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‐Ill‐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. © 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。     

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.     

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 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.     

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.     

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.     

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.     

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.     

重大危机生活事件对大学生心理成长的影响--非典对大学生自我认同的影响

目的 研究非典事件对大学生的自尊和自我效能产生了怎样的影响,过去是否曾经历过重大应激事件对个体经历非典对自我的认识和应对方式的影响。方法 应用调整后的自尊、自我效能、特质应对方式问卷,对北京理工大学经历非典事件的511名大学生进行问卷调查。结果 非典事件使大学生对自我有了更加明确和深入的认识,大部分学生都能够较好地面对该危机事件。与非典之前相比,大学生在自尊和自我效能方面都有一定的提高。积极应对方式是个体主要的处理问题方式,远远优于对消极应对方式的使用。早年曾经有过重大危机生活事件的个体与未曾经历的学生在消极应对方式上有一定的差异。结论 经历非典重大危机生活事件对于大学生的心理成熟和发展具有重要的影响作用。     

大型活动志愿者应急应对方式及影响因素研究

目的研究大型活动志愿者对突发应急事件的应对方式和影响因素。方法采用应对方式问卷、社会支持评定量表和自我和谐量表对4所高校的416名上海世博会志愿者进行问卷调查。结果志愿者自我和谐与全国大学生常模相比具有显著性差异,自我与经验的不和谐(t=-4.87,P<0.001)及自我的刻板性(t=13.06,P<0.001)比常模下降,自我的灵活性(t=5.75,P<0.001)上升。有效问卷的416志愿者中,342名的应对行为为成熟型(82.2%),不同行为类型的人员达标情况存在差异,应对行为类型和得分达标数情况相关(χ2=129.7,P<0.001)。对作用效应而言,自我经验的不和谐、自我刻板性、危机意识和应变能力的缺乏等是影响应对方式的负性因素,社会支持、自我灵活性和志愿者经历等是正性因素。支持的利用度、自我经验的不和谐、活动前培训、危机意识和应变能力的影响较为普遍,其他则比较单一。结论志愿者应对突发事件的方式总体成熟稳定,但具有个体差异,并受多种因素影响,有必要针对志愿者人群开展干预训练,进一步提高其整体应对方式的成熟程度。     

应对策略在癌症患者心理干预中的中介作用

目的：探讨在对癌症患者实施心理干预过程中应对策略及其相关因素的中介作用。方法：运用病例对照实验设计，对实验组病人进行了为期3个月的心理干预，选用疾病应对问卷作为主要测查工具，采用多因素综合分析统计方法，对120名住院化疗病人进行了比较分析。结果：干预组病人在干预后较多运用主动认知和主动行为策略，较少运用回避方法，对照组则变化不大；干预后病人情绪状态、功能状况以及生活质量的改善与所采用的应对方法有一定关系：与主动认知应对方法呈正相关，与回避性应对方法呈负相关，与主动行为应对方法则关系不明显。结论：应对策略及其相关因素在癌症患者心理干预中起一定的中介作用。     

中学生应对方式及其与心理健康的关系研究

目的探讨中学生应对方式特点及其与心理健康的关系。方法采用中学生应对方式问卷和中学生心理健康量表对757名中学生进行调查。结果中学生的应对方式的使用程度依次是解决问题、忍耐、退避、发泄、幻想、求助。根据与心理健康的关系研究，将应对方式分为：积极主动的应对方式（问题解决）；中间型应对方式（求助、退避）；消极被动的应对方式（发泄、忍耐、幻想）。结论中学生已经形成比较成熟的应对方式，但在应对方式的培养和提高上仍需要指导和帮助。     

Families coping with schizophrenia: coping styles, their origins and correlates

An analysis of the coping styles adopted by relatives of schizophrenic patients has been identified by many reviewers as essential to an understanding of the complex interactions between patient and caregiver and to the origins of relatives' expressed emotion (EE). This study reports a taxonomy of coping behaviour derived from interviews with relatives of schizophrenic patients. It was found that relatives adopted broad styles of coping across all areas of patients' behaviour change. Relationships were uncovered between the styles and (a) relatives perceived control, burden and stress, (b) patients' social functioning, severity of behavioural disturbance and progress of the illness. It is suggested that advising relatives of changes in their coping styles in the course of family intervention must be tempered by an understanding of their origins in patients' behaviour. Further research is recommended to identify the coping styles associated with the high EE/low EE research classification.     

Attachment and coping as facilitators of posttraumatic growth in Turkish university students experiencing traumatic events

This study was designed to explore the role of attachment and coping as facilitators of posttraumatic growth (PTG) in a sample of Turkish university students who experienced traumatic life events. Participants who reported a traumatic event from a list were asked to choose the most distressing one; to answer questions related to the impact of the trauma; and to fill out measures of attachment styles, ways of coping, and PTG. PTG was regressed on gender, trauma-related factors, attachment styles, and coping styles in order to examine the associations with PTG. Felt helplessness and horror, fatalistic coping, and optimistic coping were significant predictors of PTG. Fatalistic coping partially mediated the relationship between attachment anxiety and PTG.     

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.     

企业员工应对方式与心理健康之间的关系

目的：验证不同应对方式对心理健康的单独与共同影响。方法：对4745名被试用分层回归的方法分析不同应对方式对心理健康的单独影响和交互作用。结论：单独使用“消极应对”的应对方式,对心理健康水平存在不利影响;而单独使用“积极应对”的应对方式能在一定程度上改善心理健康水平。“消极应对”与“积极应对”两种应对方式结合使用能显著改善心理健康水平,比单独使用这两种应对方式对心理健康更有利。     

农村高三学生的自尊水平、应对方式和主观幸福感的研究

目的探究农村高三学生自尊、应对方式和主观幸福感之间的关系。方法运用自尊评定量表、应对方式问卷和总体幸福感量表对从陕西省三原县3所中学抽取的140名农村高三学生进行测查。结果①农村高三学生的自尊和主观幸福感处于中等偏上水平;②独立样本t检验结果显示,自尊和主观幸福感无显著性别和学科差异(P>0.05),应对方式的求助和合理化因子有显著的性别差异(P<0.05),其余各因子无显著性别和学科差异(P>0.05);③层级回归分析,解决问题和自责的应对方式对自尊和主观幸福感有部分中介作用,且中介效应显著。结论农村高三学生的自尊通过解决问题和自责的应对方式对主观幸福感产生部分影响。