Cognitive coping and childhood anxiety disorders

To investigate differences in cognitive coping strategies between anxiety-disordered and non-anxious 9–11-year-old children. Additionally, differences in cognitive coping between specific anxiety disorders were examined. A clinical sample of 131 anxiety-disordered children and a general population sample of 452 non-anxious children were gathered. All children filled out the child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k). Structured clinical interviews were used to assess childhood anxiety disorders. Results showed that anxiety-disordered children experience significantly more ‘lifetime’ negative life events than non-anxious children. Adjusted for the ‘lifetime’ experience of negative life events, anxiety-disordered children scored significantly higher on the strategies catastrophizing and rumination, and significantly lower on the strategies positive reappraisal and refocus on planning than non-anxious children. No significant differences in cognitive coping were found between children with specific anxiety disorders. Anxiety-disordered children employ significantly more maladaptive and less adaptive cognitive coping strategies in response to negative life events than non-anxious children. The results suggest that cognitive coping is a valuable target for prevention and treatment of childhood anxiety problems.     

Cognitive coping strategies and symptoms of depression and anxiety: a comparison between adolescents and adults

The present study focused on comparability of adolescents and adults in the reporting of cognitive coping strategies and their relationship to symptoms of depression and anxiety. Two samples were included: 487 adolescents attending a secondary school and 630 adults from a general practitioners practice. Data were obtained on symptoms of depression and anxiety and the use of nine cognitive coping strategies: acceptance, catastrophizing, other-blame, positive reappraisal, putting into perspective, refocus on planning, positive refocusing, rumination and self-blame.The results showed that all cognitive coping strategies were reported by adolescents to a significantly lesser extent than by adults. Further, it was shown that both in adolescents and adults a considerable percentage of the variance in symptomatology was explained by the use of cognitive coping strategies. Although adolescents and adults differed in relative strength of the relationships, generally speaking, conclusions were the same: in both groups, the cognitive coping strategies self-blame, rumination, catastrophizing and positive reappraisal were shown to play the most important role in the reporting of symptoms of psychopathology, showing the importance of introducing prevention and intervention programmes at an early stage.     

Bully victimization and emotional problems in adolescents: Moderation by specific cognitive coping strategies?

Objective

Relationships between bully victimization and symptoms of depression/anxiety were examined. In addition, it was studied whether this relationship was moderated by specific cognitive coping strategies.

Methods

Participants were 582 secondary school students who filled out online self-report questionnaires on bully victimization, cognitive coping, and depression/anxiety. (Moderated) Multiple Regression analysis was performed.

Results

Strong relationships were found between bully victimization and symptoms of depression and anxiety. On top of that, two cognitive coping strategies moderated the relationship between bullying and depression, i.e. rumination (strengthening) and positive refocusing (reducing). Cognitive coping strategies that moderated the effect of bullying on anxiety symptoms were rumination, catastrophizing (strengthening) and positive reappraisal (reducing).

Conclusion

The results provide possible targets for intervention: when helping adolescents who have been bullied, maladaptive cognitive coping strategies could be assessed and challenged, while more adaptive strategies could be acquired.     

Specificity of relations between adolescents' cognitive emotion regulation strategies and Internalizing and Externalizing psychopathology

OBJECTIVE: Of the study was to examine the extent to which cognitive emotion regulation strategies were 'common determinants' of Internalizing and Externalizing problems and/or 'specific determinants' distinguishing one problem category from the other. METHOD: The sample comprised 271 12- to 18-year-old secondary school students. Internalizing and Externalizing problems were measured by the Youth Self-Report (YSR) and Cognitive Emotion Regulation Strategies were measured by the Cognitive Emotion Regulation Questionnaire (CERQ), in a cross-sectional design. RESULTS: First, adolescents with Internalizing problems, Externalizing problems, comorbid Internalizing and Externalizing problems and a control group were compared on their specific cognitive emotion regulation strategies. Results showed that adolescents with Internalizing problems (both pure and comorbid) scored significantly higher on the cognitive emotion regulation strategies of self-blame and rumination than those with Externalizing (pure) problems or the control group. Unique relationships between the separate cognitive strategies and Internalizing and Externalizing problems were tested by means of Multiple Regression Analyses. Specific relationships were found between Internalizing problems and self-blame, rumination and positive reappraisal and between Externalizing problems and positive refocusing. No 'common' correlates were found. CONCLUSIONS: Theoretical models designed for the prediction of Internalizing problems might not simply be used for the prediction of Externalizing problems. Different (cognitive) intervention strategies should be used for adolescents with Internalizing problems and Externalizing problems.     

Coping and depressive symptoms in adolescents with a chronic medical condition: A search for intervention targets

The aim of the present study was to find relevant coping factors for the development of psychological intervention programs for adolescents with a chronic medical condition. A wide range of coping techniques were studied, including cognitive coping, behavioral coping and goal adjustment coping. A total of 176 adolescents participated. They were contacted through social networking websites or Internet forums and through schools for children with a physical disability. Several cognitive and behavioral coping strategies and goal adjustment were found to be related to symptoms of depression. The cognitive coping strategies had the strongest influence on depressive symptoms. Especially self-blame, rumination and catastrophizing seemed to be important factors. If these findings can be confirmed, they could contribute to the focus and content of intervention programs for adolescents with a chronic medical condition.     

认知情绪调节策略在中学生负性生活事件和焦虑间的中介作用

目的 探讨中学生认知情绪调节策略在负性生活事件和焦虑间的中介作用.方法 从全国10个城市抽取7 118名中学生,采用青少年生活事件量表（ASLEC）、认知情绪调节问卷中文版（CERQ-C）和儿童多维焦虑量表中文版（MASC-C）进行调查,评定中学生的焦虑状态、负性生活事件应激值、认知情绪调节策略的使用,并采用路径分析评估认知情绪调节策略的中介效应.结果 中学男生的焦虑得分低于中学女生,差异具有统计学意义（t=-17.74,P＜0.01）,男女生在ASLEC得分差异无统计学意义（t=0.09,P＞0.05）.CERQ-C的适应性策略与ASLEC得分、MASC得分成负相关,非适应策略与ASLEC得分、MASC得分成正相关.认知情绪调节策略在中学生生活事件和焦虑症状之间起着部分中介作用.结论 中学生的焦虑症状可能和其经历的负性生活事件相关,而对负性生活事件的认知情绪调节策略可能有一定的中介作用.     

Cognitive coping and depressive symptoms in the elderly: a longitudinal study

The objective of the present longitudinal study was to examine the relationship between cognitive coping strategies and depressive symptoms at old age. At the two and a half year follow-up study, a community sample of 99 people aged 67 years and older filled out a self-report questionnaire comprising the Geriatric Depression Scale, the Cognitive Emotion Regulation Questionnaire and a negative life events checklist. Cognitive coping strategies seemed to play an important role in relation to depressive symptoms in late life. Elderly persons with more depressive symptoms reported to use acceptance, rumination and catastrophizing to a significantly higher extent and positive reappraisal to a significantly lower extent than those with lower depression scores. After controlling for negative life events and prior depressive symptoms, acceptance and positive reappraisal retained their significant relationship with current depressive symptoms. It is suggested that intervention programs should pay attention to these aspects by challenging the 'maladaptive' strategies, and by supplying the more 'adaptive' strategies. This could be linked to the well-established cognitive therapies.     

Brief report: Coping among Austrian children and adolescents

The study investigated age and gender effects on coping with common stressors among 494 Austrian children and adolescents (age 8-14 years). Participants were subdivided into subgroups of late children comprising third and fourth graders, early adolescents consisting of fifth and sixth graders, and middle adolescents including seventh graders. Middle adolescents showed a maladaptive coping pattern with decreased problem and emotion-focused coping strategies and increased passive avoidance and aggression. Females scored higher on social support and also on the maladaptive coping strategy rumination. Female middle adolescents reported higher resignation than their male contemporaries and female children. Results suggest the application of primary preventive stress management programs in late childhood and early adolescence.     

Altered coordination of the neuroendocrine response during psychosocial stress in subjects with high trait anxiety

Contradicting data are available on stress responsiveness in subjects with high anxiety. In the present study we tested the hypothesis that high trait anxiety is associated with impaired coordination of the stress response, rather than global hypo- or hyper-responsiveness. The sample consisted of subjects with high (n=15) and with low (n=12) trait anxiety. Subjects with middle-range levels of anxiety were excluded from the study. After psychological characterization, the volunteers were exposed to a public speech procedure. A spectrum of neuroendocrine parameters was measured before, during and after the procedure and the results were analyzed by exploratory statistics. Psychological characterization of subjects revealed a lower preference for task-oriented but a higher one for emotion-oriented coping strategies as well as lower scores on hardiness in subjects with high trait anxiety. After the speech procedure, differences in selected mood and personality characteristics were observed, with the anxious group scoring significantly higher in scales for stress, tiredness, arousal, anxiety and depression. Factor analysis revealed that one common factor grouped blood pressure, catecholamine concentrations in blood and heart rate in non-anxious subjects, while three distinct factors separated these parameters in anxious subjects. Correlation analysis in anxious subjects showed that lower adrenocorticotropin (ACTH) and cortisol responses during stress were associated with exaggerated perception of stress and worse mental performance. Our findings indicate that subjects with high anxiety have different relationships between specific neuroendocrine parameters, subjective perception of stress and Stroop test performance.     

Somatic Complaints in Children with Anxiety Disorders and their Unique Prediction of Poorer Academic Performance

The present study aimed to examine somatic complaints in children with anxiety disorders compared to non-anxious control children and whether somatic complaints predict poorer academic performance. The sample consisted of 108 children and adolescents (aged 8–14 years) assessed by a structured diagnostic interview: 69 with a principal (i.e., most severe and/or interfering) anxiety disorder diagnosis and 39 non-anxious community controls. Established child and parent report measure of somatic complaints, anxiety, and internalizing symptoms were completed. The participants’ primary teacher was used to assess academic performance. Findings indicated that children with anxiety disorders reported more somatic complaints than the non-anxious community controls. Furthermore, a greater frequency of somatic complaints uniquely predicted poorer academic performance beyond that accounted for by anxiety and internalizing symptoms based on both child and parent report measures. Knowledge about somatic complaints in children with anxiety disorders and their relation to academic functioning may allow for early identification and prevent academic problems.     

Adolescent vulnerability and the distress of rejection: Associations of adjustment problems and gender with control,emotions, and coping

We examined adjustment problems as risks for patterns of emotions, appraisals, and coping with rejection, and explored whether these processes could account for sex (boy/girl) differences in coping. Young adolescents (N = 669, grades 6–8) completed questionnaires, which assessed responses to peer rejection threat with two short scenarios. Using structural equation modeling to test a multivariate process model, adolescents with heightened social anxiety had the most maladaptive responses to rejection threat, including elevated emotional reactions, more self-blame, and coping using more social isolation, rumination and opposition. Adolescents reporting more depressive symptoms felt less control and anticipated using less adaptive coping (less support seeking, distraction, and negotiation), whereas aggressive adolescents responded with more anger and coped via opposition. Moreover, as anticipated, sex differences in coping, symptoms, emotions, and appraisals were found. However, coping differences between boys and girls were mostly nonsignificant after accounting for symptoms, aggression, emotional reactions, and appraisals.     

Sex differences in the use of coping strategies: predictors of anxiety and depressive symptoms

This study examined sex differences in the use of coping strategies and their relationship to depression and anxiety-related psychopathology. Responses on measures of coping strategies, depression, and anxiety were obtained from a carefully screened nonclinical sample (N = 107). The results demonstrated that women who used less positive reframing had higher levels of depressive symptoms compared with women who used more positive reframing and to men irrespective of their use of more or less positive reframing. In addition, women who reported the use of more self-blame had elevated levels of trait anxiety, although a similar effect was not found for men. The observed sex differences in the use of coping strategies and their association with depression and anxiety-related problems underscores differences in the clinical presentation of anxiety and depression between women and men.     

Cognition, coping, and outcome in Parkinson's disease

ABSTRACT Background: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome. Methods: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination-Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping. Results: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping. Conclusions: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive-behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.     

Family Functioning and Adolescent Psychological Maladjustment: The Mediating Role of Coping Strategies

This study aims to analyze the mediating role of coping strategies in the relationship between family functioning and youth maladjustment. A community sample of 341 adolescents (M = 15.11 years old; SD = 1.71) completed self-report measures about such variables. Results showed that a perception of an inadequate family functioning was associated with the use of maladaptive coping strategies, as well as with youth psychological maladjustment. The results also revealed that rumination and support-seeking mediated the relationship between family functioning and internalizing behavior, and hostile expression of feelings played a mediating role between family functioning and externalizing behavior. No gender differences were found in the relationship between variables. This study emphasizes the importance of coping strategies used by adolescents to understand the relationship between family functioning and youth psychological maladjustment.     

Cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders

Objective

Research suggests that resilience is associated with favorable treatment outcome in patients with depression and/or anxiety disorders. In this regard, the identification of specific characteristics related to resilience that could provide targets for resilience-enhancement interventions is needed. Since the type of cognitive coping strategies is a possible marker of resilience, we investigated adaptive and maladaptive cognitive emotion regulation strategies contributing to resilience in patients with depression and/or anxiety disorders.

Methods

A total of 230 outpatients with depression and anxiety disorders were consecutively recruited and completed the Cognitive Emotion Regulation Questionnaire, the Connor–Davidson Resilience Scale, the Beck Depression Inventory, and the State Anxiety Inventory. A linear regression model was used to determine which cognitive emotion regulation strategies predicted resilience after controlling for relevant covariates. Additionally, this model of resilience was compared with those of depression and anxiety symptoms.

Results

Adaptive strategies were more strongly correlated with resilience than maladaptive strategies. In the regression model, more use of refocus on planning and positive reappraisal as well as less use of rumination predicted high resilience after controlling for age, gender, marital status, depression, and anxiety. Among these strategies, refocus on planning was the common strategy contributing to resilience and depression.

Conclusion

These results suggested that the cognitive emotion regulation strategies of refocus on planning, positive reappraisal, and less rumination contribute to resilience in patients with depression and anxiety disorders. It might provide potential targets for psychotherapeutic intervention to improve resilience in these patients.     

Children's interpretation and avoidant response biases in response to non-salient and salient situations: relationships with mothers' threat perception and coping expectations

This study examined the effect of situation salience on interpretation and avoidant response biases in clinically anxious and non-clinical children. The relationship between mothers' threat perception and expectations of their children's coping, and children's threat perception and coping expectations was also assessed. Forty clinically anxious and 40 non-clinical children (ages 7-14) participated with their mothers. In response to hypothetical situations, children described their likely thoughts and actions; mothers listed a typical child's thoughts and what their child would do. Consistent with information processing theories of anxiety, anxious children displayed amplified cognitive biases in response to personally salient situations, compared to non-clinical children. Mothers of anxious children had lower expectations for their children's coping than mothers of non-anxious children, mirroring differences between the groups of children. Mothers' expectations of their children's coping predicted children's coping expectations in non-salient and salient situations and threat perception in salient situations. Implications of findings are discussed.     

Difficulties in Emotion Regulation,Coping, and Dysfunctional Psychological Symptoms in Family Members of People with Gambling Disorder

Gambling disorder not only affects those who suffer from it but also has consequences for their families. Considering such repercussions are often understudied, and the aim of the present study was to evaluate the main differences between family members of people with gambling disorder (GDFMs) and those with no relatives diagnosed with gambling disorder (non-GDFMs). The variables examined in the present study included emotion regulation, coping strategies, depression, and anxiety. The sample (N = 203) was divided into two groups. This comprised a clinical group (n = 89 participants, 43.8% of the sample), with 69.7% of women (M_age = 48.63, SD = 13.36), and a community sample (i.e., no gambling-related problems in their family; n = 114, representing 56.2% of the sample), containing 64% of women (M_age = 35.89, SD = 11.45). Results showed that GDFMs scored significantly higher than non-GDFMs (i) on anxiety and depression scales, (ii) on difficulties in emotion regulation, and (iii) on maladaptive coping strategies. Additionally, difficulties in emotion regulation and coping strategies correlated with anxiety and depression. Regression analyses showed that difficulties in emotion regulation and coping strategies predicted anxiety and depression for GDFMs. These findings highlight the importance of including family members as part of the target group in gambling disorder treatment protocols.

     

Families of adolescents and adults with autism spectrum disorders in Taiwan: The role of social support and coping in family adaptation and maternal well-being

In this study we examined differences in social support and coping between mothers of adolescents and adults with an autism spectrum disorder (ASD) in Taiwan and the United States and to investigate the effects of social support and coping strategies on family adaptation and maternal well-being. Participants were 76 Taiwanese mothers who had at least one son or daughter with an ASD (10 years old and older), and a comparison group of 325 mothers in the United States matched on the age range of the child with an ASD. Mothers completed self-administered, written questionnaires and participated in an interview. Taiwanese mothers reported significantly greater use of problem-focused and emotion-focused coping strategies than did mothers in the United States. For Taiwanese families, greater use of problem-focused coping strategies was associated with lower levels of depressive symptoms and anxiety. Emotion-focused coping mediated the relationships between ethnicity/culture and several outcome measures: family adaptability, family cohesion, and maternal depressive symptoms. The higher levels of emotion-focused coping in Taiwanese mothers appeared to account for their lower levels of family adaptability and cohesion and higher levels of maternal depressive symptoms. The results from this cross-cultural study helped determine the role of social support and coping strategies in family adaptation and maternal well-being in families of individuals with an ASD in each culture. Implications for service delivery are discussed.     

The influence of rumination and distraction on depressed and anxious mood: a prospective examination of the response styles theory in children and adolescents

The present study sought to test predictions of the response styles theory in a sample of children and adolescents. More specifically, a ratio approach to response styles was utilized to examine the effects on residual change scores in depression and anxiety. Participants completed a battery of questionnaires including measures of rumination, distraction, depression, and anxiety at baseline (Time 1) and 8–10 weeks follow-up (Time 2). Results showed that the ratio score of rumination and distraction was significantly associated with depressed and anxious symptoms over time. More specifically, individuals who have a greater tendency to ruminate compared to distracting themselves have increases in depression and anxiety scores over time, whereas those who have a greater tendency to engage in distraction compared to rumination have decreases in depression and anxiety symptoms over time. These findings indicate that a ratio approach can be used to examine the relation between response styles and symptoms of depression and anxiety in non-clinical children and adolescents. Implications of the results may be that engaging in distractive activities should be promoted and that ruminative thinking should be targeted in juvenile depression treatment.     

Gender differences in young adolescents' exposure to violence and rates of PTSD symptomatology

Gender differences in exposure to violence and levels of PTSD symptomatology were examined in a school-based sample of 621 young adolescents. Also investigated as predictors of PTSD symptoms were cognitive coping strategies, perceived social support, and the affective experience of fear. Results support the importance of evaluating gender differences, differentiating between violence by type and location, and considering both cognitive and affective factors as predictors of PTSD symptomatology.