Exploring Coping Strategies in Response to Stress among Prisoners: A Comprehensive Scoping Review

Morticians face unique occupational stressors due to repeated exposure to death, grief, and trauma, which may predispose them to high levels of occupational stress and psychological distress. This study sought to evaluate the coping strategies employed by morticians working in selected mortuaries in Nairobi County, Kenya. The objectives were to identify the adaptive and maladaptive coping mechanisms used, to explore the role of spirituality and social support in coping, and to assess implications for mental health interventions. A convergent mixed methods design was adopted to strengthen the reliability of findings by combining both quantitative and qualitative data. Quantitative data were collected using the Brief COPE Inventory (Carver, 1997) administered to 18 participants, while qualitative insights were gathered through semi-structured interviews with a purposively selected subset of morticians. Data analysis was conducted separately and then integrated during interpretation to allow for triangulation. The quantitative findings revealed a predominant reliance on adaptive coping strategies, including acceptance (90%), religion (90%), emotional support (84.29%), positive reframing (82.86%), and instrumental support (81.43%). In contrast, maladaptive coping strategies were less frequent, with denial (37.14%), self-blame (38.57%), and substance use (30%) reported among participants. The qualitative analysis reinforced these patterns, identifying emotion-focused coping (50%), meaning-making through spirituality (22.2%), and problem-focused strategies (16.6%) as dominant themes. A minority of participants reported avoidant strategies, including emotional suppression and substance use (5.5%). The integration of findings suggests that morticians balance adaptive strategies rooted in spirituality, social support, and positive reframing, while a minority resort to maladaptive coping mechanisms. These results highlight the duality of coping among morticians, resilience on one hand and vulnerability on the other. Based on these findings, interventions such as Stress Inoculation Therapy (SIT), structured peer support groups, and workplace wellness programs are recommended to strengthen adaptive coping, reduce reliance on maladaptive strategies, and ultimately enhance resilience among morticians working in high-stress environments.

BackgroundThe COVID-19 pandemic has had an unparalleled impact, precipitating not only direct threats to physical health but also widespread economic and psychological challenges. This study aims to explore the dynamics of coping behaviour and psychological distress (PD) across different phases of the pandemic within an adult general population sample, spanning Austria and Italy.MethodsAn online questionnaire-based panel study was conducted between 2020 and 2023 including three measurements. We collected data on sociodemographic variables, coping responses (Brief COPE), and PD (Brief-Symptom-Checklist). Statistical analyses were conducted within a linear-mixed-model framework. Multiple imputation and sensitivity analysis were applied to validate the results obtained by complete case analysis.ResultsThe study follows 824 participants and reveals a marginal decrease in overall PD from the first to the second follow-up, particularly in clinically relevant phobic anxiety (35.6% and 34.5% to 25.4%). Most coping behaviours exhibited stable mean-levels with intra-individual variability across the study period. Maladaptive coping strategies were consistently linked to increased PD, whereas adaptive strategies were associated with decreased PD.ConclusionOur findings underscore the complex nature of coping behaviours and PD during and after the pandemic, suggesting that while mean-levels of PD and coping responses remained relatively stable, most coping strategies were subject to intra-individual change. Maladaptive strategies were associated with increased PD, pinpointing to the need for interventions that establish the foundation for adaptive coping mechanisms and promote their application. Further research should explore the reciprocal influences of mental health on coping behaviour, incorporating interventional designs to unravel the nuances of these relationships.

BackgroundCoping strategies are composites of cognitive and behavioral efforts to manage the internal and external demands of stressful situations. They have been documented to relate to general well-being and mental health. However, not all types of coping are created equal, and adaptive versus maladaptive strategies seem to have understudied differential impacts, notably with accumulated adversities.MethodsWe examined coping strategies in a sample of 489 Lebanese university students during accumulating crises, including socio-political unrest and the COVID- 19 pandemic. They were asked to fill out an online survey including standardized questionnaires of well-being (WEMWBS), depression (PHQ- 9), anxiety (HAM-A), intolerance of uncertainty (IUS), and coping (Brief COPE), in addition to demographics and questions about their attitudes and future perspectives.ResultsThe results highlight that adaptive coping strategies positively correlate with psychological well-being, whereas maladaptive ones are associated with higher levels of psychopathology. Specifically, it was shown that a positive association exists between anxiety, depression, intolerance of uncertainty, and maladaptive coping strategies while evidencing a negative association between the latter and well-being. Our multinominal regression showed that anxiety, intolerance of uncertainty and well-being were associated with low levels of adaptive coping when taking adaptive coping as a dependent variable.ConclusionOur study mainly highlights the relation between coping, uncertainty, and mental health. Although intended to help relieve tension, maladaptive strategies might worsen it instead. We emphasize previous findings to promote healthy adaptive coping strategies in times of unprecedented crises.

BACKGROUND AND AIMSPatient activation refers to the knowledge, skills and confidence needed to manage one's health [1]. Higher patient activation is associated with better health outcomes in long-term conditions [2] such as kidney disease (KD). The COVID-19 pandemic has presented a myriad of additional challenges for people living with KD. Individuals may display different coping strategies in response to stressful and difficult circumstances such as health management during the pandemic [3]. Our group conducted a multicentre survey to evaluate the impact of the pandemic on kidney patient experiences, lifestyle and health care. As part of this larger study, we hypothesized that higher patient activation may be associated with more effective coping strategies. The purpose of this analysis was to explore coping styles utilised during the pandemic across different levels of patient activation in people with nondialysis CKD (ND-CKD) and kidney transplant recipients (KTR).METHOD214 ND-CKD and KTR participants [50.9% male, mean age 60.71 (SD 14.15) years, 56.1% KTRs] completed the Patient Activation Measure (PAM-13). Participants were categorised into ‘low’ and ‘high’ activation based on their PAM-13 score (levels 1–2 as low; 3–4 as high). Coping strategies were assessed using the Brief-COPE questionnaire and categorised into adaptive coping (active coping, information support, positive reframing, planning, emotional support, humour, acceptance and religion) and maladaptive coping (venting, self-blame, self-distraction, denial, substance use and behavioral disengagement) strategies. Chi-square tests were conducted to compare coping strategies used by low- and high-activated patients.RESULTSMost participants were classified as having ‘high’ activation levels (n = 164, 77%). Table 1 shows the three most frequently used adaptive and maladaptive coping strategies across activation levels. A significantly greater proportion of those with high activation used acceptance (P = 0.006), active coping (P = 0.045) and positive reframing (P = 0.031) as coping strategies. No significance was observed between maladaptive coping strategies and activation level.Adaptive coping strategiesMaladaptive coping strategiesHigh activationLow activationHigh activationLow activation1Acceptance (79.5%)Acceptance (58.5%)Self-distraction (53%)Self-distraction (47.6%)2Religion (60.5)Religion (30.8%)Behaviour Disengagement (37.5%)Substance Use (40%)3Active Coping (48.2%)Information Support (30%)Substance Use (31.6%)Self-Blame (37.5%)CONCLUSIONThe most commonly reported coping strategy was ‘acceptance’ for individuals with high and low activation. The findings suggest that a higher proportion of people with high patient activation used adaptive coping strategies. Worryingly, regardless of activation level, about a third of participants used substance use (i.e. alcohol and drugs) as a form of coping. Identifying people with lower activation in KD can indicate the need for additional support to help them cope in challenging circumstances. Interventions to improve activation may assist in developing effective coping strategies.

Introduction Dissatisfaction with conservative treatments of various types of dorsopathies results in increased number of surgical interventions to eliminate the accompanying clinical manifestations. Patients' psychosocial characteristics are likely to impact treatment satisfaction, and personality traits as cognitive status, depression, anxiety and coping strategies of the patient have a role. The objective of the study was to assess the impact of the coping strategies of a patient on surgical treatment outcomes in older patients with dorsopathy. Material and methods The study included 149 patients with dorsopathy aged 60 years and over. The patients were divided into 2 groups. The first group (n = 54) consisted of patients with central stenosis of the spinal canal (M48.0) who underwent minimally invasive surgeries without stabilization. The second group included 95 patients with degenerative spondylolisthesis and unstable VMS (M43.1, M53.2). A variety of decompression and stabilization surgical technologies were employed for the patients. Results The majority of patients in the first group ( n = 46, 85 %) obtained satisfactory surgical outcome. Eight patient (15 %) had poor outcome. An inverse, moderate, statistically significant correlation was revealed between maladaptive coping strategies identified with Ways of Coping Questionnaire (distancing, avoidance), Stress Coping Questionnaire (behavioral avoidance of a problem), the Coping Strategy Indicator (avoidance) and surgical outcome. Surgical outcome was rated as satisfactory in 79 (83.2 %) cases and poor in 16 (16.8 %) patients of the second group (n = 95). Patients of the second group showed a greater number of coping strategies having a statistically significant correlation with treatment outcome. Patients with adaptive strategies resulting from decompression and stabilization operations had a more favorable outcome. Maladaptive coping strategies such as confrontation, avoidance and behavioral avoidance of the problem had a negative impact on treatment outcome. Discussion A comprehensive analysis of the questionnaire data showed that the more aggressive the intervention was with the use of fixation constructs, the greater the impact of the patient's coping strategies on the outcome of treatment observed. This relationship was not found in decompression cases with maladaptive strategies being most significant. Conclusion We can conclude about the predictive value of coping strategies based on the impact of the severity of adaptive and maladaptive coping strategies on the outcome and satisfaction with the surgical treatment of dorsopathies in older patients. This factor is essential for the preoperative stage to facilitate personalized treatment options for the complex group of patients.

Mindfulness has been theoretically and empirically associated with psychological health. One commonly investigated mechanism underlying the association between mindfulness and psychological health is adaptive coping. Despite research demonstrating the relationship between trait mindfulness and averaged use of adaptive (and maladaptive) coping strategies, little work has examined the potential association between mindfulness and flexibility in coping. Among various conceptualizations, coping flexibility can be operationalized in terms of within-situational coping variability, referring to the extent of use of different strategies to varying degrees in a given situation, and within-strategy temporal variability, which refers to the extent of use of a particular coping strategy across different situations over time. Using a diary study approach, the present study examined the association between trait mindfulness and the two forms of coping variability. One hundred and ninety-two undergraduates from a Singaporean university were recruited and administered questionnaires and diary logs, in which they reported on use of seven different coping strategies in response to six stressors sampled over a period of 3 weeks. Consistent with hypotheses, factor analysis differentiated within-situational coping variability, within-strategy temporal variability, and averaged use of adaptive and maladaptive coping strategies as distinct constructs. Higher trait mindfulness was associated with lower ruminative self-criticism and greater use of adaptive coping. Importantly, trait mindfulness predicted higher within-situational coping variability, over and above personality traits as well as the average use of adaptive and maladaptive coping strategies. Overall, the study lends support to the idea that mindfulness facilitates adaptive coping in the context of daily life and provides preliminary evidence for the association between mindfulness and greater coping flexibility.

The objective of this study was to compare patients with bipolar disorder (BD), their first-degree relatives and a group of healthy controls in terms of use of adaptive and maladaptive coping strategies, exploring differences between specific types of strategies and their correlations with clinical variables. This was a cross-sectional study enrolling 36 euthymic patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Significant differences were detected in the use of adaptive and maladaptive strategies by patients, their first-degree relatives and controls. Patients used adaptive strategies less often than the patients' relatives (p<0.001) and controls (p = 0.003). There was no significant difference between first-degree relatives and controls (p=0.707). In contrast, patients (p<0.001) and their relatives (p=0.004) both exhibited higher scores for maladaptive coping than controls. There was no significant difference regarding the use of maladaptive strategies between patients and their relatives (p=0.517). First-degree relatives were at an intermediate level between patients with BD and controls regarding the use of coping skills. This finding supports the development of psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies in this population.

Study ObjectivesCoping with stress is important because stress disturbs sleep. However, only a few longitudinal studies have investigated the association between coping and insomnia. We examined whether individuals with insomnia symptoms used more maladaptive coping strategies than individuals without insomnia symptoms, and evaluated the association between insomnia symptoms and coping strategies.MethodsIn this prospective cohort study, Japanese workers were enrolled and observed over a 2-year period. During both years, self-administered questionnaires on coping and insomnia symptoms were administered. Coping was assessed using the Brief-Coping Orientation to Problems Experienced, and insomnia symptoms were examined using the Athens Insomnia Scale. Generalized estimating equation modeling identified the effects of coping strategies on insomnia severity.ResultsIn total, 1358 of 1855 workers at baseline were followed up. Individuals with insomnia symptoms showed a higher use of maladaptive coping strategies and less use of humor and instrumental support than individuals without insomnia symptoms. Active coping, humor, emotional support, and instrumental support were negatively associated with insomnia severity. In contrast, venting, substance use, behavioral disengagement, and self-blame were positively associated with insomnia severity.ConclusionsThis study showed that individuals with insomnia symptoms use both adaptive and maladaptive coping strategies and are more likely to use maladaptive strategies than individuals without insomnia symptoms. In the future, interventions focused on educating people about adaptive coping strategies should be conducted to determine whether coping strategies may prevent insomnia symptoms.

Modern life comprises a myriad of stressful situations, ranging from life-threatening ones to others not so deadly, all of which activate a physiologic stress response. Engaging in healthy ways to cope can prevent us from wearing out our physiological systems. Heart rate variability (HRV) is often used as an index of emotion regulation response. Hence, our goal is to investigate whether the habitual use of coping strategies is related to a distinct pattern of HRV changes when the individual is exposed to a moderate psychosocial stressor. In this study, 60 female participants performed a psychosocial stress task—oral speech preparation—while ECG signals were collected during the whole experimental procedure. Heart rate (HR), HRV parameters (SDNN, RMSSD, LF, HF) and coping strategies (Brief COPE) were registered. Participants were divided into two groups (low and high groups) as a function of their scores on the maladaptive and adaptive coping strategies of the Brief COPE. As expected, the task alone induced increases in heart rate and reductions in HRV parameters. Additionally, the analyses revealed a different pattern of HRV (SDNN, RMSSD, LF and HF) changes in response to the stressor, with participants using less maladaptive strategies being able to maintain the HRV at baseline levels when confronting the stressor, while those using more maladaptive strategies reducing HRV during the task. These results show a different pattern of HRV changes as a function of the coping style, suggesting a possible autonomic advantage, namely, the maintenance of HRV, in individuals who use maladaptive coping strategies less frequently.

Background: Caring for individuals with mental illness can be emotionally and physically demanding, often leading to high levels of stress and psychological distress among caregivers.Objective: This study is aimed at investigating the relationship between stress, psychological distress, and cognitive coping strategies in caregivers of patients with depressive disorders in Pakistan.Method: Four hundred fifty adult caregivers (above 18 years of age; Mage = 37.11, SDage = 12.63), both men (60%) and women (40%), of the patients suffering from depression and related disorders, completed the Kessler Psychological Distress Scale, Washington University Caregiver’s Stress Scale, Cognitive Emotion Regulation Questionnaire, and a demographic sheet.Results: Results of the Pearson product–moment correlation showed that caregiver stress is significantly associated with psychological distress and cognitive coping strategies. All the maladaptive cognitive coping strategies had a significant positive relationship with psychological distress. Findings also revealed that maladaptive cognitive emotion regulation strategies (catastrophizing and others blame) significantly mediated the relationship between caregiver stress and psychological distress. Findings of the independent sample t‐test showed that women experienced more psychological distress and stress related to caregiving as compared to men, while men accepted the adverse situations earlier than women and used a more adaptive coping strategy (putting into perspective).Conclusion: In conclusion, caregivers of patients with mental illness face a complex and challenging journey marked by high levels of stress and psychological distress.

IntroductionDuring the COVID-19 pandemic, adolescents had to deal with a range of mental health problems that has increased social media addiction levels with adverse effects on life satisfaction. Previous studies have explored coping mechanisms to deal with this addiction problem, but did not consider the need to simultaneously cope with different dimensions. Therefore, our study aimed to examine the moderating effect of various coping mechanisms on the relationship between social media addiction and adolescent life satisfaction.MethodsSelf-report questionnaires were applied to 1290 secondary school students (age mean = 16.03, SD = 1.27, range: 14 to 19; and 57% female). An exploratory and a confirmatory factor analysis were performed to determine the factor structure of the Brief-Cope 28 scale. Then, a descriptive and correlational analysis of the variables and a multiple linear regression analysis was performed.ResultsWe found that the social media addiction risk was negatively associated with life satisfaction, adaptive strategies were positively correlated to life satisfaction, and maladaptive strategies were negatively correlated to it. Also, a moderation model was evaluated in which four stress management strategies, namely acceptance and perspective-taking, seeking socio-emotional support, active coping, and maladaptive strategies all conditioned the relationship between social media addiction risk and life satisfaction after controlling for demographic variables and the specific strategies of using comedy, religion and substance use. Results indicate additive and multiplicative effects of management strategies for stressful situations in the studied relationship. Seeking socio-emotional support and active coping were positively related to life satisfaction and maladaptive strategies were negatively associated with it. Multiplicative effects indicate that the relationship between the social media addiction risk and life satisfaction depends only on the acceptance and perspective taking that adolescents report. When adolescents reported having low or average levels of acceptance and perspective taking, there was a negative correlation with general life satisfaction, a connection that grew markedly stronger. In contrast, no connection between social media addiction and life satisfaction was detected for adolescents who report higher levels of acceptance and perspective-taking.DiscussionAbuse of social media and the use of maladaptive stress coping strategies were risk factors that decreased life satisfaction among adolescents during the COVID-19 pandemic period.

Gender-affirming treatments are reported to improve mental health significantly. However, a substantial number of transgender individuals report a relapse in, or persistence of, mental health problems following gender-affirming treatments. This is due to multiple stressors occurring during this period, and in general as a consequence of widespread stigma and minority stress. The aim of this pilot study was to identify different coping strategies that transgender individuals use in response to stressors prior to and following gender-affirming treatments, as mediator of mental health. Qualitative interviews were conducted to better understand the treatment outcomes and healthcare experiences of Dutch transgender individuals who had received gender-affirming treatments. Nineteen participants were included, of which 12 identified as (transgender) male, six as (transgender) female and one as transgender. Inductive coding and theory-informed thematic analysis were used to assess stressors (ncodes = 335) and coping strategies (ncodes = 869). Four stressor domains were identified, including lack of support system, stressors related to transition, and physical and psychosocial stressors post-transition. We identified six adaptive coping strategies of which acceptance, help seeking and adaptive cognitions concerning gender and transition were reported most frequently. Of the seven maladaptive strategies that we identified, social isolation and maladaptive cognitions concerning gender and transition were the most-reported maladaptive coping strategies Clinical implications: The results indicated that transgender individuals may experience significant stress, both transgender-specific and non-specific, prior to and following gender-affirming treatments and, as a result, use many coping strategies to adapt. Increased awareness of stressors and (mal)adaptive coping strategies may help to improve mental healthcare and overall support for transgender individuals. Strengths and Limitations: This is the first (pilot) study to provide insight into the range of stressors that transgender individuals experience during and after gender-affirming treatments, as well as the variety of coping strategies that are used to adapt. However, since this was a pilot study assumptions and generalizations of the evidence should be made cautiously. Results of this pilot study showed that transgender individuals may undergo significant stress during and after gender-affirming medical treatment related to the treatments and the social experiences that occur during this period, and as a result, use a range of coping strategies to adapt to the stress.

Caregivers of children with chronic illnesses experience elevated stress and reduced self-care. Although self-care can be beneficial, it is a form of disengagement coping, disengaging from the stressor to try and feel better, which has been characterized as a maladaptive coping strategy. In this study, we test the formulation that avoidance, avoiding the stressor and any thoughts related to it, is a maladaptive disengagement coping strategy, whereas distraction, taking a break from the stressor to do something pleasant, is an adaptive disengagement coping strategy. We assessed these strategies as well as psychosocial outcomes and trait predictors in caregivers of children with chronic illnesses. Results showed that those high in avoidance coping reported lower well-being, higher depression and higher stress. Alternatively, when controlling for avoidance, those high in distraction reported higher well-being, lower depression and lower stress. In addition, distraction exhibited strong relationships to increased positive emotions during caregiving situations and was associated with positive personality traits. These results suggest that not all disengagement coping strategies are equal; although avoidance may be a maladaptive strategy, distraction can be an effective positive emotional strategy for coping with the chronic stress of caregiving for a child with a chronic illness.

Differences in Coping Strategies Between Women and Men Based on Experience of Frequent Pain/Headaches in Chronic Traumatic Brain Injury

Background:Autism spectrum disorder (ASD), a lifelong neurodevelopmental condition, often imposes significant psychological stress on parents. Identifying parental coping mechanisms is essential for addressing their needs and improving mental health.Aim:To explore coping strategies and their impact on parental stress.Materials and Methods:This cross-sectional study involved 45 children diagnosed with ASD and their parents, all of whom were attending the Child and Adolescent Guidance Clinic at Tertiary care centre in Haryana. The severity of ASD in children was assessed using the Childhood Autism Rating Scale (CARS). Parental stress levels were evaluated using the stress subscale of Hindi version of the Depression Anxiety Stress Scales (DASS). The Stress Coping Behaviour Scale (SCBS) was used to assess parental coping strategies.Results:The results indicated that 58% of parents experienced mild stress, with mothers reporting significantly higher stress levels than fathers. A significant association was observed between the levels of parental stress and the types of coping strategies employed. Most parents predominantly used adaptive coping mechanisms such as active coping, emotional support, planning, acceptance, and religious practices, while maladaptive strategies were less commonly adopted.Conclusion:The study reveals that parental stress levels positively correlate with maladaptive coping strategies and negatively correlated with adaptive ones. It addresses a research gap by exploring coping strategies among parents of children with ASD in India, a context largely overlooked in Western-focused studies.