Defensive Coping Style Research Articles

Posttraumatic Stress Symptoms After Stroke: The Effects of Anatomy and Coping Style.

Posttraumatic stress disorder (PTSD) can be triggered by life-threatening medical emergencies, such as stroke. Data suggest that up to 25% of stroke survivors will develop PTSD symptomatology, but little is known about predisposing factors. We sought to examine whether neuroimaging measures and coping styles are related to PTSD symptoms after stroke. Participants were survivors of first-ever, mild-moderate ischemic stroke, or transient ischemic attack from the TABASCO study (Tel Aviv Brain Acute Stroke Cohort). All participants underwent a 3T magnetic resonance imaging at baseline and were examined 6, 12, and 24 months thereafter, using neurological, neuropsychological, and functional evaluations. At baseline, coping styles were evaluated by a self-reported questionnaire. PTSD symptoms were assessed using the PTSD checklist. Data were available for 436 patients. Forty-eight participants (11%) developed probable PTSD (PTSD checklist ≥44) during the first year after the stroke/transient ischemic attack. Stroke was more likely to cause PTSD than transient ischemic attack. Stroke severity, larger white matter lesion volume, and worse hippocampal connectivity were associated with PTSD severity, while infarct volume or location was not. In a multivariate analysis, high-anxious and defensive coping styles were associated with a 6.66-fold higher risk of developing poststroke PTSD ([95% CI, 2.08-21.34]; P<0.01) compared with low-anxious and repressive coping styles, after adjusting for age, education, stroke severity, brain atrophy, and depression. In our cohort, PTSD was a common sequela among stroke survivors. We suggest that risk factors for PTSD development include stroke severity, white matter damage, and premorbid coping styles. Early identification of at-risk patients is key to effective treatment.

Does other-affirmation increase self-directed exposure to and persuasiveness of a threatening anti-alcohol message?

Self-affirmation of personal values can reduce defensive responses to threatening health promotion messages, probably because it induces a positive and expansive view of the self. However, coping with threat is also an interpersonal process. We developed other-affirmation inductions that focus on values held by others. Two studies examined the effects of common affirmation inductions modified for other-affirmation: affirmation of a specific value (kindness) and affirmation of a personally chosen value. Randomized and controlled three-group (self-, other-, or no-affirmation conditions) single-factor design. Outcomes were time spent in self-directed viewing the message and self-reported outcomes that included intentions to reduce drinking, evaluations of the message, and risk perceptions. Students were randomized to self-, other, or no-affirmation conditions and asked to read a threatening anti-alcohol message. Self- and other-affirmation increased message viewing time in Study 1. In both studies, other-affirmation increased self-reported outcomes, and study 1 showed this effect to be more prominent in females. In Study 1, the effects of self- and other-affirmation on message exposure were greater in participants with defensive coping styles, and other-affirmation effects were mediated by more positive views of others and their values. This mediation was independent of self-affirmation. Other-affirmation increased self-reported outcomes and, in Study 1, reduced defensiveness to and improved viewing times to an anti-alcohol message. Other-affirmation could be useful, because it may be suited to particular subpopulations, such as females, and can be easily incorporated into mass-reach health communications. Statement of contribution What is already known on this subject? Self-affirmation of personally important values can reduce defensive responding to threatening health communications. Self-affirmation effects have been shown to be mediated by feelings of connectedness. What does this study add? Affirmation of personally important values in others can improve effects of a health communication. Other-affirmation effects may be greater in those with defensive coping styles. Other-affirmation was mediated by enhanced perceptions of others and their values.

Defensive coping styles, anxiety and chronic low back pain

Psychological factors, such as anxiety, are associated with ifferences in pain perception and the prevalence of chronic ain conditions [1], such as chronic low back pain (CLBP) 2]. Within other clinical populations, anxiety has also been onsidered in the context of high or low defensiveness to dentify distinct coping styles, which have been associated ith differences in treatment response and health outcomes 3–9]. This has rarely been considered within CLBP. When anxiety and defensiveness are taken together, indiiduals can be classified into four groups [10]: high-anxious, ow-anxious, defensive high-anxious and repressors. Represors are characterised by scoring low on anxiety measures but igh on defensiveness. Although self-reporting low anxiety, epressors tend to exhibit elevated physiological responses, imilar to high-anxious individuals, in stressful situations 11]. Later research has supported the distinctiveness of the our groups, and the apparent discrepancy between selfeport and physiological/behavioural reactivity in repressors 3,7,11]. It is proposed that repressors avoid attending to negtive self-relevant information due to their cognitive biases 11], and are genuine when they report experiencing low anxety (i.e. it is self-deception) [12]. Within clinical populations, repressive coping style is associated with poor prognosis, reluctance to seek social support or engage effectively in sychotherapy [5], and a greater willingness to undertake elf-care health behaviours compared with those perceived as eing outside the individual’s control [4]. In general, defenive patients may not respond well to treatment, perhaps being nwilling to acknowledge issues and challenge beliefs [3]. Chronic illnesses have typically been associated with a igh prevalence of the repressive coping style. One notable

The mediating effects of coping styles on the relationship between coping resources and psychosomatic health in patients with asthma

Objective To study the role of coping styles in the relationship between coping resources and psychosomatic health in patients with asthma. Methods 184 adult patients with asthma were investigated with General Serf-Efficacy Scale (GSES), Internality, Powerful Others, and Chance Scale (IPC), Social Support Rat-ing Scale (SSRS), Defensive Style Questionnaire (DSQ), Trait Coping Style Questionnaire (TCSQ) and Short Form 36 Health Survey Questionnaire (SF-36). Results Significant correlation between self-efficacy (r=0.356),locus of control(Ir=0.208, Pr=0.341, Cr=-0.349) ,subjective(r=0.201) and objective(r=0.189)social support, immature and middle ( r = - 0. 257 ) defensive styles and coping styles ( PCr = 0.231, NCr =-0.505 ) with Mental Component Summary (MCS) was found (all P <0.05), but Physical Component Summary (PCS) was only related to self-efficacy( r=0. 175) ,chance(r=0.150),immature(r=-0.256) and middle de-fensive Styles and negtive coping styles (all P < 0.05). PCS (t = - 5.189) and MCS (t = - 6. 758) could be predic-ted effectively by negative coping style (all P<0.01). Moreover, self-efficacy, powerful others and the use of so-cial support could had an effect on the health of patients through negative coping style. Conclusion Negative coping style could not only have a direct effect on the health of asthma patients but also be a mediator between self-efficacy, locus of control, social support and the health of patients. Key words: Coping; Asthma patients; Structural equation modeling; Coping resources; Quality of life; Cross-sectional study

Making lemonade? Defensive coping style moderates the effect of stereotype threat on women’s math test performance

People high in defensive pessimism—a coping style characterized by ruminating on worse case scenarios when under stress—perform better under high than low academic pressure. The goal of the present study was to explore whether defensive pessimists might also perform better under high rather than low stereotype threat. Results supported hypotheses: specifically, some individuals’ (e.g., defensive pessimists) performance was higher under high than low stereotype threat.

Anxiety and defensiveness: individual differences in affective startle modulation

Anxious individuals selectively attend to threatening information, and defensiveness may influence the experience and expression of anxiety. Fifty-eight undergraduates scoring high and low on measures of anxiety and defensiveness viewed pleasant, neutral, and unpleasant pictures. Acoustic startle probes were presented 60, 240, or 2,000 ms after picture onset. At 60 ms and 240 ms, repressors (low anxiety, high defensiveness) showed weaker blinks during both pleasant and unpleasant compared to neutral pictures, suggesting enhanced early attention to affective stimuli, regardless of valence. At 2,000 ms, high-anxious but not low anxious participants showed potentiated startle responses during unpleasant compared to pleasant pictures. Although this result replicated previous research on anxiety and valence modulation of startle, exploratory analyses suggested that the valence effect was restricted to trait anxious individuals tending toward a defensive coping style. Across probe conditions, defensiveness was associated with heightened startle reactivity independent of self-reported anxiety and foreground stimulus characteristics.

Emotional Word Detection and Adolescent Repressive?Defensive Coping Style

This study used a computer-based emotional word-recognition task to assess the emotional processing styles of repressive–defensive youth. A hypothesis was tested proposing that adolescent repressive– defensive coping style is associated with rapid engagement and disengagement of emotional stimuli (negative and positive). Data were collected on a male adolescent sample enrolled in a juvenile diversion program allowing for the comparison of anxious, low-anxious, and repressive–defensive youth. Consistent with prediction, repressive–defensive participants exhibited facilitated responding to emotional relative to neutral word stimuli across valence category (i.e., positive and negative). In contrast, anxious participants exhibited a unique pattern of facilitated responding to positive word stimuli. The current findings represent a first attempt at investigating the processing impairments of repressive–defensive coping style in a nonadult sample. Results are interpreted in light of broader adult and child research findings on emotional processing and affective disturbance.

Coping With Stress: Its Influence on Periodontal Therapy

Individual stress coping strategies appear to influence periodontal disease: individuals with inadequate stress behavior may be at greater risk of developing disease. The purpose of this 24-month prospective study was to examine the influence of different coping behaviors on a non-surgical periodontal therapy and on the course of periodontal disease. In 80 patients with chronic periodontitis, a non-surgical periodontal treatment was conducted after their individual stress coping strategies had been recorded. After 2 years of regular maintenance, their periodontal condition was evaluated. The stress coping questionnaire was used to obtain psychodiagnostic data. Clinical attachment loss (CAL) served as the clinical parameter. Patients with a defensive coping style had statistically significant poorer attachment values (P= 0.000) after 2 years compared to patients with other coping behaviors. The percentage of sites with slight to moderate CAL (<5 mm) was significantly less in patients with a defensive coping style than in patients with other coping strategies (P = 0.000). The number of sites with severe advanced CAL (>5 mm) was significantly correlated with a suppressive coping style (P= 0.0001). None of the individual stress coping styles revealed significant overall changes over time. The subtest of drug use (alcohol, nicotine, tranquilizers) as well as changes in this subtest over time were significantly correlated with the CAL (P = 0.003); an increase in the t value of the subtest of drug use was accompanied by a significant increase in CAL. The results of this study show that passive coping strategies were more pronounced in advanced disease as well as in cases of poor response to a non-surgical periodontal treatment, whereas patients with active coping modes had milder disease and a more favorable course of treatment. Thus, maladaptive behavior, especially in association with behavior-related risk factors such as smoking, are of great importance in the medical history, treatment, and maintenance of patients with periodontal disease.

Repressive and defensive coping during fear and anger.

In this study, the relationship between repressive and defensive coping styles and somatovisceral responses as well as emotion self-reports were investigated in 2 situational contexts conceived to induce fear and anger. Anxiety (State-Trait Anxiety Inventory; L. Laux, P. Glanzmann, P. Schaffner, and C. D. Spielberger, 1981) x Defensiveness (Marlowe-Crowne Social Desirability Scale; D. P. Crowne and D. Marlowe, 1960) x Emotion (fear, anger) moderated regression analyses revealed that compared with baseline during fear, defensiveness was related to a decrease in heart rate variability. Also during fear, repressive-defensive copers had lower self-reports of negative affect but showed higher behavioral negative affect (m. corrugator reactivity) than other participants. During anger, defensiveness was positively related to both diastolic blood pressure reactivity and m. zygomaticus reactivity. Additional analyses showed that emotional responses of repressive-defensive copers were strongly moderated by the situational context.

Coping with stress: its influence on periodontal disease.

Various forms of stress behavior were documented and in patients with periodontitis their relationship with periodontal disease was investigated. Eighty-nine patients with different forms of chronic periodontitis were included in this retrospective case-control study. They were all undergoing periodontal treatment at the Department of Dental Prosthetics, University of Graz, or a private dental practice. The control group consisted of 63 persons employed in health care at the Clinic of Graz. All participants completed a stress coping questionnaire of 114 items and 19 actional and intrapsychic stress coping modes. The questionnaire served as a psychodiagnostic survey aimed at collecting data on stress coping strategies. Clinical attachment loss (CAL) served as the clinical parameter. With the help of a factor analysis with a factorization and Varimax rotation, 5 factors were extracted from the 19 subtests. The reliability of the questionnaire was less than 0.70 only for subtests "escape" and "pharmaceutical drugs." Otherwise the internal consistency ranged between 0.74 and 0.92, and the retest reliability between 0.72 and 0.84. Subsequent assessment with the t test for independent random samples at the 5% level showed that patients differ significantly from controls in regard of factor 2 (active coping, P = 0.40) and 3 (distractive coping, P = 0.033), and that they differ very significantly from controls in regard of factor 4 (defensive coping, P = 0.000) and 5 (coping through aggression and pharmaceutical drugs, P = 0.007). In the statistical analysis of factors with regard to the severity of periodontal disease, the patients were divided into 2 groups (mild to moderate and severe). The t test for independent random samples showed significance for factor 4 (defensive coping) in that patients with a defensive coping style had greater attachment loss (pF4 = 0.04). The data corroborate the thesis that periodontitis patients with inadequate stress behavior strategies (defensive coping) are at greater risk for severe periodontal disease. However, further investigations are required to confirm the significance of inappropriate coping styles with respect to the advancement of periodontal disease.

Defensive coping styles in chronic fatigue syndrome

Objective: The cognitive–behavioral model of chronic fatigue syndrome (CFS) proposes that rigidly held beliefs act to defend individuals against low self-esteem. This study is the first to investigate the prevalence of a potential mechanism, the Defensive High Anxious coping style, among individuals with CFS. Methods: The study comprised 68 participants (24 CFS; 24 healthy volunteers; 20 chronic illness volunteers). Participants completed the Bendig short form of the Taylor Manifest Anxiety Scale (B-MAS) and the Marlowe–Crowne Social Desirability Scale (MC) in order to ascertain the distribution of participants in each group within the four coping styles defined by Weinberger et al. [J. Abnorm. Psychol. 88 (1979) 369]. Results: A greater number of participants in the CFS group (46%) were classified as Defensive High Anxious compared to the two comparison groups [ χ 2(2)=8.84, P=.012]. Conclusion: This study provides support for the existence of defensive coping mechanisms as described by the cognitive–behavioral model of CFS. Furthermore, it has been suggested that this particular coping style may impinge directly on physical well being through similar mechanisms as identified in CFS, and further research linking these areas of research is warranted.

Changing psychobiological stress reactions by manipulating cognitive processes

This study aimed at manipulating psychobiological reactions to public speaking stress by means of verbal comments during the anticipation period. Sixty male students were instructed to give a public talk in 10 min. Twenty subjects each were randomly assigned to one of three experimental conditions: During anticipation of the speech the experimenter remained silent in the control condition, gave feedback that the subject was physiologically aroused and nervous in the second (arousing manipulation), or that he was physiologically calm and relaxed in the third condition (reassuring manipulation). Within the three stress conditions heart rate, systolic blood pressure, cortisol, and electrodermal responses were highest in the condition with reassuring manipulation and lowest in the condition without manipulation. Emotional stress reactions were highest in the condition with arousing manipulation and lowest in the condition with reassuring manipulation. Compared to the group without manipulation clear intraindividual discrepancies between emotional and somatic stress reactions could be observed in the group with reassuring manipulation (emotional<somatic arousal) and the group with arousing manipulation (emotional>somatic arousal). The two groups were significantly different in their discrepancy scores. It was concluded that the arousing manipulation seemed to have induced a sensitive, the reassuring manipulation a defensive coping style.

Repressive and defensive coping styles predict resting plasma endorphin levels in the elderly

Jamner, L.D., Schwartz, G.E., 1986, Psychosom. Med. 48, 211–223, have proposed that repressive and defensive coping are associated with greater central endogenous opioid activity. They reasoned that high-defensive (HD) participants’ attenuated distress, increased pain tolerances, attenuated somatic symptomatology, and accentuated reports of positive emotions are consistent with actions of centrally active opioid peptides. The present study assessed plasma β-endorphin (END) levels, Marlowe–Crowne Social Desirability Scale (MCSD), and Taylor Manifest Anxiety Scale (TMAS) scores in men ( n=6) and women ( n=20) between the ages of 59 and 79. Contrary to predictions, HD had lower plasma endorphin levels than did low-defensive (LD) participants. Raw MCSD scores correlated negatively with endorphin levels. Findings were significant for women only, which may have been due to the small sample of men. The results are discussed as they related to the hypothesis that defensiveness involves alteration of central opioid systems.

Alexithymia: Relationship with ego defense and coping styles

There is controversy in the literature as to whether alexithymia reflects a deficit in the cognitive processing of emotions or a defensive coping style. Previous studies with clinical populations reported a strong association between alexithymia and a maladaptive (immature) ego defense style. The present study was designed to examine this relationship in nonclinical populations, and also to explore the relationships between alexithymia and three general styles for coping with stressful situations. Sample 1, 287 non-clinical adults, completed the Twenty-Item Toronto Alexithymia Scale (TAS-20) and the Defense Style Questionnaire (DSQ). Sample 2, 83 undergraduate students who had been categorized previously into alexithymic and nonalexithymic subgroups, completed the DSQ and the Coping Inventory for Stressful Situations (CISS). In sample 1, the TAS-20 and its three factors were associated most strongly with an immature defense style, weakly with a neurotic defense style, and negatively with a mature defense style. In sample 2, alexithymic students scored significantly higher than nonalexithymic students on the immature and neurotic defense factors of the DSQ and significantly lower on the mature defense factor. Alexithymic students also scored significantly higher on the emotion-oriented coping scale and the distraction component of the avoidance-oriented coping scale of the CISS and significantly lower on the task-oriented coping scale. The results fail to support the view that alexithymia is an adaptive defense or coping style.

The under-reporting tendency of hypertensives: An analysis of potential psychological and physiological mechanisms

Hypertensives have repeatedly been found to exhibit diminished self-report rates of stressor exposure and distress. In this article we discuss the evidence for two possible explanations for this phenomenon by means of reviews of the literatures on blood pressure in relation to defensive coping and pain perception. This approach provides support for the plausibility of two, not mutually exclusive, explanations: one based upon defensive coping and the other in terms of a physiologically based altered appraisal of aversive stimuli involving baroreceptor activity. Moreover, some indirect evidence has been obtained for a possible association between the two mechanisms. These findings have resulted in the formulation of a hypothetical model in which baroreceptor mediated central nervous system inhibition results in less negative appraisal of stressful situations and contributes to the development of hypertension via an operant conditioning mechanism. In addition, this mechanism may underlie the so-called defensive coping style. Finally, some directions for future research, aiming at testing the proposed model, are offered.

Defensive burying in two strains of rats selected for emotional reactivity

This paper examined defensive burying in Tsukuba High- and Low-Emotional rats (THE and TLE). The THE rats showed significantly more defensive burying and more immobility than the TLE rats. The TLE rats were more active and started prod-investigation faster than the THE rats. Some TLE rats bit the prod immediately after shock administration. No significant strain differences were observed in passive avoidance (stay away from the prod) and time spent at prod-investigation. The results indicate that THE rats are active and TLE rats are inactive in relation to defensive burying, although THE rats generally show passive coping. The relation between defensive burying and strain-specific coping styles is discussed.

Risk perception and behavior: Pessimism, realism, and optimism about aids-related health behavior

Abstract This study investigates the perceived risk of becoming infected with HIV for heterosexuals with multiple sexual partners, examines cognitive and motivational antecedents of biases in risk perception, and relates these biases to behavior. We obtained a moderate degree of optimism in a longitudinal study based on a sample of 535 visitors of a STD clinic. Further analyses—after classifying subjects as “pessimists”, “realists”, or “optimists”—revealed that pessimists were extremely pessimistic and optimists remarkably optimistic. Optimism increased with perceived control and decreased with prior experience, supporting a cognitive explanation of optimism. The data also provided some support for a motivational explanation: optimists who scored higher on a defensive coping style were more optimistic about their risks. Contrary to other findings, we found a positive relation between optimism and intentions to reduce risks. Furthermore, results revealed that optimists showed lower levels of subsequent behavioral risk. It was concluded that optimists were not unrealistically optimistic about their personal vulnerability. but rather that pessimists were unrealistically pessimistic. Previous behavior was found to be the best predictor of subsequent behavior. Although measures of perceived risk were also related to subsequent behavior, their predictive power was rather modest.

The relationship between repressive and defensive coping styles and blood pressure responses in healthy, middle-aged men and women

The current study explored the relationship between repressive coping and blood pressure responses at rest and during a mental challenge. One hundred and twenty healthy, middle-aged men and women completed anxiety and defensiveness measures. Subjects scoring below the median on anxiety and above the median on defensiveness were categorized as repressors; those below the median on both measures as low-anxious; those above median on anxiety and below median on defensiveness as moderately anxious; and those above the median on both measures as defensive moderately-anxious. As predicted, repressors showed greater systolic blood pressure reactivity in response to a mental challenge relative to the other groups ( p<0.01). Repressors also had greater resting systolic blood pressure levels than the other groups ( p<0.001). The findings are discussed with respect to the potential influence of this response pattern on blood pressure and other CVD risk factors and behaviors.

Defensive coping and blood pressure reactivity in medical patients.

Two defensive coping styles, denial of illness and repressive coping, were studied in two groups of medical patients whose blood pressure (BP) was measured during a stress interview. Denial of illness was measured using the Levine Denial of Illness Scale (LDIS), and repressive coping was measured using a combination of the Marlowe-Crowne (MC) Social Desirability Scale and the SCL-90R anxiety subscale (ANX). Consistent with our prior research indicating that LDIS was associated with adaptive outcomes in the short run, high deniers manifested reduced systolic BP reactivity compared to low deniers. Although not related to repressive coping, systolic BP reactivity was correlated positively with MC and ANX separately. The results demonstrate that LDIS and MC measure different types of defensive coping. Current theories of the MC scale suggest two possible interpretations of the MC findings, one that focuses on avoidant coping and the second on attentional coping in high MC scorers.

The relationship between repressive and defensive coping styles and monocyte, eosinophile, and serum glucose levels: support for the opioid peptide hypothesis of repression.

The opioid peptide hypothesis of repression (1) predicts that repressive coping is associated with increased functional endorphin levels in the brain, which can result in decreased immunocompetence and hyperglycemia. In a random sample of 312 patients seen at a Yale Medical School outpatient clinic, significant main effects of coping style were found for monocyte and eosinophile counts, serum glucose levels, and self-reports of medication allergies. Specifically, repressive and defensive high-anxious patients demonstrated significantly decreased monocyte counts. In addition, repressive coping was associated with elevated eosinophile counts, serum glucose levels, and self-reported reactions to medications. This behavioral, immunologic, and endocrine profile is consistent with the opioid peptide hypothesis, which provides an integrative framework for relating the attenuated emotional experience of pain and distress characteristic of repressive coping with reduced resistance to infectious and neoplastic disease.