Coping Items Research Articles

Does It Matter What You Call It? Lay Beliefs for Overcoming Chronic Fatigue Syndrome, Myalgic Encephalomyelitis, and Post-Viral Fatigue Syndrome

The study reported here examines variation in beliefs about how best to overcome a health complaint when it is nominally designated in one of 3 different ways, namely, as chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), or as post-viral fatigue syndrome (PVFS). In a repeated measures design, the participant sample (n= 140) was presented with an adapted version of Knapp and Karabenick’s (1985) questionnaire which asks respondents to rate the degree to which single-item coping strategies would be most useful for overcoming each of the 3 designated complaints. Factor analysis of the coping items produces 3 groups of items as belief components: “self-reliance,” “seeking help,” and “external control.” The chronic fatigue syndrome appellation invoked significantly higher scores on the self-reliance factor and on external control than did the other two diagnostic labels. However, seeking help was considered to be the most important strategy for overcoming all three of the designated incarnations of the condition. In conclusion, “chronic fatigue syndrome” is the linguistic construction that bestows the most beneficial outlook for assisting individuals to overcome this complaint. Thereby, the use of this descriptor in current medical nomenclatures arguably is well placed.

Factors Involved in Coping with the Dilemma of Using Physical Restraints on Elderly People with Dementia: Perspectives from Nurses who Live with Elderly Relatives

Aim: The present study aimed to clarify factors surrounding the dilemma of using physical restraints on elderly patients with dementia. Methods: We developed a 16-item survey to assess dilemma coping items. Subjects: In particular, we surveyed how nurses who live with elderly relatives coped with this issue. We enrolled 269 nurses who worked in general wards of the 3 hospitals and who agreed to participate in the present study. Ethical considerations: This study was approved by the Ethics Committee of the Nursing Department of the Meiji University of Integrative Medicine. Results and Considerations: We extracted four items with a characteristic value of one or greater, which yielded a significant KMO value of 0.79 and a cumulative contribution ratio of 66.8%. Cronbach’s α coefficient for composing items of each factor were 0.87, 0.83, 0.60, and 0.68 for factors 1, 2, 3, and 4, respectively. The same procedure as described above was performed for the 16 dilemma coping items among nurses who did not live with elderly relatives, which resulted in a total of 16 final items used in the analysis. Three items with a characteristic value of one or greater were extracted, revealing a significant KMO value of 0.78 and a cumulative contribution ratio of 56.8%. Cronbach’s α coefficient for composing items of each factor were 0.84, 0.85 and 0.79 for factors 1, 2, and 3, respectively. Therefore, we found that exposure or living with elderly relatives influenced nurses’ coping with this dilemma.

Coping with ambient stress: factorial structure and stressor-specificity of a general scale / Afrontamiento del estrés ambiental: estructura factorial y especificidad de estresores en una escala general

The aim of this study was (a) to examine the factorial structure of coping with ambient stress and (b) to examine the stressor-specificity of coping strategies. A German questionnaire was compiled and tested in an online survey (N = 703). Most of the final 23 items referred to environmental burdens and pollution in general. Exploratory and confirmatory factor analyses identified three subscales with a common second-order factor: environmental concern/activism, optimism and self-protection (Cronbach’s α: .71 to .88). A paper-and-pencil study (N = 109) confirmed the three-factor structure. In addition, coping items were reformulated to relate to five specific ambient stressors. Results showed positive correlations between responses to stressor-specific items and general items, but their degree and significance varied between stressors and subscales. Thus, the general scale on coping with ambient stress may be applied in multiple-stressor research. For research on stressor-specificity of coping strategies, stressor-specific instruments should be used.

Stress among First and Third Year Medical Students at University Kebangsaan Malaysia.

Objective:To identify the stress-prevalence and coping-strategies among University Kebangsaan Malaysia (UKM) medical students.Methods:This was an observational study conducted among 234 UKM first and third year medical students. Standardized questionnaire on stress and coping strategies was used. Stress data was related to subjective experiences on some positive and negative adjectives such as tense, relaxed etc. Positive adjectives were measured by sign “++” and “+” scoring “1” while stress-negative adjectives were measured by sign “?” and “–“ scoring “0”. Forty-eight coping items under task, emotion and avoidance strategies were measured using 5-point Likert-scale.Results:Overall stress-prevalence was 49%. Female and Malay respondents were more stressed. Significant differences of stress-level was observed between Malays and non Malays in first year (p=0.04) and in third year (p=0.01). Most common strategies used to cope stress was task-oriented while emotion oriented was least.Conclusion:Stress-prevalence and stress-level in UKM medical students was high. Most of the respondents coped stress using task-oriented strategies. Stressor and its effective management must be ensured. Educational institutions should act as a creative designer of learning environment to get relieve from educational stressor.

Measurement Structure of the Coping Strategies Questionnaire-24 in a Sample of Individuals With Musculoskeletal Pain: A Confirmatory Factor Analysis

Purpose: To examine the factorial structure of the Coping Strategy Questionnaire-24 (CSQ-24) in a sample of Canadians with chronic musculoskeletal pain.Method: The sample included 171 workers’ compensation clients (50.9% men) recruited from outpatient rehabilitation facilities in Canada. Mean age of participants was 42.45 years (SD = 9.87). Confirmatory factor analysis (CFA) was used to evaluate the factorial validity of the CSQ-24.Results: CFA indicated that the respecified 4-factor model comprising 20-specific coping items provided the best fit between the model and data, with χ2/df = 2.009, CFI = 0.916, RMSEA = .077. The Cronbach’s alpha coefficients for the 4 factors ranged from .80 to .86. The CSQ-24 correlated moderately in the predicted directions with pain intensity, activity interference, and depression, supporting its construct validity.Conclusion: The CSQ-24 was found to measure the 4 coping strategy factors reported by Harland and Georgieff (2003). It demonstrated good internal consistency reliability and construct validity and can be used as a brief coping measure for chronic pain clients in clinical rehabilitation settings.Chung-Yi Chiu, PhD, CRC, is an assistant professor, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign.

Protective Factors for Mental Disorders and Psychological Distress in Female, Compared with Male, Service Members in a Representative Sample

Although military interest in promoting psychological resilience is growing, resources protective against psychopathology have been understudied in female service members. Using a representative sample of Canadian Forces personnel, we investigated whether religious attendance, spirituality, coping, and social support were related to mental disorders and psychological distress in female service members, and whether sex differences occurred in these associations. Religious attendance and spirituality were self-reported. Coping items were taken from 3 scales and produced 3 factors (active, avoidance, and self-medication). Social support was assessed with the Medical Outcomes Study Social Support Survey. Past-year mental disorders were diagnosed with the World Mental Health Composite International Diagnostic Interview. The Kessler Psychological Distress Scale assessed distress. Multivariate regression models investigated links between correlates and psychological outcomes within each sex. For associations that were statistically significant in only one sex, sex by correlate interactions were computed. In female service members, inverse relations were found between social support and MDD, any MDD or anxiety disorder, suicidal ideation, and distress. No associations were found between religious attendance and outcomes, and spirituality was associated with an increased likelihood of some outcomes. Active coping was related to less psychological distress, while avoidance coping and self-medication were linked to a higher likelihood of most outcomes. Although several statistically significant associations were found in only one sex, only one sex by correlate interaction was statistically significant. Social support was found to be inversely related to several negative mental health outcomes in female service members. Few differences between men and women reached statistical significance. Future research should identify additional helpful resources for female service members.

Parental palliative cancer: psychosocial adjustment and health-related quality of life in adolescents participating in a German family counselling service

BackgroundParental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with parents suffering from palliative cancer or cancers in other disease stages, b) to relate psychosocial adjustment and health-related quality of life to adolescent coping, and c) to explore significant mediator and predictor variables.MethodsCross-sectional data were derived from a multi-site research study of families before child-centered counselling. N=86 adolescents and young adults were included, their mean age 13.78 years (sd 2.45), 56% being female. Performed analyses included ANCOVA, multiple linear regression, and mediation analysis.ResultsAdolescents with parents suffering from palliative cancers reported significantly less total psychosocial problems, and better overall HRQoL. There were no significant group differences regarding coping frequency and efficacy. Our set of coping items significantly mediated the effect of parental disease stage on psychosocial problems and HRQoL. Further, parental disease status and general family functioning predicted psychosocial problems (R2adj =.390) and HRQoL (R2adj =.239) best.ConclusionThe study indicates distress among adolescents throughout the entire parental disease process. Our analysis suggests that counselling services could offer supportive interventions which focus particularly on adolescent coping as well as family functioning.

Spiritual pathology and religious coping as predictors of forgiveness

Spiritual pathology, religious coping, and dispositional forgiveness were investigated in two studies with graduate students at a Christian university-based seminary. Spiritual pathology was operationalised using measures of spiritual instability and spiritual grandiosity. Study 1 (N = 194) examined patterns of correlation between positive and negative religious coping items, spiritual pathology, and dispositional forgiveness. Spiritual instability correlated with numerous positive and negative religious coping items while spiritual grandiosity did not. Dispositional forgiveness correlated with more positive than negative religious coping items. Study 2 (N = 214) tested regression models with these variables. Spiritual grandiosity showed a significant quadratic (concave down) effect in predicting dispositional forgiveness while the linear effect was not significant. A hierarchical regression model showed positive religious coping, spiritual instability, and the quadratic effect for spiritual grandiosity each predicted unique variance in dispositional forgiveness after controlling for spiritual impression management. Negative religious coping was not related to dispositional forgiveness when included with these variables.

Comparing student perceptions of coping strategies and school interventions in managing bullying and cyberbullying incidents

A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying and cyberbullying were compared. Ratings for cyberbullying were moderately lower than for traditional bullying but both had similar ranked order of reported value. The highest coping item ratings were for Seeking Help & Advice, followed by Independent Approach and Evading Problems; the lowest item ratings were for Externalising Problems and Internalising Problems. The highest intervention item ratings were for School Sanctions and Disciplinary Action, followed by Informal Approach and Support Approach, with the lowest item ratings for Curricular Approach. Students reported the most helpful approach in coping with traditional bullying and cyberbullying was the support of family members, primarily parents. Students considered the most helpful intervention for both traditional bullying and cyberbullying was permanent suspension from school. Implications for future practice in education settings are discussed with reference to whole-school anti-bullying measures.

The structure of coping among older adults living with HIV/AIDS and depressive symptoms

One-third of adults living with HIV/AIDS are over the age of 50. This study evaluated the structure of coping among 307 older adults living with HIV/AIDS. Participants completed 61 coping items and measures of anxiety, depression, loneliness, and coping self-efficacy. Exploratory factor analyses retained 40 coping items loading on five specific first order factors (Distancing Avoidance, Social Support Seeking, Self-Destructive Avoidance, Spiritual Coping, and Solution-Focused Coping) and two general second order factors (Active and Avoidant Coping). Factors demonstrated good reliability and validity. Results suggest that general coping factors should be considered with specific factors when measuring coping among older adults.

Expectancies, Socioeconomic Status, and Self-Rated Health: Use of the Simplified TOMCATS Questionnaire

BackgroundCoping has traditionally been measured with inventories containing many items meant to identify specific coping strategies. An alternative is to develop a shorter inventory that focusses on coping expectancies which may determine the extent to which an individual attempts to cope actively.PurposeThis paper explores the usefulness and validity of a simplified seven-item questionnaire (Theoretically Originated Measure of the Cognitive Activation Theory of Stress, TOMCATS) for response outcome expectancies defined either as positive (“coping”), negative (“hopelessness”), or none (“helplessness”). The definitions are based on the Cognitive Activation Theory of Stress (CATS; Ursin and Eriksen, Psychoneuroendocrinology, 29(5):567–92, 2004). The questionnaire was tested in two different samples. First, the questionnaire was compared with a traditional test of coping and then tested for validity in relation to socioeconomic differences in self-reported health.MethodsThe first study was a comparison of the brief TOMCATS with a short version of the Utrecht Coping List (UCL; Eriksen et al., Scand J Psychol, 38(3):175–82, 1997). Both questionnaires were tested in a population of 1,704 Norwegian municipality workers. The second study was a cross-sectional analysis of TOMCATS, subjective and objective socioeconomic status, and health in a representative sample of the Swedish working population in 2003–2005 (N = 11,441).ResultsIn the first study, the coping item in the TOMCATS questionnaire showed an expected significant positive correlation with the UCL factors of instrumental mastery-oriented coping and negative correlations with passive and depressive scores. There were also the expected correlations for the helplessness and hopelessness scores, but there was no clear distinction between helplessness and hopelessness in the way they correlated with the UCL. In the second study, the coping item in TOMCATS and the three-item helplessness scores showed clear and monotonous gradients over a subjective socioeconomic status (SES) ladder. Positive response outcome expectancy (“coping”) was related to high subjective SES and no expectancy (“helplessness”) to low subjective SES. In a model including age and sex, TOMCATS scores explained more variance (r 2 = 0.16) in self-reported health than both subjective (r 2 = 0.08) and objective SES (r 2 = 0.02).ConclusionThe brief TOMCATS questionnaire showed acceptable and significant correlations with a traditional coping questionnaire and is sensitive enough to register systematic differences in response outcome expectancies across the socioeconomic ladder. The results furthermore confirm that psychological and learning factors contribute to the socioeconomic gradient in health.

Are the Adaptogenic Effects of Omega 3 Fatty Acids Mediated via Inhibition of Proinflammatory Cytokines?

The study was undertaken to estimate the size of the impact of n-3 fatty acids in psychological stress and the extent to which it is mediated via proinflammatory cytokines. Structural equation modeling (SEM) was used to analyze data from 194 healthy Australians. Biomarkers used were erythrocyte polyunsaturated fatty acids (docosahexaenoic acid (DHA) and arachidonic acid (AA)), ex-vivo stimulated secretion of proinflammatory cytokines (interleukins (IL-1 and IL-6), and tumor necrosis factor (TNF)). Stress was measured with the perceived stress scale (PSS-10), found to comprise three factors: Coping (items 4, 7, 5), Overwhelm (2, 10, 6 and 8), and Emotional (1, 9 and 3). This modeling demonstrated that the effects of DHA on coping are largely direct effects (0.26, t = 2.05) and were not significantly mediated via the suppression of proinflammatory cytokines. Future modeling should explore whether adding EPA to the model would increase the significance of the mediation pathways.

Religious coping and depression in multicultural Amsterdam: A comparison between native Dutch citizens and Turkish, Moroccan and Surinamese/Antillean migrants

BackgroundDepressive patients may derive consolation as well as struggle from their religion. Outside the Western-Christian cultures these phenomena did not receive much empirical exploration. The current study aims to describe how positive and negative religious coping strategies relate to depressive symptoms in different ethnic groups in The Netherlands. MethodsInterview data were derived from the second phase of the Amsterdam Health Monitor, a population based survey, with stratification for ethnicity (native Dutch N=309, Moroccan 180, Turkish 202, Surinamese/Antillean 85). Religious coping was assessed using a 10-item version of Pargament's Brief RCOPE; depression assessment included the SCL-90-R and the Composite International Diagnostic Interview. ResultsThe five positive religious coping items constituted one sub-scale, but the five negative religious coping items had to be examined as representing separate coping strategies. Across the ethnic groups, negative religious coping strategies had several positive associations with depressive symptoms, subthreshold depression, and major depressive disorder: the most robust association was found for the item ‘wondered whether God has abandoned me’. Other significant associations were found for interpreting situations as punishment by God, questioning whether God exists, and expressing anger to God. LimitationsDue to the two-phase design and low participation in this urban sample, the non-response was substantial. Therefore, the study focused on associations, not on prevalences. ConclusionThe more or less universal finding about ‘feeling abandoned by God’ may suggest how depression represents an existential void, irrespective of the religious background.

Placing Physical Restraints on Older People with Dementia

This study aimed to clarify the coping strategies of nurses working in general wards who face the ethical dilemma of restraining older people with dementia. The participants were 272 nurses working in general wards in the Kansai region of Japan. Coping strategies were measured using a questionnaire consisting of 16 items. A low score of 1-4 points suggested good coping strategies. Factors were difficult to interpret for three of the 16 coping items identified; these items were therefore deleted. Eleven of the remaining 13 items were used for analysis. An explanatory factor analysis revealed three factors concerning coping with ethical dilemma: (1) self-initiated positive cognition and action; (2) negative cognition and action; and (3) choosing not to act, or maintaining the status quo. These findings highlight the need for programs that could disseminate effective coping strategies among nurses faced with the ethical dilemma of restraining older people with dementia.

体育授業中の友人ストレッサーとコーピング

A study was conducted to examine coping with interpersonal stress among students in physical education (PE) classes. Students (n=447) responded to 58 items that had been developed on the basis of free descriptions given by junior high school students about how they cope with interpersonal stress. Factor analysis revealed 6 coping factors that consisted of 28 coping items. These factors were named “introspection”, “neglect”, “avoidance of company”, “assertion”, “approach” and “shrug-off”. In addition, ANOVA clarified that female students (n=242) selected “avoidance of company” and “shrug-off”, more frequently than male students (n=205). Upper grade students (2nd grade students, n=146 ; 3rd grade students, n=226) showed a tendency not to use “assertion” as much as 1st grade students (n=75), and 3rd grade students tended to adopt shruging off for coping with interpersonal stress more regularly than 2nd grade students. These results suggest that although students in PE classes cope in various ways with interpersonal stress, differences in gender and/or grade have a hand in strategy selection.

Revision and Development of a Coping Checklist for Sport Based on Test Administration Immediately Following Participation

The purpose of this study was to revise and develop a coping checklist for sport. A higher order factor (engagement and disengagement coping) was identified to examine coping in sport situations. A revised 50-item Ways of Coping Checklist (WCC) was administered to 106 female athletes immediately after they had participated in a sport competition. Confirmatory factor analyses were performed on the revised WCC to examine the theoretically identified engagement and disengagement coping domains. As a result a revised 18-item inventory was internally consistent and had a better 2-factor structure than the "revised" 50-item inventory. The 18-item Coping Checklist for Sport was then administered to 4 different female and male participants (n = 197, n = 178, n = 102, n = 104). Coping items and factor loadings indicated a similar pattern across the different sport competitions and for men and women.

Variability of coping strategies in coronary artery bypass surgery patients

The state-versus-trait discussion in coping research would become more meaningful if attention is paid to the variability both of coping patterns in individual patients as well as stability of single coping strategies over time. 35 patients undergoing coronary artery bypass surgery were interviewed three times about their coping and stress experience: after cardiac catheterization, on the day before surgery, and six days after surgery. Anxiety and depression were measured. A coping attitude of "positive passivity" was present at all three points of time. While the group means were stable, vast interindividual differences occurred. Also, there was a high degree of scatter in the stability of single coping items; emotion related coping modes were more stable than cognition and action related ones. The variability of the patients' coping patterns correlated positively with the amount of stress experienced and with preoperative depression. Different coping strategies are linked to a different degree with personality traits, emotional coping modes revealing the closest connection. The variability of individual coping efforts might be linked to a personality disposition characterized by a vulnerability for stress and depressive reactions.

Surrender to God: An Additional Coping Style?

In addition to the religious coping styles proposed by K. I. Pargament et al. (1988), a surrender style of coping is proposed. Surrender is not a passive waiting for God to take care of everything; rather, it entails an active choice to relinquish one's will to God's rule. Analysis of 30 surrender-associated coping items rated by 151 Christian undergraduates yielded a 12-item Surrender Scale with a reliability coefficient of .94. A factor analysis delineated Surrender as a separate factor from the other coping styles. Preliminary incremental validity was also established employing a hierarchical multiple regression analysis. After removing the effects of the other coping styles, the Surrender Scale correlated positively with religious importance, intrinsic religiousness, spiritual well-being, and locus of control in God. Moreover, the Surrender Scale correlated negatively with Extrinsic-Personal religiousness and locus of control in luck. As hypothesized, surrender, as a coping strategy, was significantly related with the other coping styles, yet it evidenced sufficient incremental validity for its consideration as a distinct coping style.

Coping through emotional approach: scale construction and validation.

Four studies demonstrate the psychometric adequacy and validity of scales designed to assess coping through emotional approach. In separate undergraduate samples, exploratory and confirmatory factor analyses of dispositional (Study 1) and situational (Study 3) coping item sets yielded 2 distinct emotional approach coping factors: emotional processing (i.e., active attempts to acknowledge and understand emotions) and emotional expression. The 2 scales yielded high internal consistency and test-retest reliability, as well as convergent and discriminant validity. A study (Study 2) of young adults and their parents established the scales' interjudge reliabilities. Longitudinal (Study 3) and experimental (Study 4) research supported the predictive validity of the emotional approach coping scales with regard to adjustment to stressful encounters. Findings highlight the utility of functionalist theories of emotion as applied to coping theory.

Does trait coping exist? A momentary assessment approach to the evaluation of traits.

This study investigated the extent to which momentary reports of coping are a traitlike phenomenon and the validity of a questionnaire assessment of coping style. Participants (N = 96) completed the questionnaire, then monitored stressful events and coping activities for 2 days using a hand-held computer that administered a brief assessment every 40 min. Momentary reports exhibited a sizable traitlike component: Individual differences accounted for 42% of the variance for 2 coping items and 15-30% of the variance for 15 items. The questionnaire assessment of coping style was a poor predictor of average momentary coping; the coping style measure and the aggregated momentary measure of trait coping shared 23% of their variance for religion and 0-12% for the 16 other coping measures. Self-report assessments of trait coping are poor measures of the trait component of momentary coping and very poor predictors of coping in specific situations.