Psychosocial Coping Resources Research Articles

Long-Term Post-COVID-19 Health and Psychosocial Effects and Coping Resources Among Survivors of Severe and Critical COVID-19 in Central and Eastern Europe: Protocol for an International Qualitative Study.

There is a strong need to determine pandemic and postpandemic challenges and effects at the individual, family, community, and societal levels. Post-COVID-19 health and psychosocial effects have long-lasting impacts on the physical and mental health and quality of life of a large proportion of survivors, especially survivors of severe and critical COVID-19, extending beyond the end of the pandemic. While research has mostly focused on the negative short- and long-term effects of COVID-19, few studies have examined the positive effects of the pandemic, such as posttraumatic growth. It is essential to study both negative and positive long-term post-COVID-19 effects and to acknowledge the role of the resources available to the individual to cope with stress and trauma. This knowledge is especially needed in understudied regions hit hard by the pandemic, such as the region of Central and Eastern Europe. A qualitative approach could provide unique insights into the subjective perspectives of survivors on their experiences with severe COVID-19 disease and its lingering impact on their lives. The aim of the study is to qualitatively explore the experiences of adult survivors of severe or critical COVID-19 throughout the acute and postacute period in 5 Central and Eastern European countries (Bulgaria, Slovakia, Croatia, Romania, and Poland); gain insight into negative (post-COVID-19 condition and quality of life) and positive (posttraumatic growth) long-term post-COVID effects; and understand the role of survivors' personal, social, and other coping resources and local sociocultural context and epidemic-related situations. This is a qualitative thematic analysis study with an experiential reflexive perspective and inductive orientation. The analytical approach involves 2-stage data analysis: national analyses in stage 1 and international analysis in stage 2. Data are collected from adult survivors of severe and critical COVID-19 through in-depth semistructured interviews conducted in the period after hospital discharge. As of the publication of this paper, data collection is complete. The total international sample includes 151 survivors of severe and critical COVID-19: Bulgaria (n=33, 21.8%), Slovakia (n=30, 19.9%), Croatia (n=30, 19.9%), Romania (n=30, 19.9%), and Poland (n=28, 18.5%). National-level qualitative thematic analysis is currently underway, and several papers based on national results have been published. Cross-national analysis has started in 2024. The results will be submitted for publication in the third and fourth quarters of 2024. This research emphasizes the importance of a deeper understanding of the ongoing health and psychosocial challenges survivors face and what helps them cope with these challenges and, in some cases, thrive. It has implications for informing holistic care and improving the health and psychosocial outcomes of survivors of COVID-19 and will be crucial for evaluating the overall impact and multifaceted implications of the pandemic and for informing future pandemic preparedness. DERR1-10.2196/57596.

Association Between Internet Gaming Disorder and Suicidal Ideation Mediated by Psychosocial Resources and Psychosocial Problems Among Adolescent Internet Gamers in China: Cross-Sectional Study.

Adolescent internet gaming disorder (IGD) was associated with severe harm, including suicidal ideation. While suicidal ideation was predictive of completed suicides, further research is required to clarify the association between IGD and suicidal ideation among adolescents, as well as the mechanisms involved. This study aimed to investigate the understudied association between IGD and suicidal ideation, as well as novel mechanisms associated with it, among Chinese adolescent internet gamers through psychosocial coping resources and psychosocial problems. An anonymous, self-administered, cross-sectional survey was conducted among secondary school students who had played internet games in the past year in Guangzhou and Chengdu, China (from October 2019 to January 2020). In total, 1693 adolescent internet gamers were included in this study; the mean age was 13.48 (SD 0.80) years, and 60% (n=1016) were males. IGD was assessed by the 9-item Internet Gaming Disorder Checklist of the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders [Fifth Edition]), while a single item assessed suicidal ideation: "Have you ever considered committing suicide in the past 12 months?" Univariate and multivariate logistic regression associations were conducted to test the significance and directions of the potential factors for suicidal ideation. The mediation mechanism was examined by structural equation modeling. Among all participants, the prevalence of IGD and suicidal ideation was 16.95% (287/1693) and 43.06% (729/1693), respectively. IGD cases were 2.42 times more likely than non-IGD cases to report suicidal ideation (adjusted odds ratio [OR] 2.42, 95% CI 1.73-3.37). Other significant factors of suicidal ideation included psychosocial coping resources (resilience and social support, both adjusted OR 0.97, 95% CI 0.96-0.98) and psychosocial problems (social anxiety: adjusted OR 1.07, 95% CI 1.05-1.09; loneliness, adjusted OR 1.13, 95% CI 1.10-1.16). The association between IGD and suicidal ideation was partially mediated by 3 indirect paths, including (1) the 2-step path that IGD reduced psychosocial coping resources, which in turn increased suicidal ideation; (2) the 2-step path that IGD increased psychosocial problems, which in turn increased suicidal ideation; and (3) the 3-step path that IGD reduced psychosocial coping resources which then increased psychosocial problems, which in turn increased suicidal ideation, with effect sizes of 10.7% (indirect effect/total effect: 0.016/0.15), 30.0% (0.05/0.15), and 13.3% (0.02/0.15), respectively. The direct path remained statistically significant. IGD and suicidal ideation were alarmingly prevalent. Evidently and importantly, IGD was a significant risk factor for suicidal ideation. The association was partially explained by psychosocial coping resources of resilience and social support and psychosocial problems of social anxiety and loneliness. Longitudinal studies are needed to confirm the findings. Pilot randomized controlled trials are recommended to evaluate the effectiveness of interventions in reducing suicidal ideation by reducing IGD, improving psychosocial coping resources, and reducing psychosocial problems investigated in this study.

Determinants of Life Satisfaction and Quality of Life Among American Indian Women Cancer Survivors: The Role of Psychosocial Resources

ABSTRACT Purpose This study assessed the relationship of spirituality, social support, and sense of mastery to life satisfaction and quality of life to identify viable psychosocial coping resources among American Indian (AI) women cancer survivors. Method We conducted a cross-sectional survey of 73 AI women cancer survivors residing in South Dakota. A series of multivariate hierarchical regression analyses was conducted. Results Findings indicated that lower self-rated physical health was consistently associated with lower levels of life satisfaction and quality of life. Spirituality was found to be the most influential predictor for life satisfaction, while social support and sense of mastery were two significant predictors for quality of life. Discussion Our data underscored the importance of spirituality, social support, and sense of mastery to the well-being of AI women cancer survivors and as effective coping strategies to mitigate life stressors. Implications of this evidence for the design of cancer preventions and interventions are discussed.

Perceived psychosocial stressors and coping resources in chronic low back pain patients as classified by the avoidance-endurance model.

The Avoidance-Endurance Model distinguishes between subgroups of low back pain (LBP) patients with three maladaptive styles of coping with pain: fear-avoidance (FAR), distress-endurance (DER), eustress-endurance (EER), and one adaptive coping style (AR). This study aimed to compare the quantity of patients' perceived psychosocial stressors and coping resources across these subgroups. This cross-sectional study was conducted at an outpatient rehabilitation center for patients with chronic musculoskeletal pain. One hundred and thirty-seven patients (69 women/68 men) with chronic LBP were assessed using the following: a demographic checklist, the visual analogue scale, Avoidance-Endurance Questionnaire, Roland-Morris Disability Questionnaire, Pain Disability Index, and 36-Item Short Form. Subsequently, patients participated in semi-structured interviews led by clinical psychologists, which were intended to identify their perception of stressors and coping resources. The quantity of psychosocial stressors and coping resources were analyzed using deductive and inductive content analyses and then compared between subgroups using chi-square-tests. FARs experienced significantly higher levels of "mental suffering" (p = <0.001) and "other workplace problems" compared to ARs and EERs (p = <0.001). DERs reported significantly higher levels of "mental suffering" (p = <0.001), "job stress" (p = 0.022), and "familial losses" (p = 0.029) compared to ARs, whereas the AR group demonstrated significantly more "coping resources" (p = 0.001) compared to FARs. AEM-subgroups differed in the quantity of perceived psychosocial stressors and coping resources with AR, who demonstrated a lower risk for pain chronicity and reported the highest quantity of resources. The variability across subgroups may imply differences in patientś needs regarding therapeutic interventions and suggests that a resource-centered approach to cope with stress and pain may be beneficial.

Psychosocial Coping Resources and the Toll of COVID-19 Bereavement

The COVID-19 pandemic ushered in a bereavement crisis unparalleled in a generation, with devastating consequences for the mental health of those who lost a loved one to the virus. Using national survey data ( n = 2,000) containing detailed information about people’s experiences of pandemic-related stressors, coping resources, and mental health, in this study we examine whether and how three psychosocial coping resources—mastery, self-esteem, and social support—moderate the association between COVID-19 bereavement and psychological distress. We find that coping resources have both expected and unanticipated effects on the relationship between bereavement and mental health. Consistent with the stress process model, higher levels of mastery uniformly reduce the damaging effects of bereavement on depressive symptoms and anger, whereas self-esteem mitigates the positive association between losing a close tie to the virus and reports of anger. Contrary to the stress-buffering hypothesis, however, higher levels of perceived support exacerbate the positive associations between bereavement and each indicator of psychological distress. Our findings suggest that the putatively advantageous aspects of social support may be compromised, or even reversed, in the context of constrained social engagement. We discuss the theoretical implications of these findings for sociological research on the stress process.

Psychosocial resources moderate the association between stress and insomnia among patients with digestive system cancers

ABSTRACT This study explored the profiles of psychosocial resources combined with resilience and family care, and analyzed their moderating effects on the relationship between stress and insomnia in patients with digestive system cancers. A total of 366 patients were recruited to participate in this study from two tertiary hospitals in China. They were assessed using the Perceived Stress Scale – 4 items, Insomnia Severity Index, Family Concern Index Questionnaire, and 10-item Connor–Davidson Resilience Scale. Latent profile analysis and the BCH (Bolck, Croon & Hagenaars) method were used to identify the subtypes and estimate the moderating role of psychosocial coping resources. About 62.3% of participants had insomnia symptoms. Insomnia was positively correlated to the stress (r = 0.25, P < 0.001). The latent classes were the low resources class (32.8%), the medium resources class (46.1%), and high resources class (21.1%). Among these, in low (estimate value = 0.563, P = 0.003) and medium (estimate value = 0.301, P = 0.029) resources class, stress had an effect on insomnia. There was no association between stress and insomnia in high resources class (estimate value = 0.165, P = 0.637). Stress might be associated with to insomnia problems, whereas patients with high psychosocial resources are more not vulnerable. Interventions to improve family function and resilience could contribute to easing the insomnia of patients with digestive system cancers.

Impact of COVID-19 and lockdown on mental health and future orientation among young adult asylum seekers in Italy: A mixed-methods study.

The COVID-19 outbreak caused a worldwide health emergency which disproportionately affected migrants and ethnic minorities. Yet, little is known about the psychosocial effects of the pandemic among refugees and asylum seekers. This study used a convergent parallel mixed-method design to explore knowledge and opinions concerning COVID-19 and the impact of lockdown on perceived mental health and future orientation among 42 young adult asylum seekers residing in northeastern Italy. Participants took part in individual interviews comprising both qualitative and quantitative questions. Qualitative reports were analyzed using thematic content analysis, whereas descriptive statistics and paired sample t-tests were computed on quantitative data. Results indicated that most participants were correctly informed about the nature, origin, and spread of COVID-19, expressed moderate or high satisfaction concerning the clarity of communication about safety measures, and followed them most of the time. Worries about family in the home country, loneliness, fear for own and loved ones’ health, and concerns about delays in the asylum application were the most frequently mentioned stressful events. Psychological and physical distress significantly increased, and positive future orientation significantly decreased during the lockdown. However, participants also emphasized the usefulness of instrumental support from social workers and exhibited a resilient attitude characterized by the acceptance of uncertainty, sense of connectedness, and positive outlook. Overall, findings suggest that the current emergency may exacerbate psychological vulnerabilities of asylum seekers due to continued existential uncertainty. Thus, individual and contextual assets should be strengthened to promote psychosocial adjustment and coping resources in the context of the pandemic.

The experience of Veterans with disabilities: A grounded theory study on coping with trauma and adapting to a new life

ABSTRACT Research and knowledge related to psychosocial processes experienced by Turkish Veterans with disabilities and the factors that facilitate adapting to life with a disability are insufficient. This study aims to explore the psychosocial processes and coping resources experienced by Turkish Veterans with disabilities. A grounded theory design was used in the study. Snowball sampling and theoretical sampling were used to recruit participants. In-depth interviews were conducted with 20 male participants. The data were analyzed through open, axial, and selective coding and formed into themes and categories. The results were explained within the framework of the following themes: the moment of returning from the threshold of death, treatment process, returning to life after war, acceptance, and holding on to life. The analysis revealed that the participants experienced problems, such as post-traumatic stress, the inadequacy of psychosocial functioning, social disapproval, and alienation during the adaptation to life after war. Further, coping resources such as positive personality traits, spiritual coping, making sense of experience, state assurance, and family and fellow Veterans support were found to facilitate the adaptation process.

The link between food insecurity and psychological distress: The role of stress exposure and coping resources.

This study examines the association between food insecurity and mental health over a 3-year period. It also assesses the salience of life stressors and psychosocial coping resources for this association. We utilize data from a two-wave community survey of Miami-Dade County, Florida residents (N = 1488). Findings from SEM analysis reveal that greater food insecurity at W1 is associated with greater depressive symptoms at W2, lending credence to characterizations of food insecurity as a chronic stressor. This association is partly mediated by variation over the study period in social support and mastery. However, no significant mediating effects are observed for the social stress indicators assessed. Food insecurity is associated with diminished psychosocial coping resources, which leads to greater psychological distress. We discuss how these findings extend a stress and coping model of food insecurity, and implications for research and practice.

Virtual Mind-Body Programming for Patients With Cancer During the COVID-19 Pandemic: Qualitative Study.

BackgroundPatients with cancer are particularly vulnerable to stress and anxiety during the COVID-19 pandemic. Social distancing is critical for patients with cancer; however, it can also reduce their access to psychosocial coping resources.ObjectiveThe aim of this study was to explore patient experiences to generate a model of how virtual mind-body programs can support the psychosocial well-being of patients with cancer.MethodsWe conducted a qualitative study among patients (aged ≥18 years) who participated in a virtual mind-body program offered by a National Cancer Institute–designated Comprehensive Cancer Center during the COVID-19 pandemic. The program consisted of mind-body group therapy sessions of fitness, yoga, tai chi, dance therapy, music therapy, and meditation. Live integrative medicine clinicians held each session via Zoom videoconferencing for 30-45 minutes. In semistructured phone interviews (n=30), patients were asked about their overall impressions and perceptions of the benefits of the sessions, including impacts on stress and anxiety. Interviews were analyzed using grounded theory.ResultsAmong the 30 participants (average age 64.5 years, SD 9.36, range 40-80, 29 female), three major themes were identified relating to experiences in the virtual mind-body program: (1) the sessions helped the patients maintain structured routines and motivated them to adhere to healthy behaviors; (2) the sessions enhanced coping with COVID-19-related-stressors, allowing patients to “refocus” and “re-energize”; and (3) the sessions allowed patients to connect, fostering social relationships during a time of isolation. These themes informed the constructs of a novel behavioral-psychological-social coping model for patients with cancer.ConclusionsVirtual mind-body programming supported patients with cancer during the COVID-19 pandemic through a behavioral-psychological-social coping model by enhancing psychological coping for external stressors, supporting adherence to motivation and health behaviors, and increasing social connection and camaraderie. These programs have potential to address the behavioral, psychological, and social challenges faced by patients with cancer during and beyond the COVID-19 pandemic. The constructs of the conceptual model proposed in this study can inform future interventions to support isolated patients with cancer. Further clinical trials are needed to confirm the specific benefits of virtual mind-body programming for the psychosocial well-being and healthy behaviors of patients with cancer.

Group Membership and Social and Personal Identities as Psychosocial Coping Resources to Psychological Consequences of the COVID-19 Confinement.

The confinement imposed by measures to deal with the COVID-19 pandemic may in the short and medium term have psychological and psychosocial consequences affecting the well-being and mental health of individuals. This study aims to explore the role played by group membership and social and personal identities as coping resources to face the experience of the COVID-19 confinement and radical disruption of social, work, family and personal life in a sample of 421 people who have experienced a month of strict confinement in the Region of Madrid. Our results show that identity-resources (membership continuity/new group memberships, and personal identity strength) are positively related to process-resources (social support and perceived personal control), and that both are related to better perceived mental health, lower levels of anxiety and depression, and higher well-being (life satisfaction and resilience) during confinement. These results, in addition to providing relevant information about the psychological consequences of this experience, constitute a solid basis for the design of psychosocial interventions based on group memberships and social identity as coping resources.

ROLE OF RELIGIOUSNESS AND SPIRITUALITY AND SOCIAL NETWORKS IN DETERMINING DEPRESSION AMONG OLDER KOREAN AMERICANS

Korean Americans (KAs) are one of the fastest growing minority populations in the U.S. Depression is the most common psychological problem among older KAs. While the relationship between religiousness/spirituality (R/S) and well-being in later life is an important health concern, older KAs are often affiliated with a protestant church and have the highest church participation. This study assessed the role of R/S and social networks in determining depressive symptoms and identified the best predictors of depressive symptoms. Data were drawn from a cross-sectional survey with 200 older KAs residing in New York. Best-subsets regressions were used to evaluate the best predictors of depression. Findings indicated that nearly 30% of older KAs reported experiencing mild or severe depressive symptoms. The best model fit for depression involved physical health, R/S coping skills, social networks, and annual household income. Social networks and R/S coping skills were found to be a protective factor against depressive symptoms and may be an effective tool for health care strategies in the management of depression and health-promoting behaviors. Careful assessment of R/S and social networks among older KAs may provide a more comprehensive approach to traditional, biomedically derived clinical practices by focusing on the whole person in early identification of risk factors, prognosis, and intervention for depression. Health education and intervention could be framed in ways that strengthen such psychosocial coping resources for older KAs. Facilitating social participation and mobilizing R/S resources in a wide range of personally meaningful activities may mitigate psychological distress and enhance life satisfaction.

FUNCTIONAL LIMITATION AND DEPRESSIVE SYMPTOMATOLOGY: CONSIDERING PERCEIVED STIGMA AND DISCRIMINATION WITHIN A STRESS AND COPING FRAMEWORK.

This study examines whether perceived stigma and discrimination moderate the associations between functional limitation, psychosocial coping resources, and depressive symptoms among people with physical disabilities. Using two waves of data from a large community study including a representative sample of persons with physical disabilities (N=417), an SEM-based moderated mediation analysis was performed. Mediation tests demonstrate that mastery significantly mediates the association between functional limitation and depressive symptoms over the study period. Moderated mediation tests reveal that the linkage between functional limitation and mastery varies as a function of perceived stigma and experiences of major discrimination and day-to-day discrimination, however. The implications of these findings are discussed in the context of the stress and coping literature.

Structural Equation Modeling of Self-Management in Patients with Hemodialysis

The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (β=.84), hope and cognitive illness representation (β=.37 and β=.27) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

The Influence of Stressor Exposure and Psychosocial Resources on the Age-Anger Relationship.

This study examined the processes linking age, stressor exposure, psychosocial coping resources, and two dimensions of anger proneness (i.e., experienced anger and expressed anger). Longitudinal change regression analysis of data from a two-wave community panel study including a sample of people aged 18 to 93 ( N = 1,473) is performed. Age is significantly associated with declines in both experienced anger and expressed anger over the 3-year study period. These associations are substantially mediated by the lower levels of chronic stressors and discrimination-related stressors experienced among older adults. In contrast, self-esteem amplifies the association between age and expressed anger. These findings clarify the circumstances in which age matters most for changes over time in the experience and expression of anger. They highlight how certain forms of stressor exposure and psychosocial resources are linked with anger proneness and in ways that vary by age.

Unequal burdens of loss: examining the frequency and timing of homicide deaths experienced by young Black men across the life course.

I examined the frequency and developmental timing of traumatic loss resulting from the health disparity of homicide among young Black men in Baltimore, Maryland. Using a modified grounded theory approach, I conducted in-depth semistructured interviews with 40 Black men (aged 18-24 years) from January 2012 to June 2013. I also constructed adapted life history calendar tools using chronologies of loss, and (1) provided a comprehensive history of loss, (2) determined a specific frequency of homicide deaths, (3) indicated participants' relationship to the decedents, and (4) identified the developmental timing of deaths. On average, participants knew 3 homicide victims who were overwhelmingly peers. Participant experiences of homicide death started in early childhood, peaked in adolescence, and persisted into emerging adulthood. The traumatic loss of peer homicide was a significant developmental turning point and disrupted participants' social networks. The traumatic loss of peer homicide was a prevalent life course experience for young Black men and identified the need for trauma- and grief-informed interventions. Future research is needed to examine the physical and psychosocial consequences, coping resources and strategies, and developmental implications of traumatic loss for young Black men in urban contexts.

Cumulative psychosocial stress, coping resources, and preterm birth.

Preterm birth constitutes a significant international public health issue, with implications for child and family well-being. High levels of psychosocial stress and negative affect before and during pregnancy are contributing factors to shortened gestation and preterm birth. We developed a cumulative psychosocial stress variable and examined its association with early delivery controlling for known preterm birth risk factors and confounding environmental variables. We further examined this association among subgroups of women with different levels of coping resources. Utilizing the All Our Babies (AOB) study, an ongoing prospective pregnancy cohort study in Alberta, Canada (n = 3,021), multinomial logistic regression was adopted to examine the independent effect of cumulative psychosocial stress and preterm birth subgroups compared to term births. Stratified analyses according to categories of perceived social support and optimism were undertaken to examine differential effects among subgroups of women. Cumulative psychosocial stress was a statistically significant risk factor for late preterm birth (OR = 1.73; 95% CI = 1.07, 2.81), but not for early preterm birth (OR = 2.44; 95% CI = 0.95, 6.32), controlling for income, history of preterm birth, pregnancy complications, reproductive history, and smoking in pregnancy. Stratified analyses showed that cumulative psychosocial stress was a significant risk factor for preterm birth at <37weeks gestation for women with low levels of social support (OR = 2.09; 95% CI = 1.07, 4.07) or optimism (OR = 1.87; 95% CI = 1.04, 3.37). Our analyses suggest that early vulnerability combined with current anxiety symptoms in pregnancy confers risk for preterm birth. Coping resources may mitigate the effect of cumulative psychosocial stress on the risk for early delivery.

Perceived stigma among people with chronic health conditions: the influence of age, stressor exposure, and psychosocial resources.

This study addresses whether age, functional limitation and other stressor exposure, and psychosocial coping resources influence variation in perceived stigma and the form this influence takes (i.e., independent and/or interdependent). Using data from two waves of a large community study of adults (age 20-93) with chronic health conditions (n = 417), a residual change regression analysis considers direct and moderating factors influencing perceived stigma over a 3-year period. Age, functional limitation, the experience of discrimination, and self-esteem independently account for variation in perceived stigma. Moderation tests reveal that age is associated with a greater increase in stigma in the context of greater functional limitation and increases in limitation. Functional limitation and stressor exposure are also associated with declines in stigma in the context of greater mastery and self-esteem. Multiple processes bear on perceived stigma among people with chronic health conditions. Implications for stigma and stress research are discussed.

Physical Limitation and Anger

Is there a relationship between physical limitation and anger proneness? And, if so, is this relationship conditioned by associated differences in stress exposure and the availability of psychosocial coping resources? We explore these questions using data from a two-wave panel study including a representative sample of persons with and without physical limitations ( N = 1,473). Results of longitudinal change analysis demonstrate that physical limitation is associated with an increased tendency to both experience and express anger. Findings also reveal that this association is largely accounted for by variations in the experience of discrimination and differences in the psychosocial coping resources of mastery and self-esteem

Resisting the Stigma of Mental Illness

The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions under which individuals are resistant have not been identified. I define resistance as opposition to the imposition of mental illness stereotypes by others and distinguish between deflecting (“that’s not me”) and challenging resistance strategies. Individuals should be more likely to employ resistance strategies when they have: past experience with stigma resistance; past familiarity with an ill family member or friend; symptoms that are non-severe or controlled; treatment experience in settings run by consumers; initially high levels of psychosocial coping resources; and multiple role-identities. Incorporating resistance into classic and modified labeling theories of mental illness highlights the personal agency of labeled individuals, missing especially in classic labeling theory.