Coping styles in prodromes of bipolar mania

OBJECTIVES: Psychological studies have identified that different coping strategies affect outcome in bipolar disorder (BD), with the possibility of preventing mania by effective coping with prodromes. This study seeks to examine coping mechanisms using a recently developed scale to clarify the relationship of coping styles to clinical and demographic characteristics, and to identify coping differences between bipolar I and II subjects. METHODS: The Coping Inventory for Prodromes of Mania (CIPM) was completed by 203 bipolar patients, along with other diagnostic and clinical measures. The CIPM is organized into four factors of coping including: stimulation reduction (SR), problem-oriented coping (PR), seeking professional help (SPH), denial and blame (DB). CIPM psychometric properties and its relationship to demographic and clinical factors, dysfunctional attitudes, and mood symptoms were examined. Coping profiles were generated by BD subtype (I versus II). RESULTS: The CIPM displayed psychometric properties consistent with the single previous study with this instrument. Neither demographic/clinical characteristics nor mood symptoms showed any particular relationship with the CIPM. Clear differences in coping also emerged between BD I and BD II subjects. BD I tended to use a wider range of coping strategies and scored highly on the SPH factor as compared to BD II subjects. BD II participants preferred to use DB and PR, but were less likely to use SPH and SR. CONCLUSIONS: The CIPM appears to be a valid measure of coping. Coping style preferences appear to differ according to bipolar subtype.     

大中学生自杀意念及相关心理变量研究

目的:探讨大中学生自杀意念与相关心理变量的关系。方法:采用分层取样法,对某市初二到硕士研究生一年级828名被试进行自杀意念量表(SSI)等量表测试。结果:①随年龄增长,大中学生自杀意念、企图呈下降趋势。女生自杀意念比男生多,而男生自杀行为能力比女生强;②有无自杀意念者在临床症状、人格因素、应对风格及生活满意度上差异均有统计学意义;③自杀意念与症状自评量表(SCL-90)各分量表、艾森克个性问卷(EPQ)神经质、精神质、应对检查表(COPE)诸多应对风格显著相关。结论:大中学生自杀意念与临床症状、应对方式、人格和生活满意度存在相关。     

Stress and coping in multiple sclerosis: exacerbation, remission and chronic subgroups.

Individuals with multiple sclerosis were asked to identify stressors they had experienced over a 6-month period and the coping mechanisms employed to deal with those stressors. Subjects who reported currently experiencing an exacerbation of symptoms were compared with those in remission or in the chronic phase of their illness. Of the 61 subjects who completed the Hassles Scale, Uplifts Scale, and Ways of Coping, those classified as being in an exacerbation phase of MS were found to have significantly higher hassles scores than those in the chronic phase. A significant difference was also found in terms of a factor labeled 'passive avoidant and aggressive coping' derived through a factor analysis of the Ways of Coping subscales. Subjects in the exacerbation subgroup had higher scores on this coping factor than those in the chronic subgroup. The difference in hassles scores remained significant after between-group differences in length of illness and reported number of symptoms were controlled through an analysis of covariance, although the difference in coping fell short of significance in this covariance analysis.     

Individual differences in adolescent health symptoms: the effects of gender and coping

Previous studies have suggested that adult men and women experience different types and severities of physical and psychological health symptoms. This study examined whether in the case of adolescents these reported gender differences in physical and psychological health symptoms could actually be the result of differences in coping styles. Five hundred and forty-six adolescents were questioned on their coping styles and symptoms. We found gender differences in physical and psychological health symptoms (e.g. anger, depression, tension, negative moods), as well as in coping styles. We also found that the relation between health symptoms and coping varied significantly by gender. The results of this study suggest that doctors, school counselors and family therapists may want to take gender differences in coping styles into account when seeing adolescent patients for physical or psychological health symptoms, and find ways to help the adolescents cope more effectively with their stressors.     

Differential reactions of type A and type B males to negative feedback about performance

Psychological and physiological reactions to a failure experience were studied in type A males and type B males both during task and no-task periods. Before failure was induced, no difference in sympathetic reactivity was found, neither during task nor during no-task periods. After an experience of failure type A subjects showed higher sympathetic activation and effort to perform well, compared to type B subjects. The higher activation in type A subjects was even more prominent during no-task periods. The results are related to differences in coping strategy between type A and type B individuals, and the situational dependency of increased activation in type A subjects is discussed.     

Obsessive beliefs and neurocognitive flexibility in obsessive-compulsive disorder

A substantial proportion of individuals with obsessive-compulsive disorder (OCD) do not endorse the dysfunctional beliefs proposed by cognitive models of OCD to be important in the onset and maintenance of symptoms. Previous research has attempted to characterize Low and High obsessive beliefs groups in terms of cognitive and symptom correlates to distil potential etiological differences in these subgroups of OCD patients. The current study sought to further examine potential neurocognitive differences between obsessive beliefs subgroups. Performance on the Wisconsin Card Sorting Test (WCST) was compared between a Low Beliefs OCD subgroup, a High Beliefs OCD subgroup, and two anxious control groups: Panic Disorder with Agoraphobia (PDA) and Social Phobia (SP). The High Beliefs OCD subgroup performed significantly poorer on WCST subscales compared to the other diagnostic groups. These findings were not accounted for by severity of OCD or depressive symptoms. The Low Beliefs OCD subgroup performed similar to the anxiety disorder control groups. The results suggest a potential interplay between heightened obsessive beliefs and neurocognitive inflexibility.     

Different presurgical characteristics and seizure outcomes in children with focal cortical dysplasia type I or II

Purpose:   Cortical dysplasia (FCD) is a frequent cause of epilepsy in childhood. Two major pathological variants are distinguished, FCD type I and II. The aim of the study was to characterize differences between FCD type I and II with respect to imaging and EEG findings, clinical and neuropsychological presentations, and surgical outcome.
Methods:   Forty children with refractory epilepsy and histopathologically confirmed FCD were retrospectively analyzed. FCD type I was identified in 24 and FCD type II in 16 patients.
Results:   Characteristic MRI abnormalities in FCD type I included subtle white matter signal changes and regional reduction of the white matter volume. Typical MRI findings in FCD type II were increased cortical thickness, transmantle sign, gray-white matter junction blurring, fluid-attenuated inversion recovery (FLAIR) and proton density (PD) gray matter signal changes as well as T1w, and PD white matter signal changes. Continuous EEG slowing was significantly more common in patients with FCD type I. Children with FCD type I presented with lower levels of intelligence and were suffering more often from maladaptive behavior and behavioral disorders. Surgical outcome was significantly worse in the FCD type I group (seizure freedom was achieved in 21% FCD type I patients and in 75% FCD type II subjects, p < 0.001).
Conclusions:   Clinically important differences were found in children with distinct histopathological subtypes of FCD. Due to prominent neuropsychological deficits and worse seizure outcome, treatment strategies in FCD type I are more challenging than previously reported and these children should be recognized and specifically addressed within the incoherent group of patients with malformative brain disorders.     

Age of alcoholism onset. I. Relationship to psychopathology

Numerous attempts have been made to subdivide populations of alcoholics into homogeneous subgroups. Although no consensus has been reached about the characteristics of these subgroups, a number of classification schemes have identified a subgroup of patients with a high genetic loading for alcoholism, an early onset of alcoholism, a severe course, and coexisting psychiatric problems consisting of aggressive tendencies or criminality. In a recent typology proposed by Cloninger on the basis of adoption studies, this subgroup has been classified as type 2. Another group of patients who were found to differ in their mode of inheritance and clinical characteristics was classified as type 1. The identification of etiologically homogeneous subgroups is easier in studies of adoptees than in studies of individuals who were not adopted. In an attempt to divide alcoholics into two groups of individuals presenting type 1 and type 2 characteristics, we used as a criterion the age of alcoholism onset because type 2 alcoholics as well as their fathers had been found to abuse alcohol at a younger age than type 1 patients. Patients with an onset of alcoholism before their 20th birthday were found to have a significantly higher incidence of paternal alcoholism and were twice as likely to have been incarcerated for crimes involving physical violence. We also observed other features not previously described in this patient subgroup. Patients who started abusing alcohol in their teens were three times as likely to be depressed and four times as likely to have attempted suicide as patients with a later onset of alcohol abuse.     

Mediation Effect of the Coping Strategies on the Relation Between Stress and Sleep Quality

Objective Recently data has been accumulated regarding the role of coping strategies in the relationship between stress and sleep quality. Therefore, we set out to identify the mediating effects of coping strategies between stress and sleep quality. Methods A online-based cross-sectional study was performed using the Perceived Stress Scale-10, the Pittsburgh Sleep Quality Index, and a simplification of the 60-item Coping Orientation to Problems Experienced (Brief COPE) inventory in the nonclinical adult sample. The 24 items of Brief COPE were categorized into four factors (social support, problem solving, avoidance, positive thinking). Then, we used the PROCESS macro to conduct the multiple mediation analysis for the four coping styles as potential mediators in the relationship between stress and sleep quality, and an additional subgroup analysis was examined to identify a gender difference for the mediation effect. Results As a group, four coping styles mediated significantly the association between perceived stress and poor sleep quality. And avoidance has maintained its significance thought all regression analyses. Finally, this results remained as same in the females. Conclusion The effect of perceived stress on poor sleep quality was mediated by coping strategies, especially by avoidance. Thus, further research should consider the coping styles of individuals to reduce the influence of stress on sleep quality.     

Genetics of Lesch's typology of alcoholism

It is widely accepted that dopamine and serotonin (5-HT) neurotransmission can be critically involved in the development of alcohol abuse and alcohol dependence. Lesch's typology of alcoholism has been gaining increasing popularity as it qualitatively differentiates patients into different treatment response subgroups. The aim of the present study was to evaluate a possible genetic background of Lesch's typology with special emphasis placed on dopamine- and serotonin-related genes. 122 alcoholics (the mean age: 35+/-9 years) were investigated. According to Lesch's typology, 58 patients were of type I, 36 patients of type II, 11 patients of type III, and 17 patients of type IV. Alcohol drinking and family history was assessed by means of a structured interview, based on the Semi-Structured Assessment for the Genetics of Alcoholism. 150 control subjects without psychiatric disorders were also recruited. The control group was ethnically-, age- and gender-matched to the patients. The DRD2 TaqIA, exon 8, and promoter -141C ins/del polymorphisms as well as COMT Val158Met, 5HTT 44 bp del in promoter, and DAT 40 bp VNTR polymorphisms were detected by means of PCR. No significant differences were observed when the whole group of alcoholics and the controls were compared. Similarly, there were no differences between either the Lesch type I or type II alcoholics and the control subjects. No significant differences were observed between type I and type II alcoholics. Alleles frequencies were not calculated for the Lesch type III and type IV alcoholics since the number of patients was too small. The present results argue against any major role of the investigated polymorphisms in either Lesch type I or type II alcoholism. More comprehensive studies are needed to define the role of the investigated polymorphisms in Lesch type III and type IV alcoholism.     

Emotional state and coping style among gynecologic patients undergoing surgery

The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.     

Hereditary motor and sensory neuropathy type I and type II

In an attempt to clearly identify the different HMSN subgroups, we prospectively evaluated 128 subjects (46 index cases, 39 affected and 43 unaffected relatives) on clinical, genetic and electrophysiological grounds. The diagnosis of HMNS I or II was made in 77 patients. Differential diagnosis between type I and II patients was impossible on clinical grounds alone, but nerve conduction study showed a clearcut subdivision into two populations. MCV behavior was consistent within families. Inheritance, autosomal dominant in almost all cases, was probably recessive in three HMSN I subjects and pedigree analysis pointed to X-linked transmission in one HMSN I family. We found no evidence for linkage to Duffy locus. We think that similar HMSN phenotypes can be determined by different gene defects. Ulnar nerve F-conduction velocity did not significantly differ from distal MCV in HMSN I: the evidence of a diffuse slowing of nerve conduction supports the hypothesis of a primary myelin defect.

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Sommario Allo scopo di distinguere chiaramente in sottogruppi i pazienti affetti da HMSN, abbiamo studiato prospeticamente dal punto di vista clinico, genetico ed elettrofisiologico 128 soggetti: 46 casi indice, 39 parenti affetti e 43 sani. La diagnosi di HMSN I o II è state posta in 77 casi. La distinzione tra I e II tipo è risultata impossibile dal punto di vista clinico, ma lo studio delle velocità di conduzione ha dimostrato una chiara divisione in due popolazioni. Il comportamento delle VCM è risultato omogeneo all'interno delle singole famiglie. L'ereditarietà, autosomica dominante in quasi tutti i casi, è risultata probabilmente recessiva in tre soggetti con HMSN I, mentre l'analisi dell'albero genealogico suggerisce una trasmissione X-linked in un'altra famiglia di I tipo. Non abbiamo trovato linkage con il locus Duffy. In queste neuropatie fenotipi simili possono essere determinati da differenti difetti genici. La presenza di un diffuso rallentamento della conduzione nervosa periferica, evidenziata dal confronto tra velocità di conduzione della risposta Fe VCM del nervo ulnare depone per una patogenesi primitivamente mielinica dell'HMSN I.

     

Cortisol response to various stressful situations: relationship to personality variables and coping styles

Studies on personality traits and coping styles as determinants of interindividual differences in neuroendocrine responses to stress have not yet yielded conclusive results. In a previous investigation, strong hints to distinct interindividual differences in the susceptibility of the HPA axis of 12 male volunteers aged 27 +/- 5 years exposed to five different stress situations were found. In the present report, psychometric variables (personality traits and coping styles) assessed in the same subjects before the study were analyzed to test whether specific psychometric variables were related to the interindividual differences in the susceptibility of the HPA axis. The results revealed that interindividual differences in the frequency of cortisol responses to stress situations could not be predicted by any of the psychometric variables investigated. The question if psychological factors contribute to neuroendocrine stress response and to what degree warrants further interest. These preliminary findings suggest, however, that nonpsychological factors should be considered more seriously as determinants of interindividual differences in neuroendocrine stress responses in healthy subjects as well as in psychiatric patients.     

Abnormalities in event-related potential and brainstem auditory evoked response in children with nocturnal enuresis

To evaluate central nervous system functioning involvement in nocturnal enuresis, P300 and N200 event-related brain potentials and brainstem auditory-evoked potentials (BAER) were assessed in a group of 35 enuretic boys aged 7-9 years. The measurements of enuretic group were compared to those of age and sex matched non-enuretics. P300 latency in the enuretic group was significantly longer than in non-enuretic group (420 ms at parietal scalp (Pz), 414 ms at central scalp (Cz) versus 386 ms at Pz, 376 ms at Cz; P < 0.01 and P < 0.01, respectively). Both enuretic and non-enuretic subjects were divided into three subgroups his age. There was no significant difference in terms of both P300 amplitude and N200 latency and N200 amplitude between non-enuretic age subgroups. But, P300 latency over central scalp in 8 years old non-enuretic subgroup was significantly longer than in 9 years old non-enuretic subgroup (P < 0.01). No significant difference was found in latency and amplitude of P300 and N200 latency between enuretic subgroups. However, N200 amplitude at Cz in 8 years old enuretic subgroup was significantly lower than both in 7 years old enuretic subgroup and in 9 years old enuretic subgroup (P < 0.01 and P < 0.01, respectively). There were significant topographical differences in latency and amplitude of P300 and in N200 latency in enuretic age subgroups, only. There was no significant difference in interpeak latencies I-III, I-V and III-V and wave latencies I, III and V of BAERs between enuretic group and non-enuretic subgroup. Longer interpeak and wave latencies of BAERs were found both in 8 years old enuretic subgroup and 8 years old non-enuretic subgroup. CONCLUSION: Longer P300 latency in primer enuretics compare to non-enuretics is an evidence of a maturational delay of central nervous system functioning.     

Coping styles in people with chronic fatigue syndrome identified from the general population of Wichita, KS

OBJECTIVE: Studies of primary and tertiary care patients suggest that maladaptive coping styles contribute to the pathogenesis and maintenance of chronic fatigue syndrome (CFS). We assessed coping styles in persons with unexplained fatigue and nonfatigued controls in a population-based study. METHODS: We enrolled 43 subjects meeting the 1994 Research Case Definition of CFS, matching them with 61 subjects with chronic unexplained fatigue who did not meet criteria for CFS [we term them insufficient symptoms or fatigue (ISF)] and 60 non-ill (NI) controls. Coping styles and clinical features of CFS were assessed using standard rating scales. RESULTS: Subjects with CFS and ISF reported significantly more escape-avoiding behavior than NI controls. There were no differences between the CFS and ISF subjects. Among participants with CFS, escape-avoiding behavior was associated with fatigue severity, pain, and disability. CONCLUSIONS: We demonstrate significantly higher reporting of maladaptive coping in a population-based sample of people with CFS and other unexplained fatiguing illnesses defined by reproducible standardized clinical empirical means in comparison to NI controls.     

Variability in the impairment of recognition memory in patients with frontal lobe lesions

Fourteen patients with frontal lobe lesions and 14 normal subjects were tested on a recognition memory task that required discriminating between target words, new words that are synonyms of the targets and unrelated distractors. A deficit was found in 12 of the patients. Moreover, three different patterns of recognition impairment were identified: (I) poor memory for targets, (II) normal hits but increased false recognitions for both types of distractors, (III) normal hit rates, but increased false recognitions for synonyms only. Differences in terms of location of the damage and behavioral characteristics between these subgroups were examined. An encoding deficit was proposed to explain the performance of patients in subgroup I. The behavioral patterns of the patients in subgroups II and III could be interpreted as deficient post-retrieval verification processes and an inability to recollect item-specific information, respectively.     

Repressive coping reactions in patients with malignant melanoma as compared to cardiovascular disease patients

Previous research has indicated that repressive styles of coping with stressful emotions may be associated with higher cancer incidence and poorer prognosis. Other studies have suggested that coronary-prone and cancer-prone individuals may be at opposite poles on the distributions of several coping and personality variables. In order to investigate whether these differences could be reflected in a measure that integrated psychological and physiological processes, the present study compared the repressive coping reactions of malignant melanoma patients to matched cardiovascular disease patients and disease-free controls (N of 20 in each group). Repressive coping reactions were operationally defined as the discrepancy between reported anxiety and that shown physiologically (electrodermal activity) in response to anxiety-provoking statements in an experimental procedure. The concurrent validity of this procedure was established through correlations with other indices of repressive tendencies which were administered to all subjects. Analysis of variance showed that the melanoma group was significantly more ‘repressed’ on these measures, while the cardiovascular disease patients were the least repressed or most sensitized. These differences in defensive posture were independent of disease severity, which suggested that they were not merely artifacts of differences in disease-related anxiety.     

Neuropsychological and computerized axial tomography volume characteristics of empirically derived dementia subgroups

Neuropsychological assessment data from 138 Alzheimer's disease patients were cluster-analyzed to yield five separate subgroups. These clusters are best described as follows. Cluster I is a low-functioning subgroup characterized by severe generalized deficits (N = 25), cluster II is a subgroup characterized by a higher level of visual-spatial skills relative to the other groups (N = 39), cluster III (N = 21) and cluster IV (N = 42) are virtually indistinguishable in terms of verbal ability and memory, but do differ with regard to visual-spatial skills, and cluster V is a subgroup which presented with relatively better preserved verbal abilities (N = 11). Despite their different neuropsychological profiles, the subgroups did not differ significantly with regard to those complaints that were noted early in the course of the disease process. However, they were found to differ significantly with regard to the patients' educational backgrounds, the distribution of males and females, and the age of the patients at the time of onset of the disease. Analysis of the degree and lateralization of cortical atrophy using volumetric techniques suggested little relationship with neuropsychological examination results. Ventricular volume differences among the five subgroups were not found to be statistically significant after the effect of age had been partialled out. Results are discussed in relation to the multiple factors relating to brain structure and cognition in Alzheimer's disease.     

Personality traits and platelet monoamine oxidase activity in a Swedish male criminal population

BACKGROUND: A Swedish male criminal population was grouped into personality disorder subgroups and investigated with regard to personality traits and platelet monoamine oxidase (MAO) activity. The main aim of the study was to examine the possibility of a risk factor combination by having low platelet MAO activity as well as belonging to a certain diagnostic DSM-IV axis I (drug abuse in the present series) and/or II subgroup. METHODS: Personality disorders were grouped into clusters according to the cluster system used in DSM-IV axis II. The prisoners were grouped into five subgroups and each subject completed the Karolinska Scales of Personality self-report questionnaire. The comparison group for the personality data comprised 51 non-criminal males from a longitudinal Swedish project. Platelet MAO activity was assessed for the criminals as well as for a control group including 60 non-criminal healthy male Caucasians. For testing the existence of syndromes, a configuration frequency analysis (CFA) was used. RESULTS: The results showed low scores on the socialisation and high scores on the sensation seeking-related traits impulsiveness and monotony avoidance, and the somatic anxiety-related muscular tension in the criminals with any DSM-IV mental disorder, however most markedly in cluster AB and cluster B subjects. In addition, cluster AB subjects had significantly lower platelet MAO activity than controls. Two significant 'types' were found among the criminals: one was characterised by low platelet MAO activity, cluster B personality diagnosis as well as drug abuse disorder diagnosis; and the other by a pattern of normal platelet MAO activity, no cluster B personality disorder and no drug abuse disorder diagnosis. CONCLUSION: The aggregation of certain risk factors in the same individual has been shown to contribute to the development of criminal behaviour.     

Maladaptive Coping Styles in Adolescents with Internet Gaming Disorder Symptoms

Problematic Internet gaming represents a potential public health concern due to its negative consequences for players and their families. It has been argued that disordered gaming may manifest more readily in vulnerable individuals who lack alternative means of coping. This study investigated Internet gaming disorder (IGD) in relation to coping, including emotion- and problem-focused coping styles. The sample was 823 adolescents (402 males) recruited from secondary schools. Participants completed surveys including the DSM-5 IGD checklist and the Brief COPE. Symptoms of IGD were significantly positively related to denial and behavioural disengagement but were not related to 10 other coping styles. Hours spent gaming and denial coping were the strongest predictors of IGD symptoms. These findings suggest that IGD may co-occur with a tendency toward denial coping, highlighting the significant challenge for practitioners in obtaining reliable assessment by self-report and developing an effective therapeutic alliance in interventions for adolescents.