Coping Items Research Articles

Longitudinal changes in coping strategies across midlife and older adulthood: findings from the midlife in the United States study.

Most studies examining age differences in coping across adulthood come from cross-sectional studies and focus on the broader categories of problem- and emotion-focused coping. We aimed to establish a factor structure for coping items used in a national, longitudinal study of aging (MIDUS) and examine age patterns in coping strategies over 10 years. We performed exploratory and confirmatory factor analysis, and factorial invariance testing. Next we conducted a series of multilevel models for each coping factor with participants from waves II and III of the MIDUS study (N = 2,661, Mage = 55, 58% women, 84% White). We found a four-factor solution: instrumental action; denial/disengagement; positive reappraisal; focus and venting of emotions. Invariance was established across time and age. At baseline, age was positively associated with the use of three strategies, though younger adults used more focus and venting of emotions. There was an overall decrease over 10 years in use of all strategies, which was moderated by age. Positive reappraisal declined more steeply among midlife participants, whereas the remaining strategies declined more for older participants. Results highlight the multi-dimensionality of MIDUS coping items and underscores the import of age in understanding changes in coping across midlife and older adulthood.

Measuring the psychosocial wellbeing of Rohingya mothers in Cox’s Bazar, Bangladesh: Psychometric properties of an MHPSS assessment battery

Background Psychosocial research in humanitarian settings has been historically dominated by a focus on distress and disorder. As such, there is a need to establish the validity of instruments for a broad range of psychosocial outcomes, particularly among highly affected and under-represented populations. The current study describes the adaptation and testing of multiple psychosocial instruments among displaced Rohingya mothers in Bangladesh. Methods We used baseline data from 600 mothers of malnourished children aged 2 and under enrolled in an intervention study in Cox’s Bazar, Bangladesh. Instruments assessed distress (items from the International Depression Symptom Scale [IDSS] and Kessler-6 [K-6]); functional impairment (World Health Organization Disability Assessment Schedule [WHODAS]); subjective wellbeing (global Satisfaction With Life [SWL] and Personal Wellbeing Index [PWI]; and, coping (items from the Brief COPE and locally developed coping items). Instruments were piloted and refined, then used for data collection by Bangladeshi-Rohingya interviewer pairs. We conducted exploratory factor analysis, evaluated internal consistency, examined construct validity through correlation with other scales, and used regression models to explore demographic factors associated with psychosocial health. Results Both the WHODAS and coping items fit 2-factor models; other scales were unidimensional. Cronbach’s alphas ranged from .76 to .90 for the refined scales. With the exception of coping, scale correlations supported construct validity; separate measures of the same construct were highly correlated, distress and impairment were moderately correlated, and both were inversely correlated with wellbeing. Correlates of poorer psychosocial health included relative socioeconomic disadvantage, current pregnancy, and being unmarried. Conclusions Most of the standard psychosocial assessment tools performed adequately, but they did not appear to fully capture local experiences and included items of little local relevance. Findings highlight the need for further mixed methods research to develop a rich battery of instruments with cross-cultural validity, particularly for positive outcomes such as coping which was particularly challenging to assess.

Canadian Adolescents Perceptions of Survey Questions about Climate Emotions and Coping Strategies

Abstract Background Globally, there is increased research and media attention about how young people are experiencing climate change. Much of this attention is about the worry and concern young people feel about climate change, with recent survey research finding that the majority of young people are at least moderately worried about climate change. Objectives To examine the perceptions that Canadian adolescents have about survey measures that have been used to study climate emotions and the coping strategies they use. Methods Seven online focus groups occurred in December 2022 with Canadian adolescents aged 15-18. The focus groups began with a brainstorming activity followed by a semi-structured discussion about climate emotion survey questions that have been used in previous surveys. Data were analyzed using rapid thematic analysis. Results Overall, Canadian adolescents showed a preference for questions that allowed for more nuance in their response. Questions that were seen to allow for a variety of perspectives were also favored. Conclusions Findings from this study can be used to guide survey item development/adaptation in this emerging field of inquiry. Key messages • Participants indicated a preference for multi-item questions in relation to climate emotions. • Focusing on coping items was deemed a priority.

Turkish adaptation of Social Coping Questionnaire for gifted students

The objective of this research is to conclude the Turkish adaptation, validity, and reliability analysis of Swiatek's Social Coping Questionnaire (SCQ), which was first published in 1995. (However, the most recent 2001 version of the questionnaire is employed in this study.) A total of 266 gifted students (130 females and 136 males) participated in the study. The participants' ages ranged from 11 to 15. Exploratory and confirmatory factor analyses showed that the Turkish version of the scale retained the five-factor structure of the original scale. SCQ consists of 25 items in total and examines coping techniques using 5 subscales. Furthermore, the SCQ is a self-report, seven-point likert type questionnaire that assesses five coping styles: denying giftedness (7 item), social engagement (6 item), humor (3 item), and popularity (5 item). The factor loadings of the items are ranged from .79 to .40. The range of all item-total correlation coefficients was between .44 and .77. Cronbach Alpha Coefficients were determined as .77 for denying giftedness, .60 for social interaction, .60 for humor, .57 for popularity, and .48 for peer acceptance. Test re-test coefficients were as follows; .62 denying giftedness, .48 social interaction, .50 humor, .45 popularity, and .39 peer acceptance scale. The UCLA Loneliness Scale was administered to another gifted students sample to test the convergent validity of the instrument (n=102), as expected peer acceptance and humor subscale correlates negatively ( -.43) and denying giftedness subscale correlates positively (.27) with UCLA scores. The model fit was evaluated via confirmatory factor analysis using the structural equation modeling program. The analysis were performed on the 25 social coping items and resulting fit indices clearly revealed that the five-factor model of social coping provided a good fit to the data (x2 =437.08, df=262, (x2/df=1.66)), RMSEA=0.050, GFI= 0.88, CFI=0.85, NNFI=0.83, SRMR=0.072).

Translation of the Modified Polycystic Ovary Syndrome Questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Tool (PCOSQOL) in Dutch and Flemish Women with PCOS.

This study aims to determine the test-retest reliability and to confirm the domain structures of the Dutch version of the modified polycystic ovary syndrome questionnaire (mPCOSQ) and the Polycystic Ovary Syndrome Quality of Life Scale (PCOSQOL) in Dutch and Flemish women with Polycystic Ovary Syndrome (PCOS). PCOS patients were contacted with a request to complete both questionnaires (including additional demographic questions) online in their home environment on T0 and on T1. The study was approved by the Ethics Committee of Erasmus Medical Centre and of Ghent University Hospital. In this study, 245 participants were included between January and December 2021. The mPCOSQ has excellent internal consistency (α: 0.95) and a high to excellent Intraclass Correlation Coefficient (ICC) for all six domains (ICC: 0.88-0.96). The PCOSQOL demonstrates excellent internal consistency (α: 0.96) and ICC (ICC: 0.91-0.96) for all four domains. The original six-factor structure of the mPCOSQ is partly confirmed. An extra domain is added to the PCOSQOL which included coping items. Most women have no preference for one of the two questionnaires (55.9%). In conclusion, The Dutch mPCOSQ and PCOSQOL are reliable and disease-specific QoL measures for women with PCOS. Both questionnaires are recommended for clinical practice.

Measuring the psychosocial wellbeing of Rohingya mothers in Cox’s Bazar, Bangladesh: Psychometric properties of an MHPSS assessment battery

Background: Psychosocial research in humanitarian settings has been historically dominated by a focus on distress and disorder. As such, there is a need to establish the validity of instruments for a broad range of psychosocial outcomes, particularly among highly affected and under-represented populations. The current study describes the adaptation and testing of multiple psychosocial instruments among displaced Rohingya mothers in Bangladesh. Methods: We used baseline data from 600 mothers of malnourished children aged 2 and under enrolled in an intervention study in Cox’s Bazar, Bangladesh. Instruments assessed distress (International Depression Symptom Scale [IDSS] and Kessler-6 [K-6]); functional impairment (World Health Organization Disability Assessment Schedule [WHODAS]); subjective wellbeing (global Satisfaction With Life [SWL] and Personal Wellbeing Index [PWI]; and, coping (Brief COPE and locally developed coping items). Instruments were piloted and refined, then used for data collection by Bangladeshi-Rohingya interviewer pairs. We conducted exploratory factor analysis, evaluated internal consistency, examined construct validity through correlation with other scales, and used regression models to explore demographic factors associated with psychosocial health. Results: Both the WHODAS and coping items fit 2-factor models; other scales were unidimensional. Cronbach’s alphas ranged from .76 to .90 for the refined scales. With the exception of coping, scale correlations supported construct validity; separate measures of the same construct were highly correlated, distress and impairment were moderately correlated, and both were inversely correlated with wellbeing. Correlates of poorer psychosocial health included relative socioeconomic disadvantage, current pregnancy, and being unmarried. Conclusions: Most of the standard psychosocial assessment tools performed adequately, but they did not appear to fully capture local experiences and included items of little local relevance. Findings highlight the need for further mixed methods research to develop a rich battery of instruments with cross-cultural validity, particularly for positive outcomes such as coping which was particularly challenging to assess.

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

<h3>Research Objectives</h3> To identify gender differences in coping strategies by experience of pain/headaches in chronic traumatic brain injury (TBI). <h3>Design</h3> Cross-sectional study. <h3>Setting</h3> Community. <h3>Participants</h3> n=133 adults with chronic mild-severe TBI (M=7.5 years post-injury). <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Behavioral Assessment Screening Tool (BAST) coping items: two adaptive (asking someone I trust for help, going for a walk/exercising) and four avoidant (bought things I didn't need, took my emotions out on other people, unable to make decisions, went to sleep) rated on a 1=never to 5=very often ordinal scale. <h3>Results</h3> Two-thirds of women (52/78), 45% of men (23/54), and one individual (100%) identifying as transgender reported experiencing frequent pain/headaches. Almost all participants (n=130, 97.7%) felt stressed over the past two weeks. When stressed, men without pain (n=31) exercised/walked (M=3.14, SD=1.6) more often than men with pain (M=2.39, SD=1.03, p=.024) and women without pain (M=2.46, SD=1.25, p=.037). Women with pain engaged more frequently in maladaptive coping strategies (M=2.58-3.17) than women without pain (M=2.08-2.71). Women with pain bought things they did not need more often than all others (p's=.019- < .001) and went to sleep significantly more often than men with pain (p=.029) and women without pain (p=.003). <h3>Conclusions</h3> Individuals with chronic TBI frequently report feeling stressed, and many - particularly women - report experiencing frequent pain/headaches. Women experiencing pain/headaches after TBI engage in maladaptive coping more often than women without pain/headaches or men regardless of pain experience. However, they also walk/exercise to manage stress more than women without pain or men with pain, suggesting that women experiencing pain/headaches after chronic TBI may use more coping strategies - including both adaptive and maladaptive strategies - overall to manage their stress. Providers should emphasize the benefits of physical activity and social support after TBI. <h3>Author(s) Disclosures</h3> This work was supported by funding from the National Institutes for Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH/NICHD). Grant #: R03HD09445 (PI: Juengst).

Healthcare Professionals (Nurses') Perceived Stress and Coping: Amid COVID-19

Background: Nurses are the frontline health professional more likely to undergo various stressors during the pandemic Covid-19 situation. The ongoing unprecedented crisis causes more stress, especially among nurses, as they are the most vulnerable group who predominantly get impacted while delivering comprehensive care.&#x0D; Aim: This study explored the level of stress among nurses working in different healthcare settings.&#x0D; Methods: A descriptive cross-sectional study among nurses from developed and developing countries between 7 February and 7 April 2020 was adopted for this research. Sixty-four nurses working in different healthcare settings were included in the study. A self-developed online questionnaire using google documents was used to collect data that comprised baseline data, Cohen Perceived stress scale, simplified coping items, and items of psychosocial perception. Results: It was revealed that 75.64% of studied participants (N=64) had a high level of stress, with a mean anxiety score and Standard deviation of 3.52± 1.084, during the Covid-19 pandemic situation. A statistically significant association was found between the demographic variables such as experience and participation in the COVID-19 team at p&lt;.05, whereas gender, age, and working unit do not show any significant associations.&#x0D; Conclusion: Heath institutions' effective and efficient protocols are required to enhance nurses' mental strength and alleviate their lack of coping strategies, particularly during a crisis.

Factor analysis of the adolescent version of the behavioural assessment screening tool (BAST-A) in adolescents with concussion

ABSTRACT Objective: Develop and validate the Behavioral Assessment Screening Tool for Adolescents with brain injury. Setting: Concussion clinics Participants: Adolescents with mild traumatic brain injury 3 months after initial concussion clinic visit (n = 138). Design: Assessment development and validation (cross-sectional cohort) study Main Measures: Behavioral Assessment Screening Tool – Adolescent Results: Expert panel members added or modified items specific to adolescents to the original Behavioral Assessment Screening Tool for adults. The Content Validity Index was 97.2%. Exploratory factor analysis of the Behavioral Assessment Screening Tool – Adolescent reduced the initial 70 items to 46 primary items with a 3-factor solution: Negative Affect & Fatigue, Executive & Social Function, and Risk Behaviors. Internal consistency reliabilities ranged from good to excellent for all factors (Cronbach’s α =.80-.95). We retained four secondary maladaptive coping items (from an initial six), though these require further modification and testing (Cronbach’s α =.67). Conclusion: The Behavioral Assessment Screening Tool for Adolescents, a measure of neurobehavioral symptoms after mild traumatic brain injury in adolescents, has a multidimensional factor structure with evidence of good internal consistency reliabilities. Future work will further evaluate its convergent and discriminant validity and employ item response theory analyses for validation in a new sample of adolescents with concussion.

Religious Coping, Hopelessness, and Suicide Ideation in Subjects with First-Episode Major Depression: An Exploratory Study in the Real World Clinical Practice.

Background. This study aimed to evaluate the potential relationships between religious coping, hopelessness, and suicide ideation in adult outpatients with the first episode of major depressive disorder (MDD). Methods. Ninety-four adult outpatients with MDD were assessed through the Hamilton Depression Rating Scale (HAM-D), the Beck Hopelessness Scale (BHS), and the Scale of Suicide Ideation (SSI). Religious coping was assessed with the Italian version of the Brief RCOPE scale, consisting of seven positive coping items (PosCop) and seven negative coping items (NegCop). Results. The results showed that the Brief RCOPE PosCop scale exhibited a strong inverse correlation with HAM-D, BHS, and SSI, whereas HAM-D and BHS were positively correlated with SSI. Brief RCOPE NegCop scores were positively correlated only with SSI. Regression analysis with SSI as the dependent variable showed that higher Brief RCOPE PosCop scores were associated with lower suicide ideation, whereas higher HAM-D and BHS scores were associated with higher suicide ideation. Conclusion. Positive religious coping may be a protective factor against the development of suicide ideation, perhaps counteracting the severity of depressive symptoms and hopelessness. The evaluation of religious coping should be performed in all subjects with MDD in everyday clinical practice. However, this study was preliminary, and limitations must be considered.

Coping Strategies and Psychological Symptoms Among Children on St. Thomas in the Aftermath of Hurricanes Irma and Maria.

Research has shown that experiencing a hurricane can lead to internalizing, externalizing, and posttraumatic stress (PTS) symptoms in children. However, the effects of experiencing two hurricanes within a short time frame have not been examined. Moreover, there is limited research examining how children's coping is linked to their psychological functioning and no research using the empirically supported conceptualization of coping that includes primary control coping (i.e., attempts to control the stressor) and secondary control coping (i.e., attempts to adapt to the stressor). This study examined the psychological functioning of 108 children and adolescents (69.7% Black, Non-Hispanic; 56.5% female; M age = 11.59 years, SD = 2.43) in Grades 3-12 as measured 3 months after experiencing Hurricanes Irma and Maria on the island of St. Thomas. Participants completed electronic questionnaires about their demographic characteristics, hurricane exposure (i.e., perceived life-threat, life-threatening events, loss/disruption after hurricanes), coping strategies utilized, and their psychological functioning (i.e., PTS, internalizing, and externalizing symptoms). A principal component analysis of the coping items determined four coping factors: primary control, secondary control, disengagement, and negative coping. Linear regressions, including children's age and aspects of hurricane exposure, found primary control coping was positively associated with PTS symptoms, β = .18, whereas secondary control coping was negatively associated with PTS and externalizing symptoms, βs = -.17 and -.19, respectively. Negative coping, but not disengagement coping, was positively associated with all three outcomes, βs = .31-.42. These findings suggest positive ways children can cope after experiencing a hurricane, informing possible early intervention efforts.

Dyadic coping and the cortisol:CRP ratio: How marital stress influences physiological state

Although previous data indicate that dyadic coping is associated with Hypothalamic-Pituitary-Adrenal (HPA-axis and C-reactive protein (CRP) separately, no study has reported on the ratio between these two systems and dyadic coping, despite this index of physiological homeostasis being associated with physical health and depression. Forty-eight community volunteers who were either married (n = 36) or cohabiting (n = 12) provided saliva and serum samples, and also completed a dyadic coping inventory. There was a significant inverse correlation between cortisol:CRP ratio and dyadic coping, but only for married participants. One of the six dyadic coping items, related to being able to calmly discuss something within a dyad, was the key factor in the association between dyadic coping and cortisol:CRP ratio. These findings provide some initial support for the influence of the way that spouses interact to solve problems and the balance between their HPA and immune systems.

Single-item teacher stress and coping measures: Concurrent and predictive validity and sensitivity to change

This study examined the concurrent and predictive validity of single-item scales for assessing teacher stress and coping. Correlations between the stress and coping items and present and end-of-year teacher-reported burnout and self-efficacy generally aligned with hypotheses, with stronger associations between coping and burnout and self-efficacy in comparison to the associations between stress and burnout and self-efficacy. Stress and coping items also predicted concurrent and future emotional exhaustion controlling for covariates; however, only coping consistently predicted additional variance in future emotional exhaustion with both stress and coping items in the model. Further, the coping item, not the stress item, demonstrated sensitivity to detect intervention effects; that is, teachers randomly assigned to receive a classroom management intervention (the Incredible Years Teacher Classroom Management program) had significantly higher coping scores compared to a wait-list comparison group. The results of this study provide support for the continued use of single-item stress and coping measures of teacher well-being, and areas for further research and potential use of these measures are discussed.

Factor structure of a coping measure in the 2013 Canadian Forces Mental Health Survey.

Coping has been the subject of numerous studies over the past decades, yet significant debate remains regarding the structure of this construct. Exploratory and confirmatory factor analyses were conducted on 2013 Canadian Forces Mental Health Survey (CFMHS) data to examine the factor structure of coping items. A total of 6,696 Canadian Armed Forces (CAF) Regular Force members completed a coping inventory that assessed 14 coping strategies (e.g., problem solving, talking to others). Results indicated that coping among CAF Regular Force members was best represented by two factors: positive coping and negative coping. Coping strategies categorized as positive coping included active efforts to confront the stressor or improve one's well-being, whereas those categorized as negative coping reflected passive or avoidant efforts or behaviours that may compromise one's health. Positive coping factor scores were positively associated with perceptions of one's ability to handle difficult problems and day-to-day demands, while negative coping factor scores were negatively associated with such perceptions, suggesting that the factors had good concurrent validity. Additional analyses pointed to higher positive and negative coping scores among female Regular Force members compared with male Regular Force members. The additional analyses also showed generally less favourable coping scores among lower-ranking Regular Force members and those with a history of deployment to Afghanistan relative to their respective counterparts. Lastly, Regular Force members who received mental health training demonstrated higher positive coping scores. The report discusses implications for the use of coping indicators in future analyses involving the CFMHS.

Religiousness and Symptoms of Depression in Native and Immigrant Chronic Dialysis Patients in the Netherlands.

For immigrant chronic dialysis patients, religious behavior and religious coping may have a different impact on depressive symptoms compared to native patients. This study aims to describe both cross-sectional and longitudinal associations between religious behavior and coping with symptoms of depression for 281 native and 277 immigrant dialysis patients in the Netherlands. A higher prevalence of depressive symptoms was found in immigrant compared to native patients (49% vs. 36%). No significant cross-sectional or longitudinal associations were found in both groups between religious behavior and positive religious coping with depressive symptoms. Strong significant cross-sectional associations were found between negative religious coping items and depressive symptoms in both groups, while no longitudinal associations were found. So, similar impact of religiousness on the presence of depressive symptoms was found for both native and immigrant dialysis patients. Therefore, these results do not explain the higher prevalence of depressive symptoms found in immigrant chronic dialysis patients compared to native patients.

The prevalence and role of coping strategies in the nutritional intake of children born with esophageal atresia: a condition-specific approach.

This study describes results of a condition-specific approach to the assessment of coping strategies in nutritional intake situations used by children with esophageal atresia. One hundred three families of children 2-17 years old with esophageal atresia participated (94% response rate). Following standardized focus groups with 30 families, nine coping items were developed, reflecting nine different coping strategies in nutritional intake situations. The coping items were pilot tested by 73 new families and evaluated for feasibility, validity, and reliability. The families also completed a validated condition-specific quality-of-life questionnaire for children with esophageal atresia, which included the scale Eating-Quality-of-life. Data were analyzed using descriptives, between-group analysis, and Spearman's rho (P<0.05). Altogether, the coping items were feasible, valid, and reliable. Items reflecting problem-focused strategies revealed that 89% of 2-17 years old 'recognized their responsibility' and managed nutritional intake problems on their own, 79% 'tried to solve their feeding problems' testing different solutions, 79% took a 'confronting approach' to do what peers did in eating situations, and 54% 'sought other people's support'. Items reflecting emotion-focused strategies showed that 86% of the children 'accepted' their feeding difficulties, 68% 'reappraised feeding difficulties into positive outcomes' such as to eat only when food tasted good. Moreover, 63% of the children 'avoided' nutritional intake situations, 29% 'expressed worry or fear' when faced with these situations, while 25% 'distanced' themselves from eating problems by hiding or throwing away food. The children's use of coping strategies were mostly related to the existence of digestive symptoms (P<0.05). Positive and negative coping strategies were identified. Of particular note was a correlation cluster of the so-called disengagement strategies 'avoidance', 'expression of emotional concerns' and 'distancing'. These strategies were negatively correlated with Eating-Quality-of-Life. Conversely, taking a 'confronting approach' correlated positively with Eating-Quality-of-life (P<0.05). Hence, most children with esophageal atresia employ various coping strategies in nutritional intake situations. A good Eating-Quality-of-life may be positively affected by treating digestive morbidity and encouraging children to take an active approach to their eating problems rather than using disengagement coping.

Basic Dimensions of Resilient Coping in Paramedics and Dispatchers

Introduction Paramedics and dispatchers are exposed to high levels of stress and consequent psychological injury. Resilience training enhances the capacity to cope with stress and be resilient. It is widely recommended that resilience training be customised to specific occupational groups, but there is no established method for achieving such customisation. Exploratory factor analysis was used to identify dimensions underlying resilient coping in paramedics and dispatchers. The objective was to provide a basis for customised resilience training in this population. Methods The Resilient Coping Survey (RCS) was developed on the basis of interviews with paramedics and dispatchers as well as scoping review to identify coping items relevant to this occupational group. The RCS included scales of coping (Resilience at Work and the Self-Compassion Scale – Short Form), a scale of self-perceived resilience (the Brief Resilience Scale) and a set of items reflecting coping skills specific to paramedic service work. The survey was administered to paramedics and dispatchers in British Columbia, Canada. Results 703 paramedics and dispatchers responded to the survey. Analysis of the survey data identified five resilient coping factors: balance, self-acceptance, trusted social support, meaningful work and physical self-care. Each of these factors predicted resilience. No difference was found overall in resilience across gender; but only for male workers did resilience fall steadily with years of service. Conclusion Resilience training for paramedics and dispatchers would appropriately target the five resilient coping factors and be delivered throughout the paramedic service career.

Factor structure of the Behavioral Assessment Screening Tool (BAST) in traumatic brain injury

Objective: Establish the factor structure of the Behavioral Assessment Screening Tool (BAST), a self-reported emotional/behavioral symptom measure for adults with traumatic brain injury (TBI).Setting: Community.Participants: Community-dwelling adults with moderate–severe TBI (n = 162; n = 110).Design: Assessment development (cohort study).Main measures: Behavioral Assessment Screening Tool.Results: The original BAST included 61 items (55 primary, six secondary), an Environmental Context checklist including recent major life events, and three open-ended questions about other relevant factors. Two rounds of pilot testing and exploratory factor analysis of the BAST (n = 162; n = 110) reduced the total items to 37 primary items and six secondary coping items. The final BAST had a five-factor solution with communalities ranging from 0.323 to 0.771. Internal consistency reliabilities ranged from acceptable to excellent for all factors (Cronbach’s α = 0.76–0.90). The items related to coping, given only to those endorsing stress, had a two-factor solution with communalities ranging from 0.224 to 0.605, but demonstrated acceptable to poor internal consistency (Cronbach’s α = 0.46–0.68). Participants rated ease of use and overall satisfaction with completing the scale as high, with mean scores of 6.42 and 6.22 out of 7, respectively.Conclusions: The BAST, a measure of behavioral and emotional symptoms after TBI, has a multidimensional factor structure with evidence of good internal consistency reliability. Future work will evaluate the convergent, discriminant, and discriminative validity of the BAST and employ item response theory analyses to further develop a short version for mobile health assessment.Implications for RehabilitationLong-term monitoring of behavioral and emotional symptoms after traumatic brain injury could improve clinical management and reduce negative participation and quality of life outcomes.The Behavioral Assessment Screening Tool demonstrates reliability for use among adults with chronic traumatic brain injury, through its factor structure and internal consistency reliabilities, to measure chronic behavioral and emotional symptoms.The Behavioral Assessment Screening Tool is a screening tool to identify potential behavioral and emotional problems that individuals with chronic traumatic brain injury may be experiencing; it could be implemented in a proactive, rather than reactive, system for long-term monitoring of these symptoms to improve early identification of clinical disorders.

Developing an item bank to measure the coping strategies of people with hereditary retinal diseases.

Our understanding of the coping strategies used by people with visual impairment to manage stress related to visual loss is limited. This study aims to develop a sophisticated coping instrument in the form of an item bank implemented via Computerised adaptive testing (CAT) for hereditary retinal diseases. Items on coping were extracted from qualitative interviews with patients which were supplemented by items from a literature review. A systematic multi-stage process of item refinement was carried out followed by expert panel discussion and cognitive interviews. The final coping item bank had 30 items. Rasch analysis was used to assess the psychometric properties. A CAT simulation was carried out to estimate an average number of items required to gain precise measurement of hereditary retinal disease-related coping. One hundred eighty-nine participants answered the coping item bank (median age = 58years). The coping scale demonstrated good precision and targeting. The standardised residual loadings for items revealed six items grouped together. Removal of the six items reduced the precision of the main coping scale and worsened the variance explained by the measure. Therefore, the six items were retained within the main scale. Our CAT simulation indicated that, on average, less than 10 items are required to gain a precise measurement of coping. This is the first study to develop a psychometrically robust coping instrument for hereditary retinal diseases. CAT simulation indicated that on an average, only four and nine items were required to gain measurement at moderate and high precision, respectively.

Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study.

This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10-17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.