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.     

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.     

Optimism,coping style and emotional well‐being in cardiac patients

Objective. Optimism is associated with superior emotional well‐being in people with chronic and acute health problems, possibly because optimists are more likely to implement problem‐focused coping. Another interpretation posits that optimism can be a defensive response designed to diminish affective reactions to health problems. The study objective is to investigate this possibility. Design. A cross‐sectional examination of relationships between dispositional and relative optimism, threat avoidance and emotional well‐being in 85 cardiac patients. Results. Blunting, a measure of threat avoidance, was found to be associated with both optimism and emotional well‐being, and the common variance was predictive of positive affect. As expected, this link was stronger in people with low self‐efficacy for problem‐focused coping. Conclusion. These findings support a defensive interpretation of optimism amongst patients with recently‐experienced cardiac disease, particularly as the effect was more pronounced in the low self‐efficacy subsample. We discuss possible explanations for these findings and implications for the study of coping with serious illness.     

Repressive coping style and positive self‐presentation

Objective: This paper reviews 59 studies looking at cognitive, individual differences and physiological correlates of the repressive coping style, as defined by Weinberger, Schwartz, and Davidson (1979). A central aim is to evaluate the relative importance of the anxiety and social desirability components of repression. Thus, the empirical study investigates the relationships between repression and a number of relevant, but hitherto unexamined, constructs, including trait emotional intelligence (trait EI), self‐estimated intelligence, functional and dysfunctional impulsivity, and stoicism. It was hypothesized that repressors would score higher than the other three groups on trait EI, self‐estimated IQ and functional impulsivity, but lower on dysfunctional impulsivity. Method: In total, 259 (174 females) participants from three British universities completed questionnaires measuring the dependent and independent variables. Participants were divided into four groups (truly low anxious, non‐defensive/high anxious, defensive/high anxious and repressors) based on their scores on anxiety and social desirability. Analyses (moderated multiple regressions and ANOVAs) were conducted both on the total sample as well as on ‘extreme‐scoring’ individuals. Results: Where there were significant differences, the hypotheses were supported, particularly with respect to trait EI, self‐estimated IQ and impulsivity. Using ‘extreme‐scoring’ groups did not effectively change the results. The regressions revealed an absence of significant interactions between anxiety and social desirability. Conclusion: Results are discussed in terms of the now replicated effect that repressors present a highly positive and optimistic self‐image, despite cognitive and behavioural data suggesting that their coping style is psychologically unhealthy. In addition, it is argued that many findings in the repressive coping style literature can be parsimoniously explained through main effects of anxiety or social desirability alone (i.e., without invoking a construct that combines the two).     

Use of herbal medicine in primary care patients with mood and anxiety disorders

Studies have documented the increasing use of complementary and alternative medicine over the last decade, especially in distressed individuals with symptoms of anxiety, depression, and pain. Herbal medicine is a specific form of complementary and alternative medicine often used by individuals seeing traditional medical practitioners and, hence, has the potential to interact with other medically prescribed treatments. The study examined the use of herbal medicine in a group of primary care patients with symptoms of anxiety and depression. The rate of use of herbal medicines was 11%, and use was selectively associated with a diagnosis of major depression, higher education, and a lower burden of medical illness. Use was not associated with receipt of pharmacotherapy or psychotherapy for anxiety or depression.     

Case conceptualization from a process‐based and modular perspective: Rationale and application to mood and anxiety disorders

This article presents the theoretical, clinical, and practical arguments supporting a process‐based transdiagnostic approach to psychotherapy. A working definition of “psychological process” is provided, as well as a tri‐dimensional categorization of psychological processes potentially involved in psychopathology. Guidelines are proposed to select psychological interventions based on the active psychopathological processes evidenced in a given case. We also provide a rationale to organize treatment as a set of modules, each addressing a specific psychopathological process. Next, we review the main processes that may be active in mood and anxiety disorders, and that are accessible to clinicians in regular practice. For each process, we propose a validated assessment questionnaire. Finally, we offer a free‐access web‐based instrument that allows clients to fill in these questionnaires via an internet survey, and that provides therapists with a tool to easily decode and interpret the questionnaire results and to present them to the clients.     

对病情知情与否食管癌患者应对方式的差异

食管癌作为一种危害生命的负性生活事件,不仅给患者带来躯体上的痛苦,对其精神也带来严重创伤,不同的患者采用不同的应对方式对自己的心理反应进行调节适应.研究表明,面对能提高患者的生活质量,回避也可以有效减轻患者的负性情绪;而屈服则增加患者心理压力,其始终与不良的心身健康呈正相关[1].对病情知情与否对患者的心身症状有一定影响[2],本研究探讨知情与否食管癌患者应对方式的差异.     

Coping style in hypertensive patients: nature and consequences

Examined the coping styles and health behaviors of hypertensive and normotensive patients visiting a primary care setting for acute medical problems. Hypertensive individuals were far more likely to display a "high-monitoring" (information-seeking) mode of coping than normotensive individuals, who tended to be "low monitoring" (information avoiding) in their coping. Although hypertensive patients reported less dysfunction in their current medical problems than did normotensive patients, they nonetheless reported greater concerns about their condition and its impact. Finally, hypertensive patients were rated by physicians as more likely to desire help with both their presenting medical problem and their stress-related problems. Future research should help to specify the exact relations among coping style, stress, and symptom reporting in hypertension.     

Coping and problem solving of self‐mutilators*

People who self‐mutilate have been hypothesized to have deficient skills in coping and problem‐solving that leave them vulnerable to the adoption of self‐mutilation as a coping strategy. This hypothesis was tested using male incarcerated self‐mutilators with comparisons being made with non‐mutilating, prisoner, and non‐prisoner control groups. Examination of the inherent resources which enable an individual to effectively cope with stress demonstrated a depressed score for self‐mutilators on the scale measuring self‐worth and optimism about life. Assessment of the strategies used to cope with real problems demonstrated that self‐mutilators engage in more problem avoidance behaviors. Self‐mutilators also recorded less perceived control over problem‐solving options. The results are discussed in terms of the effectiveness of self‐mutilation as a coping strategy and the need to adopt a multidimensional approach to the investigation of coping. © 2003 Wiley Periodicals, Inc. J Clin Psychol, 2003.     

Cognitive-behavioural interventions for mood and anxiety disorders in HIV: A systematic review

Background

Mood and anxiety disorders are highly prevalent and comorbid with HIV/AIDS. However, there is a paucity of research on the effectiveness of cognitive-behavioural interventions (CBI) for common mental disorders in HIV-infected adults. The present study sought to review the existing literature on the use of CBI for depression and anxiety in HIV-positive adults and to assess the effect size of these interventions.

Methods

We did duplicate searches of databases (from inception to 17–22 May 2012). The following online databases were searched: PubMed, The Cochrane Central Register of Controlled Trials and PsychArticles.

Results

We identified 20 studies suitable for inclusion. A total of 2886 participants were enroled in these studies, of which 2173 participants completed treatment. The present review of the literature suggests that CBI may be effective in the treatment of depression and anxiety in individuals living with HIV/AIDS. Significant reductions in depression and anxiety were reported in intervention studies that directly and indirectly targeted depression and/or anxiety. Effect sizes ranged from 0.02 to 1.02 for depression and 0.04 to 0.70 for anxiety.

Limitations

Some trials included an immediate postintervention assessment but no follow-up assessments of outcome. This omission makes it difficult to determine whether the intervention effects are sustainable over time.

Conclusion

The present review of the literature suggests that CBI may have a positive impact on the treatment of depression and anxiety in adults living with HIV/AIDS.     

Distress and post‐traumatic stress disorders in high risk professionals: adult attachment style and the dimensions of anxiety and avoidance

This study examines the relationship between adult attachment and psychological distress in a population of 544 people working for a security company and for the Belgian Red Cross. The results indicate that fearful–avoidant and preoccupied attached individuals report more stress than secure attached and insecure attached individuals of the dismissive type. Next, the same attachment styles appear to differentiate between individuals who do and individuals who do not develop a post‐traumatic stress syndrome (PTSD) after being confronted with a critical incident. Breaking the attachment styles into the two underlying dimensions of attachment anxiety and avoidance, our results suggest that anxiety is more of an issue than avoidance in psychological distress and the occurrence of PTSD. Copyright © 2006 John Wiley & Sons, Ltd.     

The impact of co-occurring mood and anxiety disorders among substance-abusing youth

BACKGROUND: Co-occurring mood and anxiety disorders are highly prevalent amongst substance-using young adolescents, and have been associated with a range of adverse outcomes. Few studies however have examined the impact of affective disorders in samples of older adolescents and young adults attending youth drug treatment services. METHODS: One hundred young people (mean age 19.4 years) were recruited from two youth drug treatment services in Melbourne, Australia. A structured interview and questionnaires assessing drug use, psychopathology, risk-taking behaviours and quality of life were administered at a mutually convenient location. RESULTS: Fifty percent of the sample met criteria for at least one current mental health disorder. Excluding individuals with a current psychotic illness (n=3), 49% met criteria for a current mood or anxiety disorder, with 68% reporting a lifetime history. There were high rates of current Major Depressive Disorder (MDD; 27%) and Post-traumatic Stress Disorder (PTSD; 26%) within the sample. Participants with these disorders were more likely to have a higher number of comorbid disorders, report more substance-related problems and a poorer quality of life. LIMITATIONS: Cross-sectional design, lack of biological assays. CONCLUSIONS: In older adolescence and emerging adulthood, young drug users with comorbid affective disorders have greater mental health and substance use morbidity than those with substance use problems alone. These findings have important clinical implications for the management and rehabilitation of young people with substance use disorders.     

中青年2型糖尿病患者压力知觉对焦虑的影响:应对方式的中介作用

目的:分析中青年2型糖尿病患者压力知觉对焦虑的影响以及应对方式的中介作用.方法:采用整群随机抽样法,选择哈尔滨市某2所三级甲等医院内分泌科首次收治的312名中青年2型糖尿病患者为研究对象,使用一般人口学调查问卷、简易应对方式问卷、压力知觉量表、贝克焦虑量表进行问卷调查,使用SPSS 20.0和A-MOS 17.0进行统...     

Coping with daily events and short-term mood changes: an unexpected failure to observe effects of coping.

This study examined the relationship between coping efforts and stress-related mood changes. Men and women with high levels of work or marital stress reported stress and coping efforts approximately once an hour for 2 days using an electronic diary. Stress episodes were identified as a stress-free time followed by a stressor at the next time point. Analyses examined how appraisals and coping influenced pre- to poststress mood change and how problem appraisals were related to coping efforts. Greater mood changes were associated with appraisals of high stress and high disruptiveness. Appraisals of high control and high desirability were associated with more planning, direct action, and fewer acceptance coping efforts. Coping failed to predict any pre- to poststressor mood changes. Possible explanations for the overall failure of coping to predict momentary mood changes are discussed.     

Psychological response to amniocentesis: II. Effects of coping style

Differences in coping style were assessed in a group of women undergoing amniocentesis and a control group not having the procedure. Subjects were divided into two groups according to coping style; "monitors" (information seekers) and "blunters" (information avoiders). In the amniocentesis group, coping style was associated with differences in mood state and change in mood state over time. "Monitors" experienced greater mood disturbance than "blunters" both before and during the procedure, but this effect disappeared after communication of amniocentesis results. Coping style was not associated with differences in maternal attitudes toward pregnancy or maternal-fetal attachment. In the control group, there were no differences between "monitors" and "blunters" on any of the mood state or pregnancy measures. Implications of these findings for providers of genetics services are discussed.     

Neuroimaging studies of psychological interventions for mood and anxiety disorders: empirical and methodological review

This article reviews the methods and results of published neuroimaging studies of the effects of structured psychological interventions for mood and anxiety disorders. The results are consistent with neural models of improved affective- and self-regulation, as evidenced by psychotherapeutic modulation of brain metabolic activity within the dorsolateral, ventrolateral, and medial prefrontal cortices, the anterior cingulate, the posterior cingulate/precuneus, and the insular cortices. Specific recommendations for future studies are outlined, and the clinical and theoretical significance of this research is discussed.     

医学毕业生就业焦虑与应对方式和社会支持的关系研究

探讨医学毕业生的就业焦虑与应对方式和社会支持三者之间的关系。采用就业焦虑问卷、应对方式问卷和社会支持评定量表对温州某医科高校医学毕业生进行调查。结果显示:医学毕业生应对方式的3个维度问题解决应对方式和合理化应对方式与社会支持呈正相关,消极情绪应对方式与社会支持呈负相关。问题解决应对方式与就业焦虑呈负相关,消极情绪应对方式与就业焦虑呈正相关,社会支持与就业焦虑呈负相关。采用积极的应对方式会缓解医学毕业生的就业焦虑,同时要提高医学毕业生的社会支持系统以降低其就业焦虑水平。