Coping Flexibility Research Articles

Coping Flexibility: Match Between Coping Strategy and Perceived Stressor Controllability Predicts Depressed Mood

AbstractIndividual differences in coping responses can predict psychological distress, anxiety, and depression; therefore, it is vital to explore adaptive coping strategies. Recent research suggests that an individual’s ability to choose strategies based on the context may be more important than the ability to use any one strategy, an ability termed coping flexibility. For example, problem-focused coping is adaptive for situations of high control, while emotion-focused coping is adaptive for situations of low control. This conceptualization of coping flexibility, termed strategy-situation fit, consists of the match of strategy to situation. The purpose of the present study was to evaluate if daily fluctuations in strategy-situation fit for daily stressors would be associated with daily levels of depressed mood. A seven-day diary study in a sample of undergraduate students (n = 75) was completed. The results of generalized linear mixed models demonstrated that in situations of high stress and high control, more use of emotion-focused coping was related to higher levels of depressed mood. Additionally, in situations of high stress and low control, more use of emotion-focused coping was related to lower levels of depressed mood. These findings suggest that the match between emotion-focused coping and perceived stressor controllability can be a predictor of daily experiences of depressed mood when faced with high-level stressors.

영유아교사의 대처유연성이 정신적 웰빙에 미치는 영향: 분노조절효능감과 불안조절효능감을 매개로

This study aims to investigate the effects of early childhood teachers' coping flexibility on their mental well-being and to determine whether anger regulation efficacy and anxiety regulation efficacy play a mediating role in this process. A survey was conducted with 329 early childhood teachers, and the collected data were analyzed using SPSS 25.0 and AMOS 22.0. The results showed that coping flexibility, anger regulation efficacy, anxiety regulation efficacy, and mental well-being were all positively correlated, and the relationship between coping flexibility and mental well-being was mediated by anger regulation efficacy. These findings suggest that early childhood teachers who can cope flexibly with stressful situations are more mentally healthy and that effective emotional regulation skills, particularly the ability to regulate anger, may play an important role in the mental health of early childhood teachers. This study confirms the need for interventions to improve coping flexibility and anger regulation efficacy to promote the mental well-being of early childhood teachers.

Self-Transcendence Explains How Stress Reduces Mental Well-Being in Emerging Adults: A Conditional Approach of Coping Flexibility

Stress and well-being are important life experiences, but we cannot improve well-being by avoiding stress. If we want to increase well-being, we can start by determining the relationship between stress and well-being and other factors that may be effective in this relationship. This cross-sectional study investigates the hypothetical mediating and moderating roles of self-transcendence and coping flexibility in the relationship between stress and mental well-being among Turkish university students. A total of 403 students enrolled in a state university in Türkiye participated in the study. The sample was 75% female ( n = 302) and 25% male ( n = 101), with ages ranging from 18 to 25 years ( M = 21.21, SD = 2.70). Findings revealed that stress significantly predicted university students’ mental well-being in a negative direction. Furthermore, the study identifies self-transcendence and coping flexibility as hypothetical mediators in the relationship between stress and mental well-being. Finally, it was found that coping flexibility moderated the effect of stress on self-transcendence and mental well-being. Under conditions of high coping flexibility, there are stronger, negative associations between stress and self-transcendence and stress and mental well-being. Overall, this study contributes to the understanding of the important role of self-transcendence and coping flexibility in promoting mental well-being and combating stress in the university environment.

Exploring the Effects of Coping Flexibility on Sleep Quality via Subjective Distress: A Longitudinal Study of Young Adults.

Coping flexibility is one's ability to modify their coping strategies and adapt to the demands of stressful situations. However, limited studies have demonstrated that coping flexibility directly influenced sleep quality. This study examined the relationships between coping flexibility, subjective distress, and sleep quality. We hypothesized that coping flexibility would enhance sleep quality via subjective distress. In total 99 male and 151 female college students completed questionnaires on coping flexibility, subjective distress, and sleep quality. Subsequently, they completed the questionnaire on sleep quality six months later. Structural equation modeling showed a significant indirect effect of coping flexibility, which indicated that higher coping flexibility was associated with higher sleep quality via reduced subjective distress. Our findings suggested that subjective distress and lower coping flexibility were risk factors for poor sleep quality.

Feasibility, acceptability and outcomes of a contextual schema therapy-based mobile program for depressive symptoms in adults

BackgroundGiven the high prevalence of depression worldwide, there is a pressing need for increasing treatment accessibility and identifying treatment modalities that can sustainably address depression. The present study aims to test the feasibility, acceptability, outcomes and mechanisms of a brief online self-help program for depressive symptoms in adults (nCompass), based on Contextual Schema Therapy principles. Method102 participants scoring above 14 on the Beck Depression Inventory – Second Version were recruited online and randomly allocated to either the 15-day nCompass intervention or a self-administered online psychoeducation group. Participants filled in self-report measures of depression, schema coping and psychological flexibility at baseline, immediately following the intervention and at a two-week follow-up. Additionally, nCompass participants were administered an instrument measuring the acceptability of the program. ResultsThe nCompass intervention was overall feasible and acceptable, with most participants completing the intervention and assessing it as easy to use, satisfactory and useful. Furthermore, results indicate higher decreases in depression and schema coping in the nCompass group by follow-up, compared to the control group. Changes in depressive symptoms from pre-test to post-test and follow-up in the nCompass group were explained by changes in surrender coping. There were no significant differences in psychological flexibility between the groups at either post-test or follow-up. DiscussionOur results highlight the nCompass program as a promising option for treating depressive symptoms in the general population.

Flexibility predicts chronic anxiety and depression during the first year of the COVID-19 pandemic-A longitudinal investigation of mental health trajectories.

The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Purpose in life among haemodialysis caregivers: Links with adaptive coping, caregiver burden, and psychological distress.

Research has evidenced that purpose in life helps to minimise the strains of providing informal care to a significant other, but little is known about whether this psychological resource influences the paths from stressors to the health outcomes of family caregiving and through which mechanisms it can exert this protective effect. This study aimed to explore the moderating role of purpose in life on the (mediated through adaptive coping) relationship between caregiver burden and psychological distress in haemodialysis caregivers. A cross-sectional study was conducted with a convenience sample of family caregivers (n=173; M=55.9, SD=15.6years old) of adults undergoing haemodialysis. A moderated-mediation model was computed to explore the interaction effects of purpose in life on the path between burden and distress, having adaptive coping behaviours as parallel mediators. Results showed that purpose in life had a buffering effect on the mediated (through acceptance coping) relationship between burden and distress (index of partial moderated-mediation: bsimple=-0.029, 95% bootstrap confidence interval (CI) [-0.070, -0.002]), and that this conditional effect was lowest at high levels of the moderator (at +1SD: bsimple=0.038, SE=0.026, 95% bootstrap CI [0.001, 0.098]). Use of emotional support (F(1,159)=4.395, p=0.038) and positive reframing (F(1,159)=5.648, p=0.019) also mediated this path. This study expands knowledge about the modifiable internal resources through which purpose in life can help promote psychosocial adjustment to the haemodialysis caregiving process. Mental health promotion initiatives aimed at this population need to consider combining different intervention approaches to foster purpose in life and train adaptive (and flexible) coping skills.

'I cannot accept it' distressing experiences in parents of children diagnosed with cancer: A qualitative study.

To explore the distressing experiences of Chinese parents of children with cancer from the perspective of psychological inflexibility. A qualitative study using a descriptive qualitative approach based on the model of psychological inflexibility was adopted. Individual semi-structured interviews through synchronized online video were conducted with 21 Chinese parents of children with cancer from October 2020 to May 2021. Data were analysed using content analysis. Four themes and 11 subthemes were identified: (i) immersion in struggling and suffering, (ii) avoidance and suppression, (iii) blaming and complaint and (iv) helplessness and worthlessness. Parents were unwilling to accept the diagnosis and witness their children's suffering, trapped in uncontrollable negative emotions and thoughts. Avoiding emotions and socializing, blaming themselves or complaining of injustice were common. They felt helpless towards life and valueless without the child. The research findings provide additional perspectives in understanding the distressing experiences in parents of children with cancer. Overall, the emotional and coping styles indicated the lack of psychological flexibility of parents when facing childhood cancer, which is profoundly influenced by Chinese culture. Healthcare professionals are recommended to provide culturally sensitive strategies or interventions for building psychological flexibility in addressing parental psychological distress. The study provides insights into exploring distressing experiences and reveals the inflexible psychological and behavioural patterns in parents of children with cancer, which could benefit healthcare providers in managing parental psychological distress and helping these parents build flexible coping strategies. The COREQ guideline was followed. No patient or public involvement.

The Association of College Students’ Epidemic Stress Perception and Life Satisfaction in China: Role of Coping Flexibility and Perceived Social Support

The mental health problems caused by COVID-19 pandemic to every person and every group cannot be ignored, especially for college students, who are the main force of the society. Few studies explore the mechanism of action between college students’ epidemic stress perception and life satisfaction in China. The study aims to understand the association between the epidemic stress perception of COVID-19 on life satisfaction, and examines the effect of coping flexibility and perceived social support in China. We investigated 597 college students by questionnaire and found college students’ epidemic stress perception of COVID-19 was significantly negatively associated with life satisfaction; coping flexibility partially mediated the relationship between college students’ epidemic stress perception of COVID-19 and their life satisfaction; perceived social support moderated role in the first half of the mediating pathway. Practical strategies to improve college students’ life satisfaction were discussed in the paper.

Individual factors as predictors of secondary traumatic stress and burnout in forensic inpatient staff.

Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long-term work-related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited. One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs. Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn-out. Unexpectedly, staff who reported a more anxious attachment style were burnt-out; however, there are limitations to this finding. Policies and practices in forensic settings should reflect the risk of STS and burnout. Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). INTRODUCTION: Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences. This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs. 98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff. Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style. This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor. The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals.

Positive Childhood Experiences and Spiritual Well-Being: Psychological Flexibility and Meaning-Based Coping as Mediators in Turkish Sample

Spiritual well-being enhances life quality, acts as a stress reliever, and mitigates unfavorable feelings. It helps individuals find meaning and purpose, increasing inner peace and happiness while improving stress management and overall well-being. This study examined whether positive childhood experiences are linked to spiritual well-being and if psychological flexibility and meaning-based coping serve as mediators. The sample included 1061 participants (Mage = 39.38; SD = 8.82) from various Turkish cities. Structural equation modeling assessed relationships between spiritual well-being, positive childhood experiences, psychological flexibility, and meaning-based coping. Results showed that positive childhood experiences directly enhance spiritual well-being, mediated by psychological flexibility and meaning-based coping. This underscores the significance of fostering positive childhood experiences to promote spiritual well-being and coping mechanisms.

Are there sociodemographic-specific associations of coping with heart disease and diabetes incidence?

Psychological factors, including psychological distress and well-being, have been associated with cardiometabolic disease risk. Here, we examined whether a psychological process, namely how individuals cope with stressors, relates to such risk, which has been understudied. During 2004-2006, 2,142 participants without heart disease and diabetes from the Midlife in the U.S. study completed a validated coping inventory assessing six strategies (positive reinterpretation and growth, active coping, planning, focus on and venting of emotion, denial, and behavioral disengagement) and relevant covariates. As a proxy for coping flexibility, participants were also classified as having lower, moderate, or greater variability in their use of these strategies. Heart disease and diabetes were documented in 2013-2015. Logistic regressions modeled adjusted odds ratios (AORs) and 95% confidence intervals (CIs) of developing heart disease and diabetes, separately, with coping exposures. In sociodemographic-adjusted models, greater use of adaptive strategies predicted lower diabetes risk (e.g., positive reinterpretation and growth: AOR = 0.83; 95% CI [0.72, 0.96]); estimates were weaker for maladaptive strategies, and all strategies were unrelated to heart disease. All associations for coping variability were null. In secondary analyses, greater use of adaptive strategies predicted lower heart disease risk in more educated participants only (e.g., active coping: AOR = 0.71; 95% CI [0.55, 0.92]) and lower diabetes risk in females only (e.g., planning: AOR = 0.75; 95% CI [0.61, 0.91]). Results were maintained additionally adjusting for health, behavioral, and social factors. Findings suggest sex and education differences in coping's association with heart disease and diabetes. Future studies should recognize adaptive strategies may be more potent for health among certain populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

MUPSA-based evaluation of portable equipment utilization for risk reduction in nuclear power plants: Framework and case study

Based on the lessons from the Fukushima accident, new strategies to mitigate the spread of accidents in nuclear power plants have been established that consider portable equipment. The diverse and flexible coping strategies (FLEX) and multi-barrier accident coping strategy (MACST) based on the utilization of portable equipment are being adopted in case of an extended loss of all AC power and loss of ultimate heat sink. In this context, the establishment of specific strategies for utilizing portable equipment has emerged as an important issue. This study proposes a multi-unit probabilistic safety assessment (MUPSA)-based evaluation framework consisting of several steps to quantitatively assess the reduction in risk from the use of portable equipment at a multi-unit site, which can provide a basis for establishing optimal portable equipment strategies. According to the framework, after first defining the scope of the evaluation, risk-significant types of portable equipment are selected and the scenarios are analyzed. Risk reduction is then evaluated using modified MUPSA models according to the deployment of the portable equipment. A case study was conducted for an internal loss of off-site power (LOOP) and seismic LOOP focusing on how to evaluate the effectiveness of portable equipment through the developed framework.

Glutamatergic supramammillary nucleus neurons respond to threatening stressors and promote active coping

Threat-response neural circuits are conserved across species and play roles in normal behavior and psychiatric diseases. Maladaptive changes in these neural circuits contribute to stress, mood, and anxiety disorders. Active coping in response to stressors is a psychosocial factor associated with resilience against stress-induced mood and anxiety disorders. The neural circuitry underlying active coping is poorly understood, but the functioning of these circuits could be key for overcoming anxiety and related disorders. The supramammillary nucleus (SuM) has been suggested to be engaged by threat. SuM has many projections and a poorly understood diversity of neural populations. In studies using mice, we identified a unique population of glutamatergic SuM neurons (SuMVGLUT2+::POA) based on projection to the preoptic area of the hypothalamus (POA) and found SuMVGLUT2+::POA neurons have extensive arborizations. SuMVGLUT2+::POA neurons project to brain areas that mediate features of the stress and threat responses including the paraventricular nucleus thalamus (PVT), periaqueductal gray (PAG), and habenula (Hb). Thus, SuMVGLUT2+::POA neurons are positioned as a hub, connecting to areas implicated in regulating stress responses. Here we report SuMVGLUT2+::POA neurons are recruited by diverse threatening stressors, and recruitment correlated with active coping behaviors. We found that selective photoactivation of the SuMVGLUT2+::POA population drove aversion but not anxiety like behaviors. Activation of SuMVGLUT2+::POA neurons in the absence of acute stressors evoked active coping like behaviors and drove instrumental behavior. Also, activation of SuMVGLUT2+::POA neurons was sufficient to convert passive coping strategies to active behaviors during acute stress. In contrast, we found activation of GABAergic (VGAT+) SuM neurons (SuMVGAT+) neurons did not alter drive aversion or active coping, but termination of photostimulation was followed by increased mobility in the forced swim test. These findings establish a new node in stress response circuitry that has projections to many brain areas and evokes flexible active coping behaviors.

Glutamatergic supramammillary nucleus neurons respond to threatening stressors and promote active coping.

Threat-response neural circuits are conserved across species and play roles in normal behavior and psychiatric diseases. Maladaptive changes in these neural circuits contribute to stress, mood, and anxiety disorders. Active coping in response to stressors is a psychosocial factor associated with resilience against stress-induced mood and anxiety disorders. The neural circuitry underlying active coping is poorly understood, but the functioning of these circuits could be key for overcoming anxiety and related disorders. The supramammillary nucleus (SuM) has been suggested to be engaged by threat. SuM has many projections and a poorly understood diversity of neural populations. In studies using mice, we identified a unique population of glutamatergic SuM neurons (SuMVGLUT2+::POA) based on projection to the preoptic area of the hypothalamus (POA) and found SuMVGLUT2+::POA neurons have extensive arborizations. SuMVGLUT2+::POA neurons project to brain areas that mediate features of the stress and threat responses including the paraventricular nucleus thalamus (PVT), periaqueductal gray (PAG), and habenula (Hb). Thus, SuMVGLUT2+::POA neurons are positioned as a hub, connecting to areas implicated in regulating stress responses. Here we report SuMVGLUT2+::POA neurons are recruited by diverse threatening stressors, and recruitment correlated with active coping behaviors. We found that selective photoactivation of the SuMVGLUT2+::POA population drove aversion but not anxiety like behaviors. Activation of SuMVGLUT2+::POA neurons in the absence of acute stressors evoked active coping like behaviors and drove instrumental behavior. Also, activation of SuMVGLUT2+::POA neurons was sufficient to convert passive coping strategies to active behaviors during acute stress. In contrast, we found activation of GABAergic (VGAT+) SuM neurons (SuMVGAT+) neurons did not alter drive aversion or active coping, but termination of photostimulation was followed by increased mobility in the forced swim test. These findings establish a new node in stress response circuitry that has projections to many brain areas and evokes flexible active coping behaviors.

Contributions of Coping Flexibility and Associated Functional Brain Connectivity to Resilient Trajectories of Mental Health During the COVID-19 Pandemic

The COVID-19 pandemic has presented an unprecedented challenge for individual mental health. In this study, we examined the lasting impact of the pandemic on mental health among Chinese college students and tested whether different coping dimensions contributed to resilience. Using a 2-year longitudinal design with four waves, we identified four common trajectories for individuals’ levels of depression and anxiety: resilient, recovered, delayed, and chronic. With prepandemic coping and resting-state neuroimaging data as predictors, we found that coping flexibility and corresponding connectivity patterns significantly predicted increased odds ratios of resilient trajectories for depression and anxiety. However, use of specific emotion-regulation strategies (i.e., cognitive reappraisal and expressive suppression) did not predict resilient trajectories. Overall, findings help to identify heterogeneity in emotional trajectories during the pandemic and indicate that coping flexibility plays a critical role in resilience. This work has implications for clinical-risk identification and developing mental-health interventions for the current pandemic and future crises.

Exploring the relationship between coping styles and well-being among Chinese university students: A longitudinal study based on the transactional stress model.

In the context of the COVID-19 pandemic, university students were exposed to increased stress, which significantly affected their well-being. This study examines the coping mechanisms employed by Chinese university students during this crisis, with a particular focus on the potential protective role of coping flexibility in maintaining their well-being. Using the transactional stress model and the dual-process theory of coping flexibility, this longitudinal study analyzed the responses of 206 Chinese university students at three measurement points in late 2022. The findings suggest that disruptions in daily life during the pandemic likely led students to engage in problematic internet use as a coping strategy, which subsequently led to reduced well-being. However, the study also shows that coping flexibility plays a crucial protective role in maintaining students' well-being. These findings highlight the urgent need for targeted interventions aimed at enhancing coping flexibility among university students, especially in the evolving post-pandemic landscape.

Effects of three prophylactic interventions on French middle-schoolers’ mental health: protocol for a randomized controlled trial

Adolescence is a strategic developmental stage in terms of preventing later difficulties and ensuring good mental health. Prophylactic interventions, which are conducted before the onset, prolongation, or worsening of difficulties, and aim to prevent or reduce symptoms or to promote wellbeing, therefore appear particularly appropriate for adolescents. However, existing prophylactic interventions conducted with adolescents have several weaknesses, including sparse theoretical frameworks, ambivalent evidence of their efficacy, and implementation and dissemination difficulties. In addition, no data are currently available on the effectiveness of such interventions in France. To fill this gap, a four-arm randomized controlled trial will be performed to assess the effectiveness of three prophylactic interventions targeting reactive, proactive and interpersonal adaptation in fourth-grade middle-school students, together with participants’ experience and perception of the interventions. Based on existing knowledge about adolescents, their learning mechanisms, and field constraints, these three interventions have been designed to promote their learning and receptiveness to interventions. Compared with baseline (i.e., before the intervention), we expect to observe a significant decrease in the level of distress (anxiety and depressive symptoms, functional impairment, and psychosocial difficulties) and a significant increase in the level of wellbeing after the intervention, across the three intervention groups, but not in the control group. In addition, we expect to observe post-intervention improvements in the processes targeted by the reactive adaptation intervention (operationalized as coping strategy use and flexibility), those targeted by the proactive adaptation intervention (operationalized as the tendency to engage in committed actions and general self-efficacy), and those targeted by the interpersonal adaptation intervention (operationalized as assertiveness in interactions), but only in the corresponding groups, with no change in any of these processes in the control group. The results of this research will not only enrich our knowledge of the processes involved in adolescents’ distress and wellbeing, but also provide clues as to the best targets for intervention. Moreover, the material for these interventions will be freely available in French on request to the corresponding author, providing access to innovative and fully assessed interventions aimed at promoting adolescents’ mental health in France.This clinical trial is currently being registered under no. 2023-A01973-42 on https://ansm.sante.fr/. This is the first version of the protocol.

Patient Reported Sexual Adaptation Following Prostate Cancer Treatment: An Analysis of Related Variables and Sexual Outcomes Associated with Sexual Adaptation Styles.

Sexual concerns after prostate cancer (PCa) treatment are high. Flexible coping is a crucial element to maintaining sexual activity after PCa and improves adaptation outcomes. We aimed to identify potential sexual adaptation styles reported by men following PCa treatment, and to assess relationships among associated variables and outcomes. Individuals (n = 223) with PCa treatment history (e.g., radical prostatectomy [n = 165, 74.0%], external beam radiation [n = 83, 37.2%], hormone/androgen deprivation therapy [n = 83, 37.2%]), completed an online survey assessing sexual variables and processes of sexual adaptation. Using a combination of inductive and deductive coding, open-ended responses were thematically analyzed and grouped into sexual adaptation styles. Factors potentially associated with sexual adaptation styles (e.g., age, perceived partner involvement, co-morbidities, relationship duration, time since PCa treatment, desire for physical affection, depression, relationship adjustment) were tested using multinomial logistic regression. Outcomes of sexual well-being (sexual distress, sexual bother, sexual satisfaction) and relationship adjustment were compared against each sexual adaptation style using a multivariate analysis of variance. Sexual activity status and satisfaction with the adaptation process was assessed across the sexual adaptation styles using a chi-square analysis and post-hoc tests. Two distinct categories were identified: those who had Adapted (n = 185) and those who had Not Adapted (n = 38). Four sexual adaptation styles emerged in the adapted category: Relationship Renegotiation (n = 53) and Sexual Renegotiation (n = 47), which were couples-focused styles, and Acceptance/Resignation (n = 34) and Masturbation/Erection (n = 48), which were individual-focused styles. Participants who could not be categorized as one style, but rather met several, were identified as Mixed (n = 3). Higher rates of depression, lower relationship adjustment, lack of sexual activity, and greater dissatisfaction with the adaptation process were observed for Not Adapted participants. Participants engaged in any type of adaptation style fared better than those who had Not Adapted. Couples-focused styles tended to emphasize renegotiation, including a changed perspective on the expression of the relationship. Perceived direct engagement of the partner facilitated adaptation and emphasized engagement with flexible coping, either through redefining priorities or ways of being sexual. Individual-focused styles emphasized pre-cancer erectile function, and either aimed to return to capacity for penetrative sexual activity or accepted its inaccessibility and largely an abandonment of partnered sexual activity.

Context matters: Exploring the adaptive nature of self-regulation skills in predicting abstinence among veteranswith alcohol use disorder.

Alcohol use disorder (AUD) is highly prevalent among veterans in the United States. Self-regulation skills (e.g., coping and emotion regulation) are important biopsychosocial factors for preventing relapse. However, how variation in self-regulation skills supports abstinence based on contextual demands is understudied in veterans with AUD. In a prospective longitudinal design, treatment-seeking veterans (n = 120; 29 females) aged 23-91 with AUD completed the Alcohol Abstinence Self-Efficacy Scale to assess temptation to drink across several high-risk situations (i.e., negative affect, social/positive emotions, physical concerns, and craving/urges) as well as the Brief-COPE and Emotion Regulation Questionnaire to assess self-regulation skills. Abstinence status was assessed at 6 months. T-tests were used to identify self-regulation skills that differed between abstinent and non-abstinent individuals. Multivariate regression with model selection was performed using all possible interactions between each high-risk situation and the self-regulation skills that significantly differed between groups. Overall, 33.3% of participants (n = 40; nine females) were abstinent at 6 months. Abstinent individuals reported significantly higher use of suppression (p = 0.015), acceptance (p = 0.005), and planning (p = 0.045). Multivariate regression identified significant interactions between (1) planning and physical concerns (p = 0.010) and (2) acceptance, suppression, and craving/urges (p = 0.007). Greater planning predicted abstinence in participants with higher temptation to drink due to physical concerns (e.g., pain). For individuals with lower temptation to drink due to cravings/urges, simultaneous higher suppression and acceptance increased the likelihood of abstinence. Conversely, for participants with higher cravings, greater acceptance with lower suppression was linked to a higher probability of abstinence. Results suggest that the adaptiveness of self-regulation skills in predicting AUD recovery is dependent on contextual demands and highlight the need for culturally sensitive treatments. Collectively, these findings indicate that further research on coping and regulatory flexibility may be an important avenue for tailoring AUD treatment for veterans.