Emotional Approach Coping Research Articles

The research about emotional approach coping and PTSD after Wenchuan-earthquake in unaffected region

Objective To investigate the post traumatic stress disorder scores of undergraduate and the correlation between emotional approach coping(EAC) in unaffected region after Wenchuan-earthquake.Methods PTSD Check list-Civilian Version (PCL-C) and emotional approach coping scale(EACS) were used to assessed 880 undergraduates in Nanjing. Results (1)The average score of PCL-C was 30.52±9.64, and the prevalence rates of PTSD was found 5.3%.(2)Gender difference were found in social function(male:1.66±0.80,female:1.52±0.63, t =2.664,P =0.005) and positive scores of PTSD(male:31.32±10.81,female:29.81±8.41,t =2.263,P =0.022).(3)No significant difference was found in different specialty between PTSD,but in emotional procession and emotional expression.(4)Emotional-approach coping and expose time in front of media came into the regression equation of PTSD symptoms.Conclusion The score of PCL-C of undergraduate in unaffected region are infected by how long he spend in front of media and how he use emotion-approach coping strategy to cope with this shock bringing by Wenchuan-Earthquake Key words: PTSD; Unaffected region; Emotional approach coping; College students

Neurobiological correlates of coping through emotional approach

This investigation considered possible health-related neurobiological processes associated with “emotional approach coping” (EAC), or intentional efforts to identify, process, and express emotions surrounding stressors. It was hypothesized that higher dispositional use of EAC strategies would be related to neural activity indicative of greater trait approach motivational orientation and to lower proinflammatory cytokine and cortisol responses to stress. To assess these relationships, 46 healthy participants completed a questionnaire assessing the two components of EAC (i.e., emotional processing and emotional expression), and their resting frontal cortical asymmetry was measured using electroencephalography (EEG). A subset ( N = 22) of these participants’ levels of the soluble receptor for tumor necrosis factor-alpha (sTNFαRII), interleukin-6 (IL-6), and cortisol (all obtained from oral fluids) were also assessed before and after exposure to an acute laboratory stressor. Consistent with predictions, higher reported levels of emotional expression were significantly associated with greater relative left-sided frontal EEG asymmetry, indicative of greater trait approach motivation. Additionally, people who scored higher on EAC, particularly the emotional processing component, tended to show a less-pronounced TNF-α stress response. EAC was unrelated to levels of IL-6 and cortisol. Greater left-sided frontal EEG asymmetry was significantly related to lower baseline levels of IL-6 and to lower stress-related levels of sTNFαRII, and was marginally related to lower stress-related levels of IL-6. The findings suggest that the salubrious effects of EAC strategies for managing stress may be linked to an approach-oriented neurocognitive profile and to well-regulated proinflammatory cytokine responses to stress.

Different methods of single‐session disclosure: What works for whom?

Examine distress, emotional approach coping, and attachment as moderators of effects of written (WED) versus interpersonal (IED) emotional disclosure and written time management (WTM). Fifty-seven undergraduates with stressful experiences randomized to a single session of WED, IED, or WTM. Assessment of immediate reaction (NA) and 6-week follow-up (intrusions/avoidance). Those with higher baseline distress had increased NA, avoidance and intrusions when engaged in WED or IED (vs. WTM). For emotional processors, WED (vs. IED) produced less NA, avoidance, and intrusions. Attachment predicted increased NA in WTM. Baseline distress and personality characteristics form boundary conditions for written disclosure.

Emotional approach coping and self‐efficacy moderate the effects of written emotional disclosure and relaxation training for people with migraine headaches

We tested whether emotional skills and headache management self-efficacy (HMSE) moderated effects of written emotional disclosure (WED) compared with control writing and a different intervention, relaxation training (RT). Undergraduates with migraine headaches reported emotional approach coping (EAC) and HMSE; were randomized to WED, RT, or control; and assessed on health measures at baseline and 3-month follow-up. Greater EAC predicted improvement following WED compared with RT and control, whereas low HMSE predicted improvement following both WED and RT, compared with control. Emotional skill may specifically - and low health management self-efficacy may generally - predict positive responses to WED.

Writing about emotions versus goals: Effects on hostility and medical care utilization moderated by emotional approach coping processes

The study compared emotionally disclosive writing and writing about goals as the 'best possible self' to a control condition and evaluated coping through emotional processing (EP) and expression (EE) as moderators of effects at 1-month follow-up. Undergraduates (N=63) were randomly assigned to emotional disclosure (EMO), best possible self (BPS), or a control condition (CTL). Outcomes were hostility, medical visits, depressive symptoms, physical symptoms, and blood pressure. At 1 month, hostility decreased in high-EP participants in EMO relative to BPS and decreased in low-EP participants in BPS relative to EMO. Low-EP participants had fewer medical visits in BPS, whereas high-EP participants had more visits in BPS relative to other conditions. Benefits may accrue when the expressive task is matched to the individual's preferred coping strategy.

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. The primary outcome measures for this study were psychological distress and psychological well-being. Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.

Emotional approach and problem-focused coping: A comparison of potentially adaptive strategies

This study examined for whom and under what circumstances emotional-approach coping and problem-focused coping are differentially more effective. Eighty-nine participants identified a current stressful situation and then were randomly assigned to either: (a) write for 15 minutes about their feelings (emotional-approach coping); or (b) write about how to solve their problem (problem-focused coping). Participants also completed a self-report measure that assessed how they coped during the two weeks after the exercise. Coping effectiveness was assessed by measuring positive affect, negative affect, and physical symptoms. Dimensions of emotional processing (e.g., clarity and attention to emotions) were assessed using self-report. Gender, type of stressful event (interpersonal vs. achievement), and individual differences in emotional processing moderated the effect of type of coping on positive affect.

Contextual life stress and coping strategies as predictors of adjustment to breast cancer survivorship

The study presented here examined the influence of contextual life stress and coping strategies on change in adjustment over the year following completion of treatment for breast cancer. We also investigated whether contextual stressful life events moderate the relationship between coping strategies and adjustment, such that cancer-specific emotional approach coping processes would predict better psychosocial outcomes only in the context of lower life stress and would have less impact on adaptation in the context of heightened life stress. In a sample of women (n = 558) who had recently completed treatment for nonmetastatic breast cancer and were part of a psychoeducational intervention trial to facilitate the transition to survivorship, life stress in the year prior to study entry, cancer-specific coping strategies, and general and cancer-specific adjustment were assessed at baseline, and adjustment outcomes (i.e., vitality, depressive symptoms, cancer-specific distress, personal growth) also were assessed at 6-month (n = 417) and 12-month (n = 397) follow-up. Although cross-sectional relationships between life stress and adjustment were demonstrated, findings suggest that contextual life stress does not appear to have a direct influence on change in adjustment in the first year after breast cancer treatment. Instead, life stress interacted with cancer-specific coping to predict adjustment, such that cancer-specific emotional approach coping was adaptive only under conditions of low contextual life stress.

The Relationship of Racism, Chronic Stress Emotions, and Blood Pressure

To test a middle-range theory of chronic stress emotions to examine the effects of perceived racism and emotion-focused coping on psychological and physiological health outcomes in African Americans. A descriptive-correlational, causal modeling study was conducted with a convenience sample of 162 community-dwelling adults. Participants completed the Racism and Life Experience Scale; Krieger Racial Discrimination Questionnaire; Toronto Alexithymia Scale; Emotional Approach Coping Scale; State-Trait Personality Inventory; and a demographic data sheet. Automated blood pressure (BP) readings were obtained. Structural equation modeling techniques were used to examine the hypothesized causal and correlational links between the theoretical constructs, as well as to examine the relationship between the observed variables and the latent constructs measured. FINDING AND CONCLUSIONS: The proposed model fits the sample data. Racism was a commonly experienced stressor associated with chronic stress emotions, but not with BP. Emotion-focused coping was strongly associated with socioeconomic status and chronic stress emotions but not with BP.

The Role of Anxiety Sensitivity and Lack of Emotional Approach Coping in Depressive Symptom Severity Among a Non‐Clinical Sample of Uncued Panickers

Panic attacks and depression frequently co‐occur, and the presence of this co‐morbidity is often associated with worse outcomes compared with each disorder alone. Despite this, not everyone who experiences panic attacks also suffers from depression, suggesting that individual difference factors may play a role in this co‐morbidity. The purpose of this study was to provide a preliminary investigation of two such individual difference factors, examining the role of anxiety sensitivity and lack of emotional approach coping in depressive symptom severity among a non‐clinical sample of uncued panickers. A sample of 79 college students reporting the occurrence of uncued panic attacks within the past year completed a series of questionnaires assessing the lower‐order factors of anxiety sensitivity, emotional approach coping, panic attack frequency, panic‐related disability, panic symptom severity and depressive symptom severity. Participants with more severe depressive symptoms reported greater anxiety sensitivity, panic attack frequency, panic symptom severity, panic‐related disability and lack of emotional approach coping. The particular anxiety sensitivity dimension of fear of cognitive dyscontrol and lack of emotional approach coping emerged as the best predictors of depressive symptom severity. Findings are discussed in terms of their implications for the improved understanding of this co‐morbidity, as well as its treatment.

The efficacy of creative arts therapies to enhance emotional expression, spirituality, and psychological well-being of newly diagnosed Stage I and Stage II breast cancer patients: A preliminary study

Breast cancer is the second most common type of cancer among women in the United States. The psychological impact of the disease may include adjustment disorders, depression, and anxiety and may generate feelings of fear, anger, guilt, and emotional repression. The purpose of this pilot study was to explore the efficacy of a complementary creative arts therapy intervention to enhance emotional expression, spirituality, and psychological well-being in newly diagnosed breast cancer patients. Thirty-nine women with Stage I and Stage II breast cancer were randomly assigned to an experimental group who received individual creative arts therapy interventions or a control group of delayed treatment. A series of analyses of covariance were used to analyze the results, which indicated the intervention was not effective in enhancing the emotional approach coping style of emotional expression or level of spirituality of subjects in this sample. However, participation in the creative arts therapy intervention enhanced psychological well-being by decreasing negative emotional states and enhancing positive ones of experimental group subjects. Recommendations for future research are discussed.

Effects of Writing About Emotions Versus Goals on Psychological and Physical Health Among Third‐Year Medical Students

A randomized, controlled trial compared writing about emotional topics (EMO) to writing about goals as the "best possible self" (BPS; after King, 2001) and evaluated emotional approach coping, i.e., efforts to cope through processing and expressing emotion, as a moderator of writing effects on psychological and physical health in 64 third-year medical students. In participants with higher baseline hostility, the EMO condition was associated with less hostility at 3 months compared to the BPS and control conditions. Emotional processing (EP) and emotional expression (EE) moderated the effect of experimental condition on depressive symptoms at 3 months; high EP/EE participants reported fewer depressive symptoms in the EMO condition, whereas low EP/EE individuals reported fewer depressive symptoms in the BPS condition compared to the EMO and control conditions. A moderating effect of EP on physical health was also identified, such that low EP individuals who wrote about goals (BPS) had fewer health care visits at 3 months compared to low EP participants in the EMO and control conditions.

Assessing alexithymia and related emotional ability constructs using multiple methods: Interrelationships among measures.

This study examined relationships among various measures of emotional ability reflecting different methods of assessment: self-report, clinical interview, collateral report, and emotion-relevant performance. On 140 young adults, the authors assessed self-reported alexithymia, emotional approach coping, and trait metamood skills; observer-reported alexithymia; interviewer-rated alexithymia; emotional awareness in response to vignettes; and emotional intelligence test performance. There were moderate magnitude correlations among the self-report measures, but correlations among other measures were relatively low. Confirmatory factor analyses supported a 3-factor model in which explicit self, implicit self, and explicit other measures were differentiated. These emotional ability measures do not form a unitary construct but differ as a function of the person providing the information and whether the measure is explicit or implicit.

Coping Through Emotional Approach: A New Look at Emotion, Coping, and Health‐Related Outcomes

Researchers studying stress and coping processes have attempted to identify which coping strategies are most adaptive in stressful encounters. A generally accepted conclusion has been that emotion-focused coping processes are associated with dysfunctional outcomes. Studies from our and other research teams challenge the "bad reputation" of emotion-focused coping by demonstrating that items measuring emotion-focused strategies in published coping questionnaires are confounded with distress and self-deprecation. We have developed and validated new instruments to assess coping though acknowledging, understanding, and expressing emotion, that is, coping through emotional approach. Longitudinal and experimental studies using these new scales have documented the adaptive potential of emotional-approach coping in the context of several types of stressors, including infertility, breast cancer, and chronic pain. However, characteristics of the environmental context, stressful experience, and individual are important moderators of the relations of emotional-approach coping and health-related outcomes. Potential mediators and moderators of coping through emotional approach, clinical relevance of the construct, and directions for research are discussed.

Adaptation to being at-risk for Huntington's Disease and the availability of genetic testing: application of a stress and coping model

This study examined the utility of a stress/coping model in explaining adaptation in two groups of people at-risk for Huntington's Disease (HD): those who have not approached genetic testing services (non-testees) and those who have engaged a testing service (testees). The aims were (1) to compare testees and non-testees on stress/coping variables, (2) to examine relations between adjustment and the stress/coping predictors in the two groups, and (3) to examine relations between the stress/coping variables and testees' satisfaction with their first counselling session. Participants were 44 testees and 40 non-testees who completed questionnaires which measured the stress/coping variables: adjustment (global distress, depression, health anxiety, social and dyadic adjustment), genetic testing concerns, testing context (HD contact, experience, knowledge), appraisal (control, threat, self-efficacy), coping strategies (avoidance, self-blame, wishful thinking, seeking support, problem solving), social support and locus of control. Testees also completed a genetic counselling session satisfaction scale. As expected, non-testees reported lower self-efficacy and control appraisals, higher threat and passive avoidant coping than testees. Overall, results supported the hypothesis that within each group poorer adjustment would be related to higher genetic testing concerns, contact with HD, threat appraisals, passive avoidant coping and external locus of control, and lower levels of positive experiences with HD, social support, internal locus of control, self-efficacy, control appraisals, problem solving, emotional approach and seeking social support coping. Session satisfaction scores were positively correlated with dyadic adjustment, problem solving and positive experience with HD, and inversely related to testing concerns, and threat and control appraisals. Findings support the utility of the stress/coping model in explaining adaptation in people who have decided not to seek genetic testing for HD and those who have decided to engage a genetic testing service.

Appraisal-coping goodness of fit: a daily internet study.

Using an Internet daily diary methodology, this study tested the goodness of fit hypothesis, which highlights the importance of the match between controllability appraisals and coping efforts in adjustment to stressful events. For 28 days, 190 undergraduates described their most stressful event and its controllability, how they coped, and their daily positive and negative mood. Individuals demonstrated fit across situations, with control appraisals associated positively with problem-focused coping and negatively with emotional approach coping and avoidance coping. A pooled within-person interaction indicated that problem-focused coping had a stronger positive association with positive mood when dealing with high versus low control stressors. Significant variation also was found in several other within-person interactions between control appraisals and coping, and some evidence was found for the notion that individual differences in the degree of matching coping to control appraisals were associated with person-level adjustment.

Finding meaning in parenting a child with Asperger syndrome: correlates of sense making and benefit finding

This study explored the nature of two construals of meaning, benefit finding and sense making, in parents of a child with Asperger syndrome, and examined relations between both meaning constructs and the Double ABCX family stress model variables (initial stressor and pile-up of demands, appraisal, social support, coping strategies and adjustment) [H.I. McCubbin, J.M. Patterson, Social Stress and the Family: Advances and Developments in Family Stress Theory and Research, Haworth, New York, 1983, pp. 7–37]. A total of 59 parents completed questionnaires. Content analyses of parents’ responses to questions inquiring about gains and sense making explanations revealed 8 benefit and 12 sense making themes. Results of correlations indicated that one or more of the meaning variables were related to each of the Double ABCX model predictors of parental adjustment. The meaning variables were positively related to adaptive coping processes: social support, self-efficacy, and problem-focused and emotional approach coping strategies.

Psychosocial factors related to the correspondence of recipient and provider perceptions of social support among patients diagnosed with or at risk for malignant melanoma.

This study examined considered perceptions of social support and factors contributing to increased support among 18 patients diagnosed with or at risk for malignant melanoma and their partners. Partner support, perceived stress, emotional approach coping and partner empathy were evaluated. Results showed lack of correspondence between patient and partner reports of support. Greater correspondence between reports was associated with increased patient emotional approach coping. Partners reported increased empathy following the patients' diagnoses and more perceived stress than patients. Patients indicated greater use of emotional approach coping than their partners. Male partners reported engaging in less emotional expression than female partners. Interventions might incorporate partner participation to resolve misperceptions of support and to foster factors that promote increased support.

Contrasting emotional approach coping with passive coping for chronic myofascial pain.

Passive or emotion-focused coping strategies are typically related to worse pain and adjustment among chronic pain patients. Emotional approach coping (EAC), however, is a type of emotion-focused coping that appears to be adaptive in some nonpain populations but has not yet been examined in a chronic pain population. In a sample of 80 patients (75% women, M = 48.67 years of age) with chronic myofascial pain, we contrasted how EAC (assessed with the Emotional Approach Coping Scale) and 5 passive pain-coping strategies (assessed with the Vanderbilt Multidimensional Pain Coping Inventory (VMPCI)) were related to sensory and affective pain, physical impairment, and depression. Passive coping strategies were positively correlated with one another, but EAC was inversely correlated with most of them. The VMPCI passive strategies were substantially positively related to negative affect, whereas EAC was inversely related to negative affect. Controlling for potentially confounding demographics, higher EAC was related to less affective pain and depression, even after controlling for negative affect. Using passive coping strategies, in contrast, was associated with more pain, impairment, and depression, although these relations were greatly attenuated after controlling for negative affect. When considered simultaneously, EAC, but not passive coping, was related to affective pain, and both EAC and passive coping were significant correlates of depression, although in opposite directions. In secondary analyses, we found that EAC was related to less pain (particularly sensory) among men and to less depression among women. Unlike the use of passive pain-coping strategies, which are associated with worse pain and adjustment, the use of EAC (emotional processing and emotional expression) with chronic pain is associated with less pain and depression. This suggests that some emotion-focused types of pain coping may be adaptive, and it highlights the need to assess emotional coping processes that are not confounded with distress or dysfunction.

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.