The nature of coping in treatment for marijuana dependence: latent structure and validation of the Coping Strategies Scale.

Abstract

The Coping Strategies Scale (CSS) was designed to assess adaptive changes in substance-use specific coping that result from treatment. This study sought to examine the latent structure of the CSS in the hope that it might shed light on the coping processes of drug users and guide the development of a brief version of the CSS. Respondents on the CSS were 751 men and women treated in 3 clinical trials for marijuana dependence. Posttreatment CSS data were analyzed to determine the nature of coping responses in patients who have been trained to use specific strategies to deal with substance use disorders. Exploratory factor analysis yielded 2 factors, categorized as problem-focused and emotion-focused coping, but confirmatory factor analysis did not support this structure. When infrequently endorsed items were removed, however, confirmatory factor analysis revealed a good fit to the data. Contrary to expectations, practical strategies that often form the basis for coping skills training, such as avoiding those who smoke, were not frequently endorsed. Problem-focused items reflected cognitive commitments to change. Emotion-focused items included cognitive reinterpretations of emotions to help manage emotional reactions. Brief versions of the CSS based on these factors showed good convergent and discriminant validity. The CSS, and the brief versions of the CSS, may prove useful in future treatment trials to evaluate effects of treatment on coping skills acquisition and utilization in substance dependent individuals.