Self-reported Coping Strategies Research Articles

Coping With Side Effects: A Daily Diary Study in Women With Breast Cancer Living With Adjuvant Endocrine Therapy.

Adjuvant endocrine therapy (AET) is increasingly being prescribed for up to 10years to people diagnosed with hormone receptor-positive breast cancer. AET intake is often accompanied by side effects that significantly impact the well-being of people. The way individuals cope with medication-related side effects might play a pivotal role in their emotional adaption. This intensive-longitudinal study investigated the association between self-reported coping strategies (Brief COPE) and psychological well-being (Patient Health Questionnaire-4) among women undergoing AET. A multilevel factor analysis resulted in the identification of four coping factors, namely, problem-focused, support-focused, meaning-focused, and avoidance-focused coping. Daily coping efforts and experienced side effects were analyzed as predictors of psychological well-being using multilevel modeling. A total of 215 women (Mage=56.5±10.9years) participated, resulting in a total of n=2080 daily surveys (M=9.67±1.08). On average, women reported 3.7±2.2 different side effects per day. Days characterized by an elevated frequency of side effects and increased burden were associated with diminished well-being. Using more problem- and meaning-focused strategies than usual to cope with side effects correlated positively with well-being. Conversely, employing more support- and avoidance-focused coping strategies than usual was linked to reduced psychological well-being. Exploratory analyses focusing on individual coping strategies provided nuanced insights into coping behaviors. The present findings underscore the relationship between women's coping efforts concerning medication-related side effects during AET and their daily well-being. Psychosocial education (e.g., cognitive behavioral therapy) may offer valuable benefits for patients by helping them develop adaptive coping strategies to manage side effects.

Social genomics, cognition, and well-being during the COVID-19 pandemic.

Adverse psychosocial exposure is associated with increased pro-inflammatory gene expression and reduced type-1 interferon gene expression known as the conserved transcriptional response to adversity (CTRA). CTRA is not well-studied in cognitive impairment but may contribute to late-life cognitive decline. We examined perceived stress, loneliness, well-being, and the impact of coronavirus disease 2019 (COVID-19) and the relationship to the expression of genes associated with the CTRA. Mixed-effect linear models were used to quantify associations between psychosocial variables and CTRA gene expression. Eudaimonic well-being (EWB) was inversely associated with CTRA gene expression in participants with both normal cognition (NC) and mild cognitive impairment (MCI). Self-reported coping strategies differed by cognitive status and variably impacted CTRA gene expression. EWB is an important correlate of stress, even in people with MCI. The prodromal cognitive decline appears to moderate the significance of coping strategies as a correlate of CTRA gene expression. Conserved transcriptional response to adversity (CTRA) gene expression is higher with lower eudaimonic well-being.Eudaimonic well-being was important in both participants with normal cognition and those with mild cognitive impairment.Coping strategies and impact on CTRA gene expression differed by cognitive status.Loneliness in a population with relatively low loneliness scores did not impact CTRA gene expression.

Ayahuasca-induced personal death experiences: prevalence, characteristics, and impact on attitudes toward death, life, and the environment.

Despite an emerging understanding regarding the pivotal mechanistic role of subjective experiences that unfold during acute psychedelic states, very little has been done in the direction of better characterizing such experiences and determining their long-term impact. The present paper utilizes two cross-sectional studies for spotlighting - for the first time in the literature - the characteristics and outcomes of self-reported past experiences related to one's subjective sense of death during ayahuasca ceremonies, termed here Ayahuasca-induced Personal Death (APD) experiences. Study 1 (n = 54) reports the prevalence, demographics, intensity, and impact of APDs on attitudes toward death, explores whether APDs are related with psychopathology, and reveals their impact on environmental concerns. Study 2 is a larger study (n = 306) aiming at generalizing the basic study 1 results regarding APD experience, and in addition, examining whether APDs is associated with self-reported coping strategies and values in life. Our results indicate that APDs occur to more than half of those participating in ayahuasca ceremonies, typically manifest as strong and transformative experiences, and are associated with an increased sense of transcending death (study 1), as well as the certainty in the continuation of consciousness after death (study 2). No associations were found between having undergone APD experiences and participants' demographics, personality type, and psychopathology. However, APDs were associated with increased self-reported environmental concern (study 1). These experiences also impact life in profound ways. APDs were found to be associated with increases in one's self-reported ability to cope with distress-causing life problems and the sense of fulfillment in life (study 2). The study's findings highlight the prevalence, safety and potency of death experiences that occur during ayahuasca ceremonies, marking them as possible mechanisms for psychedelics' long-term salutatory effects in non-clinical populations. Thus, the present results join other efforts of tracking and characterizing the profound subjective experiences that occur during acute psychedelic states.

Burnout among public sector pharmacy staff two years into the COVID-19 pandemic.

This study aimed to determine the prevalence and factors contributing to burnout among public sector pharmacy staff in Sarawak, Malaysia, two years into the COVID-19 pandemic. Impact of burnout on their lives and their coping strategies were also examined. A cross-sectional online survey was carried out among all pharmacy staff in public healthcare facilities throughout Sarawak. Burnout was measured using the Copenhagen Burnout Inventory. Multiple logistic regression analysed demographic and work characteristics associated with burnout. Open-ended replies on burnout causes, impact, coping strategies and employer's role were coded and thematically analysed. A total of 329 responses were received. The prevalence of personal, work and patient-related burnout was 54.7, 47.1 and 35.3%, respectively. Respondents facing problems with child support were 8.26 and 3.62 times more likely to suffer from personal and work-related burnout. Working in areas with potential exposure to COVID-19 patients increased the odds of patient and work-related burnout by 2.80 and 1.86 times, respectively. Burnout symptoms affected their quality of life; nevertheless, self-reported coping strategies were mostly positive. Respondents emphasised the need for organisational interventions, including increased resource allocation, better workload distribution and promotion of work-life balance, to mitigate burnout. A significant percentage of public sector pharmacy staff continue to experience burnout two years into the pandemic. Regular well-being assessments and supportive policies are recommended to help them cope with increased stress. Additional training for supervisors may be necessary to effectively manage staff and workload during a pandemic.

Association of Self-Reported Coping Strategies With Speech Recognition Outcomes in Adult Cochlear Implant Users.

To characterize the degree to which individual coping strategies may influence speech perception after cochlear implantation. Retrospective cohort study. Tertiary referral center. Adult, postlingually deaf cochlear implant recipients. The Coping Orientation to Problems Experience inventory, a validated, multidimensional self-reported coping scale, was administered preoperatively. Speech perception was measured using consonant-nucleus-consonant (CNC) phoneme and word scores, AzBio sentence accuracy in quiet and noise, and Hearing in Noise Test sentences in quiet preoperatively and at 1, 3, and 6 months postoperatively. Quality of life was measured with the Hearing Implant Sound Quality Index and the Nijmegen Cochlear Implant Questionnaire. Thirty-six patients were included in this study. Mean age at surgery was 70.7 ± 11.4 years. Acceptance was associated with a decreased AzBio in noise score in the 6 months after CI (regression coefficient b = -0.05; 95% confidence interval [CI], -0.07 to -0.03; p < 0.01). Denial was associated with a decreased AzBio in quiet score (b = -0.05; 95% CI, -0.09 to -0.01; p < 0.05), whereas humor was associated with an increased AzBio in quiet score (b = 0.02; 95% CI, 0.01 to 0.04; p < 0.05). Humor was also associated with an increased Hearing in Noise Test score (b = 0.05; 95% CI, 0.02 to 0.07; p < 0.05). Denial was associated with decreased CNC word (b = -0.04; 95% CI, -0.06 to -0.02; p < 0.01) and phoneme (b = -0.04; 95% CI, -0.07 to -0.02; p < 0.01) scores, whereas substance use was associated with increased CNC word (b = 0.03; 95% CI, 0.01 to 0.05, p < 0.01) and phoneme (b = 0.04; 95% CI, 0.02 to 0.06; p < 0.01) scores. Scores on self-reported quality of life measures were not significantly correlated with coping strategies. A variety of adaptive and maladaptive coping strategies are used by postlingually deaf adult cochlear implant users. Denial and acceptance may be more predictive of poor speech performance, whereas humor and substance use may be more predictive of improved speech performance.

Examining the Autonomic Nervous System in the Relationship among Heart Rate Variability, Stress Coping, and Cognitive Ability in Individuals with Psychiatric Disorders.

Depression is one of the most severe psychiatric disorders and affects patients on emotional, physical, and cognitive levels. Comorbid somatic conditions, such as cardiovascular diseases, are frequent and affect the quality of life, as well as mortality. Underlying maladaptive autonomic nervous system regulation influences emotional and cognitive processes. This study, thus, aimed to investigate the relationship among heart rate variability (HRV), self-reported coping strategies, executive function, and inhibition in individuals with psychiatric disorders. Data of 97 patients treated in a multi-professional psychiatric rehabilitation center for 6 weeks were analyzed. Subjects underwent psychological tests (Stress Coping Style Questionnaire, Emotional Competence Questionnaire, and Becks Depression Inventory-II), a cognitive test (Color-Word Interference Test), and a 24 h electrocardiogram to record HRV. Patients with higher depression scores had significantly lower HRVs and decreased self-reported abilities for stress coping. Depression severity did not affect cognitive inhibitory abilities. HRV was related to neither coping strategies nor cognitive inhibition abilities. However, lower HRV was related to higher values of Negative Stress Coping (β = −0.21, p < 0.05). This relationship was fully mediated by depression severity (−4.79, 95% CI: −8.72, −0.72). HRV is not related to quantitative cognitive inhibition, but to the self-reported ability to cope with negative emotions in individuals with psychiatric disorders.

Self-Reported Coping Strategies for Managing Work-Related Stress among Public Safety Personnel.

Public safety personnel (PSP) experience a disproportionately high number of on-the-job stressors compared to the general population. PSP develop self-initiated actions, or coping strategies, that either confront the situation (approach strategies) or avoid the situation (avoidance strategies) to reduce the impact of stressors on their well-being. Understanding how PSP cope with stress is critical to ensuring their safety and that of the public. In the current study, we examined the coping strategies of PSP (n = 828 in the total sample). Participants managed their experiences of occupational stress or distress using three primary approach coping strategies: education (learning about mental illness and their causes), self-reliance (processes of self-reflection), and treatment (pharmaceutical, psychotherapy) that were considered adaptive. Results demonstrate PSP used multiple coping strategies simultaneously to deal with occupational stress. PSP who reported doing better tended to attribute their success to treatment, specifically psychotherapy, either alone or in combination with other interventions, and almost always emphasizing important supports from co-workers, families, and friends. Changing workplace culture could help to de-pathologize the effects of stress reactions being perceived as individual “failings”.

Interactive effects of coping strategies and emotion dysregulation on risk for peer victimization

The aim of the current longitudinal study was to examine the interactive effects of six common coping strategies (i.e., adult support seeking, friend support seeking, problem solving, humor, passive coping, and cognitive distancing) and emotion (i.e., anger and sadness) dysregulation on concurrent levels and subsequent trajectories of peer victimization over a 2-year period. Participants were 287 predominantly Caucasian students (53.7% boys; ages 6–9) from an elementary school located in the Midwestern United States. Self-reported coping strategies and emotion dysregulation were assessed at baseline; children also provided ratings of peer victimization annually over a 2-year period. Results indicated that the effectiveness of particular coping strategies may depend on children's overt, undercontrolled displays of anger and sadness. Consistent with recent recommendations, these findings suggest that some youth may require interventions that focus on both enhancing emotion regulation skills and teaching strategies for responding to peer victimization in a more adaptive manner.

Motor proficiency as a correlate of coping in late adult lifespan. An exploratory study

ABSTRACT Background and Objectives A body of studies suggests that coping resources may represent a protective factor against functional and cognitive losses associated with advanced ageing. This study intended to examine the contributions of global cognition, functional mobility, and muscular strength on self-reported coping strategies in late adulthood. Methods One hundred and thirty-seven community-based older individuals (Mage = 77.2 years, SD = 5.8 years, age range: 63–92 years), 48 males and 89 females with and without signs of cognitive decline completed a battery of tools assessing global cognitive function, problem-focused coping, muscular strength (assessed by handgrip strength, HGS) and functional mobility (assessed using the instrumented Timed-Up-and-Go test). Results Significant associations were found between problem-focused coping, global cognitive function, HGS, functional mobility parameters, age, and education. Moreover, when the effects of education and gender were controlled for, HGS, functional mobility, and global cognitive function scores accounted for 44% of the variance in coping. Conclusions In clinical practice, the use of functional mobility and muscular strength measures to screen the physical health of older individuals should be encouraged.

Targeting Coping to Improve Surgical Outcomes in Pediatric Patients With Median Arcuate Ligament Syndrome: Feasibility Study.

Background: Median arcuate ligament syndrome (MALS) is a vascular compression syndrome leading to postprandial epigastric pain, nausea, and weight loss; it can be treated surgically. While most patients report improved quality of life following surgical intervention, 30% continue to experience chronic abdominal pain. Pre-surgical diagnoses of depression and/or anxiety have been found to significantly predict post-surgical: quality of life, highest experience of pain, anxiety, and parent- and self-reported coping strategies. As such, increasing the coping strategies of pediatric patients with MALS may impact their post-surgical outcomes. The purpose of the current study was to: (1) implement a pre-operative cognitive behavioral therapy protocol with a focus on psychoeducation and coping strategies; and (2) determine feasibility of a pre-surgical intervention for this population.Method: Children (<18 years of age) with a diagnosis of MALS who were eligible for surgical intervention were invited to participate in a 7-week in-person or video-based pre-surgical cognitive behavioral therapy intervention. Psychiatric comorbidities were assessed at baseline and post-surgery; patient-reported distress, pain interference and intensity, health-related quality of life, and health status were assessed at four time points (baseline, week 4, week 7, and post-surgery). Descriptive analyses were used to characterize the sample, assess feasibility outcomes (i.e., attrition rates), and explore symptom-based outcomes across time.Results: Twelve pediatric patients (M age = 15.2 ± 1.7; 91.7% female) and their parents (91.7% mothers) participated. Feasibility metrics based on protocol completion were exceeded for engagement at the stages of consent (68.4% vs. goal of ≥50%), treatment initiation (92.3% vs. 85%), and treatment completion (84.6% vs. 75%). Out of the 12 participants, nine (75%) met criteria for at least one comorbid psychiatric diagnosis at baseline and nine (75%) elected to undergo MALS surgery after completing the intervention.Conclusion: The intervention implementation was feasible, despite chronic pain symptoms experienced by the sample, a high prevalence of psychiatric diagnoses, and an international pandemic, suggesting that it would be beneficial to further evaluate the efficacy of the intervention. Future research should include stakeholder input in the design, deployment, and evaluation of a pilot efficacy trial of pre-surgical cognitive behavioral therapy for pediatric patients with MALS.

Supporting dentists' health and wellbeing - a qualitative study of coping strategies in 'normal times'.

Background Research has highlighted multiple determinants of dentists' health and wellbeing, and has raised concerns over workforce morale and retention. Limited research has been undertaken on possible solutions. Thus, the aim was to explore the coping strategies used or advocated by dentists to protect and support their health and wellbeing.Methods This qualitative study involved a purposive sample of dentists working in England taking account of age, gender, career stage, work sector, geographical area, position and route of entry to registration. Dentists were approached via gatekeepers across England to participate in semi-structured interviews. A topic guide, informed by past research, was used to guide the discourse. Informants' views were audio-recorded and field notes were made. Data were transcribed and analysed using an interpretative phenomenological approach to generate theory with the support of the framework methodology.Results Twenty dentists were interviewed from a range of backgrounds. Self-reported coping strategies included a range of strategies for 'taking control', including 'embracing self-care' and 'seeking professional support', while drawing on 'supportive personal and social networks'. Managing professional careers included diversifying through greater 'mixing' of NHS with private work, privatising, specialising, or combining dentistry with another role. Strengthening job security and facilitating diversity of experience remain important for supporting the health and wellbeing of dentists. Selling practices or, in the extreme, completely leaving the profession were considered practical options. At organisational level, building sustainable teams and transforming culture were advocated as important; while at systems level, reforming the NHS and bridging the gap between the profession and regulatory body were considered vital. Additionally, the need for strong professional leadership and wider societal debate was advocated as part of a whole systems approach to enable job satisfaction in delivering high-quality, patient-centred, evidence-based care in future.Conclusion While dentists demonstrated a range of coping mechanisms, multi-level action was advocated to enhance the health, wellbeing and retention of dentists. Systems reform at macro- and meso-levels is urgently advocated to enable fulfilling careers within dentistry, particularly for those at the front line of primary dental care in the public sector. Personal resilience alone will not suffice and recommendations for action are explored to avert a public health catastrophe. This is a time for reflection, debate and action.

Teachers' Mental Health and Self-Reported Coping Strategies During the COVID-19 Pandemic in Ecuador: A Mixed-Methods Study.

PurposeThis study assessed the psychological distress, life satisfaction, and perceived stress of Ecuadorian teachers who adopted online learning in response to the COVID-19 pandemic. It also aimed to qualitatively report the coping strategies used to maintain their mental health and well-being.MethodsA web-based cross-sectional survey was conducted from June to mid-August 2020.ResultsIn total, 394 teachers completed the questionnaire, and from those, 320 also completed an optional open-ended question included in the survey. More than half of the participants reported taking care of children under 11 years and/or adults over 65 years. At the time of the study, most of the participants were teaching in higher education settings. Age was significantly correlated with all the psychological variables, females presented higher levels of perceived stress, and teachers with home care responsibilities presented higher psychological distress as well as perceived stress. Teachers who had previous training and experience with online teaching presented lower levels of distress, perceived stress as well as higher levels of life satisfaction. The most used coping strategies included seeking social support, exercising, and engaging in leisure activities.ConclusionThe results provide useful information to help develop initiatives that promote teacher well-being. Future studies should consider using a more diverse sample and dedicate attention to work-family conflicts as well as social and structural inequalities that may have a toll on teachers’ mental health and performance.

Household Food Insecurity and Dietary Diversity Among Kenyan Households During the COVID-19 Pandemic

ObjectivesThis study compares 1) household food insecurity and 2) household dietary diversity before and during the COVID-19 pandemic, and 3) examines self-reported coping strategies among three communities around Lake Victoria, Kenya.MethodsWe conducted in-person home interviews with 90 randomly selected households in March 2020 prior to the first reported case of COVID-19 in Kenya and followed up with 88 of these same households by phone in June 2020 during COVID-19. We assessed household foodinsecurity status using the Household Food Insecurity Access Scale (HFIAS) and assessed dietary diversity using the Household Dietary Diversity Score. We compared differences in household food insecurity scores and prevalence across time using the paired T-test and McNemar's test, respectively. We compared household dietary diversity scores and the proportion of households consuming each food group across time using the Wilcoxon signed rank test and McNemar's test for paired samples, respectively.ResultsThe prevalence of severe food insecurity increased from 82% before COVID-19 to 91% during COVID-19 (P = 0.03) and household dietary diversity scores fell from 9.5 ± 1.5 to 8.6 ± 1.5 (P < 0.001). Households coped by reducing their food intake at mealtimes, borrowing money from family and friends, and purchasing food on credit.ConclusionsThese findings demonstrate a high and growing level of vulnerability faced by these communities. Strategies to address food insecurity and access to diverse foods during the COVID-19 pandemic are urgently needed.Funding SourcesCornell Atkinson Center for Sustainability

Coping with the transition to remote instruction: Patterns of self-regulated engagement in a large post-secondary biology course

The COVID-19 disruption presented considerable challenges for university students, requiring the sudden need for increased engagement in remote learning environments and the ability to cope with academic and familial demands. To examine how students self-regulated their learning during the disruption, we surveyed undergraduates (n = 226) enrolled in four sections of a large biology course once during the first week of the semester, immediately after the disruption, and through the end of the semester. The results indicated significant decreases in student motivation, increases in students’ perceived costs, and quadratic changes in self-reported coping strategies and mental depletion during disrupted learning. In a final model, students’ self-efficacy and perceptions of cost, as well as feelings of anger and personal responsibility for family combined to form a parsimonious set of predictors that explained variance in course performance.

Efficacy of a Brief, Peer-Delivered Self-management Intervention for Patients With Rare Chronic Diseases

Patients coping with rare diseases need psychosocial support. To evaluate the efficacy of a brief, transdiagnostic, peer-delivered intervention for patients with rare diseases in addition to care as usual (CAU) compared with CAU only. In this 2-group randomized clinical trial conducted from October 5, 2017, to July 12, 2019, patients were recruited via specialized clinics and patient organizations across Germany and participated from home. The study included consecutive adult patients with neurofibromatosis type 1, Marfan syndrome, primary sclerosing cholangitis, and pulmonary arterial hypertension who have limited functionality because of the disease. Exclusion criteria were a life-threatening health status and ongoing psychotherapeutic treatment. Of 143 patients screened for eligibility with a semistructured telephone interview, 54 were excluded, and 89 were randomized: 45 patients were randomly allocated to the peer-delivered intervention group, and 44 to the control group; 87 patients (98%) completed the 6-month follow-up assessment. The analysis was performed using an intention-to-treat principle. Data cleansing and analysis were conducted between April 25, 2019, and February 13, 2020. The 6-week intervention consisted of a self-help book and telephone-based peer counseling in addition to CAU. The control group received CAU alone. Peer counselors received training, structured consultation guidelines, and supervision. The primary outcome was acceptance of the disease as assessed using the Illness Cognition Questionnaire (ICQ; mean sum scores range from 0 to 18, with higher values representing more acceptance) 6 months after the intervention. Secondary outcomes included self-reported coping strategies (Health Education Impact Questionnaire), illness cognition (ICQ and Illness Perception Questionnaire), depression severity (Patient Health Questionnaire 9-item depression scale), anxiety severity (Generalized Anxiety Disorder Scale), quality of life (12-Item Short-Form Health Survey), and social support (Social Support Questionnaire). Outcomes were assessed before the intervention, after the intervention, and at a 6-month follow-up. The mean (SD) age of the 89 participating patients was 46.3 (14.9) years; 59 (66%) were women. There were no group differences regarding baseline variables. All patients allocated to the intervention group completed the intervention. Six months after the intervention, but not directly after completing the program, the intervention group had significantly higher rates of acceptance (ICQ) of the disease (primary outcome) compared with the CAU group. Mean (SD) baseline ICQ scores were 9.61 (3.79) in the control group and 9.86 (3.40) in the intervention group. Mean (SE) ICQ scores at 6 months were 10.32 (0.42) for the control group and 11.79 (0.42) for the intervention group, with a significant mean difference of -1.47 (95% CI, -2.63 to -0.31; P = .01). Several secondary outcomes, including different coping strategies, social support, and mental quality of life, were significantly higher after the intervention compared with the control group. In this randomized clinical trial, a self-help and peer counseling intervention improved patients' acceptance of their rare chronic diseases. Self-management and peer support can efficiently address the unique care needs of patients with rare diseases. isrctn.org Identifier: ISRCTN13738704.

Coping, Resilience, and Perceived Stress in Individuals with Internet Gaming Disorder in Taiwan.

Aim: Gaming escapism is an essential factor for developing internet gaming disorder (IGD). We evaluated coping strategies, resilience, stress, and depression in individuals with IGD. Methods: We included 69 participants with IGD and 138 controls (69 regular gamers and other non-gamers) in Taiwan. The self-reported coping strategies, coping stress with gaming, resilience, perceived stress, and depression were assessed. Results: Participants with IGD had higher dysfunctional coping, coping stress by gaming, perceived stress, and depression, as well as lower problem-focused coping and resilience. Regression analysis revealed that coping by gaming was associated with dysfunctional coping mechanisms, particularly venting and self-distraction. Compared with participants with adequate resilience, those with lower resilience had higher perceived stress, depression, and coping by gaming, and lower problem-focused and emotion-focused coping. Dysfunctional coping and coping by gaming were associated with perceived stress and depression in both IGD and control groups. Problem-focused coping was negatively associated with perceived stress and depression in controls. Conclusion: Individuals with IGD had higher perceived stress and depression, as they were more likely to cope with stress by dysfunctional coping and gaming and less likely to try problem-focused coping, particularly those with lower resilience. Interventions for IGD should promote problem-focused coping, such as active coping and planning strategies, particularly among those with lower resilience.

Adult Age Differences in Coping Strategies After the 2016 Flood

The 2005 Hurricanes Katrina and Rita had a devastating impact on south Louisiana, as did the more recent flooding in 2016. Multiple disaster exposures are associated with distress which may be lessened through adaptive coping behaviors, although prior disaster losses may affect current coping responses. In this study, we assessed self-reported coping strategies, resilience, and mental health outcomes after the 2016 flood. The sample was comprised of mostly middle-aged and older adults (N = 223, age range: 18-89 years). Three groups were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in 2016, and (3) twice-flooded adults who had relocated to Baton Rouge because of catastrophic losses in Hurricanes Katrina and Rita and they experienced damage in the 2016 flood. Analyses of variance confirmed that the three groups differed in coping responses, with non-flooded controls using significantly fewer strategies than their once and twice flooded counterparts. Correlation analyses demonstrated that age was positively associated with adaptive forms of coping (acceptance, religiosity) and negatively correlated with maladaptive coping (self-blame). These data suggest that awareness of prior severe weather experiences and catastrophic losses, which are likely for older adults living in hurricane prone areas, are an important consideration for disaster planning and the development of age-sensitive interventions to mitigate adversity.

Financial Toxicity Following Surgical Treatment for Breast Cancer: A Cross-sectional Pilot Study.

Despite growing national attention, there is limited understanding of the patient- and treatment-level characteristics related to treatment cost-associated distress ("financial toxicity") in breast cancer patients. Our aim is to identify risk factors for financial toxicity amongst breast cancer patients undergoing surgical treatment. This is a single-institution cross-sectional survey of adult female breast cancer patients who underwent lumpectomy or mastectomy between January 2018 and June 2019. Financial toxicity was measured via the 11-item comprehensive score for financial toxicity (COST) instrument. Responses were linked with data on patient demographics and clinical history abstracted from the corresponding medical record. Multivariate regression was used to identify patient- and treatment-level factors associated with worsening financial toxicity. Secondary outcome measures included self-reported coping strategies for high treatment costs. A total of 571 patients were included; overall, these individuals were mostly white (76.0%), in-state residents (72.3%), and married (73.0%). Following multivariate analysis, lower financial distress was associated with the use of supplemental insurance, increasing annual household income, and a higher credit score (score > 740). Conversely, work reduction or cessation, increased out-of-pocket spending, advanced tumor stage, and being employed at the time of diagnosis were associated with increased financial distress. Patients with higher reported financial distress were more likely to decrease their spending on food, clothing, and leisure activities. Financial toxicity was associated with baseline demographic, disease, and treatment characteristics in our cohort of insured patients. These characteristics may be critical opportunities for interventions related to financial navigation along the treatment continuum.

Personality and coping in life challenge narratives

BackgroundSelf-reported personality traits are known to correlate with self-reported coping strategies. However, these correlations may be inflated by common method variance. The current study examined personality traits and coping strategies in autobiographical narratives. MethodIn open-ended interviews, 122 late-midlife participants described their single greatest life challenge. Participants’ responses were content coded for various coping strategies. We examined correlations between narrated coping strategies and self-reported personality traits assessed by the NEO-Five Factor Inventory. ResultsExtraversion was associated with narrated engagement coping. Neuroticism was associated with narrated disengagement coping. A trend suggested that conscientiousness was negatively associated with narrated disengagement coping. Surprisingly, openness was negatively associated with narrated problem-solving. ConclusionsThe current study replicates and extends the personality and coping literature into the domain of life narrative. Associations between extraversion, neuroticism, and coping styles appear to be robust outside the context of self-report coping questionnaires.

Dive into the Hunger Pool: Exploring Students' Self-reported Challenges, Coping Strategies, and Recommendations Related to Food Insecurity at the University of Kentucky

Dive into the Hunger Pool: Exploring Students' Self-reported Challenges, Coping Strategies, and Recommendations Related to Food Insecurity at the University of Kentucky