A comparison of the relative utility of coping and acceptance-based measures in a sample of chronic pain sufferers.

Previous research suggests that to define the problem of chronic pain as a problem of coping may not be as useful as framing it as a problem of acceptance for some patients. The coping approach may encourage, or at least permit, a somewhat inflexible agenda of pain reduction or control while the acceptance approach may allow a more flexible agenda of willingness to have pain in some circumstances where that serves the goal of better life functioning. The purpose of this study was to continue to examine the relative utility of concepts of coping and acceptance of pain. Two hundred and thirty consecutive patients seeking assessment from a pain management service were the participants in the study. Patients completed the Coping Strategies Questionnaire (CSQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). A revised scoring method was used for the CSQ (to correct for technical limitations noted in the past) and recently developed subscales of the CPAQ were examined. Correlation results showed that the acceptance variables were reliably stronger predictors of distress and disability compared with coping variables. Regression analyses confirmed that, compared with coping variables, acceptance accounted larger unique increments in variance in measures of patient functioning regardless of whether the coping variables were given priority in the regression equations. Increasing data support the view that the pain management field may benefit from evolving toward incorporating a less control-oriented and more accommodating view of aversive private experiences in some circumstances.     

Childhood Maltreatment and Psychopathology: Prospective Tests of Attachment,Cognitive Vulnerability,and Stress as Mediating Processes

A childhood history of maltreatment is a distal risk factor for depression, although less research has examined the proximal mechanisms for this relation. To address this question, three theoretically derived mechanisms were tested as mediators: an insecure attachment style, a negative cognitive style, and negative life events. These mediating processes were examined in two prospective studies. In the first, young adults (n = 652) completed a detailed self-report measure assessing a childhood history (before age 14) of physical, sexual, and emotional abuse. In the second, an independent sample of young adults (n = 75) were interviewed with a well-validated, objective, contextual threat interview that assesses a childhood history (before age 14) of physical, sexual, and psychological abuse as well as the surrounding familial context of emotional neglect, antipathy, discipline, and discord. In both studies, participants completed measures of the proposed mediators as well as anxiety and depressive symptoms at 2 time points (10-week interval in Study 1 and 2-year interval in Study 2). Across both studies, a childhood history of emotional maltreatment and adversity specifically predicted prospective elevations of depressive symptoms, whereas no specific form of childhood maltreatment predicted anxiety symptoms after controlling for initial symptoms and overlap among forms of maltreatment. Further, support was found for the proposed mediating processes. An insecure attachment style, a negative cognitive style, and negative events helped to account for the link between childhood maltreatment and later depressive symptoms in young adulthood.     

Venous leg ulcer patients: a review of the literature on lifestyle and pain-related interventions

Background. Having a leg ulcer has a major impact on daily life. Lifestyle is mentioned in most leg ulcer guidelines but mostly without much emphasis on the subject. Aims and objectives. Evidence for the effect of nutrition, leg elevation and exercise on the healing of leg ulcers was reconsidered. Furthermore, the evidence for effective pain‐related interventions was investigated. Design. Systematic literature review. Methods. Medline, Cinahl, Psychinfo and Cochrane were searched for studies on pain related interventions, and the effectiveness of leg elevation, leg exercise and nutritional interventions in patients with venous leg ulceration. Results. Some evidence was found to support a positive effect of leg exercises on the endurance and power of the calf muscle and on the haemodynamic status of the limb. There is also evidence for a positive effect of leg elevation during bed rest without compression. No hard evidence was found concerning the effect of enriched or altered nutrition on wound healing. However, there is some evidence of nutritional deficits in this patient group. The use of eutectic mixture of local anaesthetic cream is effective for reducing pain in wound debridement, but pain relief in daily life is insufficiently treated. Conclusion. There is no real evidence of effectiveness of the investigated lifestyle interventions but there are indications that lifestyle interventions might contribute to healing or prevention of venous leg ulceration. Relevance to clinical practice. Although there is no hard evidence, it can be expected that interventions such as nutritional monitoring, guided exercise and leg elevation will have a substantial impact on wound healing in patients with venous leg ulceration. The use of eutectic mixture of local anaesthetic cream can be advised for pain relief with wound debridement. The current lack of effective pain treatment with venous leg ulceration emphasizes the need for effective pain treatment.     

乳腺癌患者围术期人格特质及医学应对方式的临床研究

目的探讨不同人格特质的乳腺癌患者手术前后采取应对方式的特点,为临床心理护理提供理论依据。方法采用艾森克人格问卷(EPQ)、医学应对方式问卷(MCMQ)分别对84例乳腺癌患者的人格特质和应对方式进行测评和分析。结果本组患者手术前后人格特点表现内向、情绪较稳定,术前以“回避”应对方式为主,术后以“面对”应对方式为主,但“屈服”应对方式分值一直处于中等水平,相关分析发现“面对”与EPQ-E呈正相关,而与EPQ-N无相关性,“回避”与EPQ-E、N均无相关性,“屈服”与EPQ-E呈负相关,与EPQ-N呈正相关。结论乳腺癌患者围术期采取的应对方式受人格因素影响,应根据其特点制定相应护理策略。     

Predictors of physical and mental health in hospital nurses within the People's Republic of China

REVIEW OF LITERATURE: Prior research has suggested that nurses contend with a variety of workplace stressors and personal factors that can contribute either positively or negatively to their physical and mental health. However, limited research in this area has been conducted on nurses within China. AIM: The study sought to determine in Chinese hospital nurses: (a) the most common workplace stressors, (b) the most frequently used ways of coping with stress, and (c) which combination of variables (workplace stressors, ways of coping, psychological hardiness and demographic characteristics) was the best predictor of both physical health and mental health. METHODS: The subjects were 480 nurses working in a variety of clinical settings, within five hospitals, located in three major mainland Chinese cities. A survey design was implemented using five self-report instruments. RESULTS: Workplace stressors most frequently identified were workload and dealing with death and dying. Ways of coping most often cited were positive reappraisal, self-control and planful problem solving. The best predictors of physical health were psychological hardiness, conflict with other nurses, uncertainty about patient treatment, seeking social support and confrontive coping. The best predictors of mental health were psychological hardiness, conflict with other nurses, workload, seeking social support, age, likelihood to leave nursing within the next 12 months and escape-avoidance coping. DISCUSSION: These findings suggest areas of concern that need to be addressed, by both hospital and nursing administration, in order to establish a positive and productive work environment for Chinese nurses.     

Parental explanatory style and its relationship to the classroom performance of disabled and nondisabled children

This study examined the relationship between the explanatory style of parents for events involving their school-aged children and the children's classroom performance. Parents and teachers of 52 disabled and 40 nondisabled elementary school students completed questionnaires. Those children whose parents attributed bad events to internal, stable, and global causes tended not to fulfill their potential in the classroom, according to ratings by their teachers. The same patterns held for both disabled and nondisabled children. Findings suggest that the attributional beliefs of parents can affect the behavior of their children.This paper is based on an honors thesis in psychology at the University of Michigan, completed by the first author under the supervision of the second author. We wish to thank Jane Somers for making this research possible. Lisa M. Bossio gave helpful editorial advice. Anne Vanden Belt is now at the School of Medicine, University of Pennsylvania.     

Children's online coping strategies: Rethinking coping typologies in a risk-specific approach

Understanding how children deal with problematic situations online is helpful in developing efficient awareness raising and online resilience building initiatives. In this article, we will discuss and develop typologies for online coping strategies. In a school survey, 2046 Flemish children aged 10–16 were asked about how they (would) respond when confronted with different types of online risks. Using principal component analyses and multi-dimensional scaling, we identified different types of cross-risk and risk-specific coping strategies, and explored which types of coping have similar underlying meanings. The results suggest to distinguish behavioral avoidance tactics from mere passive responses or indifference. Young people tend to perceive online coping strategies along two dimensions: engagement versus disengagement and technical versus non-technical measures. Behavioral avoidance is popular among younger children and is associated with a medium level of active engagement and often combined with communicative approaches. Girls are more communicative and respond more proactively.     

首发与复发精神分裂症患者父父、母母心理健康、应对方式对照研究

目的:探讨首发与复发精神分裂症患者父父、母母及首发患者父母心理健康、应对方式。方法:将精神分裂症患者父母186例,按患者首发与复发分为父父、母母和首发父母3组,分别测验症状自评量表(SCL-90)及简易应对方式问卷(SCSQ)并进行对比分析。结果:首发父亲组SCL-90除抑郁、敌对、偏执及其他与复发父亲组无差异外(P0.05),其余各因子及总分均高于复发组(t=1.884~5.613,P0.05或0.01),消极应对高于复发组(t=4.154,P0.01);首发母亲组SCL-90除敌对、恐怖与复发母亲组无差异外(P0.05),其余各因子及总分均高于复发组(t=2.011~5.942,P0.05或0.01),积极无差异(P0.05),消极应对高于复发组(t=4.672,P0.01);首发父、母组间SCL-90除恐怖、其他无差异外(P0.05),其余各因子及总分父亲低于母亲(t=-1.774~-5.120,P0.05或0.01),积极应对无差异(P0.05),消极应对父亲低于母亲(t=-1.783,P0.05)。结论:首发精神分裂症患者父母心理健康水平低,应对方式简单消极,母亲的心理健康更需关注。