沙盘游戏创新实验对大学生独生子女应对方式的影响,了解该实验的教学效果。方法:本研究选取9名大学生,开展了为期8周,每周4个学时的沙盘游戏创新实验,并采用简易应对方式量表(SCSS)和被试的主观感悟来考察此种沙盘干预方法是否能够改善大学生独生子女的应对方式。结果:通过对所有被试应对方式前后测得分的Wilcoxon秩和检验,表明沙盘游戏创新实验显著改善了大学生的消极应对方式(Z=-2.25,P0.05);通过对大学生独生和非独生子女前后测得分差异进行Mann-Whitney检验,沙盘游戏创新实验对改善独生子女消极应对方式的效果好于非独生子女(Z=-1.95,P0.05)。结论:沙盘游戏创新实验作为一种新型的干预方式,能够帮助大学生积极应对挫折,改善消极应对方式,使其有效回避一系列心理问题,促进人际关系的改善。     

Who stays in addiction treatment groups? Anxiety and avoidant attachment styles predict treatment retention and relapse

Attachment styles have been shown to be an important predictor of relationship quality and well‐being. They have also been linked with ability to function well in groups. Insecure attachment styles are thought to be an underlying cause of addiction and represent a target for change in one‐to‐one therapy. How attachment styles themselves affect group therapy for addiction is understudied. The current study addresses this gap by examining the effects of attachment styles on relapse and treatment retention amongst a population of people attending addiction therapy groups. Fifty‐eight individuals in such groups completed measures of attachment anxiety and avoidance. Participants were followed up 4 weeks later, and their continued treatment attendance and relapse status were recorded. In terms of treatment retention, high anxiety/high avoidant participants had the highest retention. In terms of relapse, low anxiety/high avoidant participants had the lowest rates. These results are discussed in terms of the potentially protective effects of avoidant attachment styles during group therapy and the role of anxiety attachment in the continued maintenance of both protective and risky personal relationships.     

Differential efficacy of written emotional disclosure for subgroups of fibromyalgia patients

Objectives. To identify differential health benefits of written emotional disclosure (ED). Methods. Pain‐coping style and demographic characteristics were examined as potential moderators of ED treatment efficacy in a randomized controlled trial with female fibromyalgia patients. Results. Of three pain‐coping styles, only patients classified as interpersonally distressed (ID) experienced significant treatment effects on psychological well‐being, pain, and fatigue. Treatment effects on psychological well‐being were also significantly greater for patients with a high level of education. Conclusions. Patients with an ID‐coping style and/or high education appear to benefit most from ED.     

Coping style of substance-abuse patients: effects of anxiety and mood disorders on coping change

The authors studied the coping style of substance-abuse patients during clinical cognitive-behavioral group therapy, and the effects of mood and anxiety disorders on changes in coping style. Change in coping style was studied prospectively in a cohort of 132 residential-drug-abuse patients. In addition to pretreatment assessments, which included diagnosis of mood and anxiety disorders and addiction severity, repeated measurements of coping style were performed at predetoxification, pretreatment, and after three and six months of treatment. Considerable change in coping style between predetoxification and pretreatment was found, suggesting that coping assessment in a predetoxification phase is confounded by state factors surrounding treatment entry. Coping style of detoxified substance abusers is related to the presence of mood and anxiety disorders. Coping style was not found to be related to the severity of drug abuse. Furthermore, maladaptive coping styles decreased after three months of inpatient-substance-abuse treatment, and more-adaptive coping styles remained stable for another three months of inpatient treatment. Patients with an anxiety disorder improved less on coping style when compared to non-anxiety patients. Presence of a mood disorder had no impact on coping-style improvement. The results indicate that more attention should be focused on anxiety disorders during substance-abuse treatment in order to improve coping style. Furthermore, more studies are needed on the relation between substance abuse, coping style, and psychopathology.     

Genetic and environmental influences on coping styles: a twin study.

OBJECTIVE: Coping styles are generally considered to be environmentally driven, primarily by family influences. However, because personality traits are commonly influenced by genetic effects, we hypothesized that heredity is also important for coping. METHODS: We tested this hypothesis by assessing 19 coping styles, as well as four secondary coping factors, by questionnaire in 212 pairs of monozygotic and dizygotic twins. We then examined heredity by structural equation modeling. RESULTS: All coping styles showed evidence of genetic influences. The coping styles shared one common genetic factor. In addition, each coping style was also influenced by other separate genetic factors. Shared environment had no significant influence on coping styles. Three of 19 more specific coping styles showed shared environmental effects as well as genetic influences, 14 were solely under genetic influences, and two showed only shared environment effects. CONCLUSIONS: We suggest that hereditary effects on certain coping style preferences cannot be explained solely by genetic influences on major personality traits and temperament. An analysis of the relationships between coping and personality in twin subjects may elucidate the distinction between genetic and environmental effects.     

Behavioral Preparation of Patients for Gastrointestinal Endoscopy: Information,Relaxation, and Coping Style

Abstract

The effectiveness of two techniques for preparing patients to undergo a stressful medical examination was assessed using observer self-report, and physiological measures of distress during gastrointestinal endoscopy. Patients were either informed about expected sensations, trained in systematic muscle relaxation, or received normal hospital procedures. The influence of coping styles on the effectiveness of information and relaxation techniques was examined for measures of fear, avoidance, emotional control, arousability, and independence.

Information and relaxation interventions reduced heart rate increases and observer ratings of distress during tube insertion. Relaxation training also increased positive mood change following the procedure. Interactions between coping styles and recovery measures suggested patients benefited most from preparation that matched their preferred coping style, but were not harmed by preparation that did not match their preferred style. Discussion focuses on how coping styles may interact with preparation procedures and suggests that the use of coping styles as criteria for excluding patients from certain preparation techniques is inappropriate.     

Response to environmental change in rainbow trout selected for divergent stress coping styles

An extensive literature has documented differences in the way individual animals cope with environmental challenges and stressors. Two broad patterns of individual variability in behavioural and physiological stress responses are described as the proactive and reactive stress coping styles. In addition to variability in the stress response, contrasting coping styles may encompass a general difference in behavioural flexibility as opposed to routine formation in response to more subtle environmental changes and non-threatening novelties. In the present study two different manipulations, relocating food from a previously learned location, and introducing a novel object yielded contrasting responses in rainbow trout selected for high (HR) and low (LR) post stress plasma cortisol levels. No difference was seen in the rate of learning the original food location; however, proactive LR fish were markedly slower than reactive HR fish in altering their food seeking behaviour in response to relocated food. In contrast, LR fish largely ignored a novel object which disrupted feeding in HR fish. Hence, it appears that the two lines appraise environmental cues differently. This observation suggests that differences in responsiveness to environmental change are an integral component of heritable stress coping styles, which in this particular case, had opposite effects on foraging efficiency in different situations. Context dependent fitness effects may thus explain the persistence of stable divergence of this evolutionary widespread trait complex.     

Swimming against the tide: characteristics of Muslim‐Arab women in Israel who initiated divorce

The present study compared Muslim‐Arab women in Israel who initiated divorce (n=45) with those who stayed in stressful marital relationships (n=46). Based on an ecological approach and using a cross‐sectional design, we explored the differences between the two groups with regard to the following variables: personal resources (education, paid employment, hardiness, styles of coping with stressful situations, and egalitarian gender role ideology), spousal variables (evaluation of marital difficulties), and environmental resources (formal and informal support from the environment). The findings revealed that levels of education and rates of participation in the labor force were higher among the divorced women than among those who stayed in stressful marriages. In addition, the divorced women had a more egalitarian gender role ideology and tended to adopt problem‐focused styles for coping with stressful situations, whereas the married women tended to combine emotion‐focused and problem‐focused styles. The main difficulty experienced by the divorced women was the husbands' violence, whereas the married women primarily experienced difficulties related to the husbands' alcoholism or drug addiction. In light of the findings, practical recommendations are presented. © 2010 Wiley Periodicals, Inc.     

Mental health problems and coping styles of urban and rural high school students in China

Few studies have compared urban and rural adolescents' mental health problems, especially in developing countries. The purpose of this study was to investigate the mental health problems and coping styles of adolescents in urban and rural areas in China. A total of 927 urban and rural high school students in Shandong Province of China were recruited for the study. The results of the study are as follows: (a) students in rural low‐socioeconomic status (SES) areas, especially females, had more mental health problems than did those in rural high‐SES and urban areas; (b) rural low‐SES students were more likely to cope by venting and fantasizing than did the other two groups; (c) regardless of residence and SES, mental health problems were inversely related to the use of problem solving as a coping strategy, but positively related to fantasizing; and (d) urban‐rural differences in mental health problems were not entirely accounted for by group differences in coping strategies. © 2011 Wiley Periodicals, Inc.     

大学生求职面试后应对方式及其与人格的相关

目的：研究大学生求职面试后的应对方式，探讨其与人格的关系。方法：通过个别访谈和开放式问卷收集项目，编制大学生求职面试后应对方式问卷，对622名大学毕业生进行调查；其中238人同时完成中国人人格量表（QZPS—SF）。结果：探索性因素分析发现应对方式有问题解决和回避两个维度；方差分析表明，城镇生源毕业生更倾向于采用问题解决应对方式；应对方式阿维度与人格特质七维度的回归分析表明，人际关系和处世态度对问题解决应对方式有显著影响：外向性、行事风格、处世态度对回避应对方式有显著影响。结论：大学生求职面试后应对方式具有稳定结构．并与部分人格特质的相关关系显著.     

Positive coping up- and down-regulates in vitro cytokine productions from T cells dependent on stress levels

BACKGROUND: Specific coping styles have been shown to modulate stress-induced immune alterations and influence actual health outcomes. This study examined the effects of stressors and coping styles on human T-cell subpopulations and in vitro cytokine production using a cross-sectional design. METHODS: Seventy-one men (18-60 years old) were asked to complete a self-administered questionnaire that evaluates quantitative workload, mental demand and coping styles. The numbers of T-cell subpopulations and concentrations of interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) after stimulation with phytohemaglutinin were measured. RESULTS: Positive and negative coping were negatively related to IL-4 and the number of CD4+ cells, respectively. Interactions between positive coping and mental demand significantly affected the number of CD8+ cells, IFN-gamma, IL-4 and the IFN-gamma/IL-4 ratio. Among men reporting high mental demand, positive coping was related to increased IFN-gamma and IFN-gamma/IL-4. Among men reporting low mental demand, positive coping was related to a decreased number of CD8+ cells and lower concentrations of IFN-gamma and IL-4. Analyses adjusting for the numbers of CD3+ and CD8+ cells revealed that the interactive effects of positive coping and mental demand on cytokine levels were attributable to the changes in T-cell function rather than the number of T cells. No modulating effect of anxiety on the associations of stressors and coping with immune function was observed. Depressive symptoms slightly, though not significantly, modulated the association of negative coping and the number of CD4+ cells. CONCLUSIONS: From the perspective of immunology, optimal stress characteristics were determined by an individual's coping styles, with positive coping being associated with stress-induced changes in the number of CD8+ cells and in vitro cytokine production from T cells. Our findings suggest that it is important to consider the interactive effects of the complexity of work and the individual coping style in stress management.