Use Of Engagement Coping Strategies Research Articles

Stress and well-being in autistic adults: Exploring the moderating role of coping.

The wider stress literature points to negative associations between stress and well-being. Similarly, the use of engagement coping strategies and disengagement coping strategies in the face of stress are related to improved and reduced well-being respectively. However, in the autistic population stress and coping research is limited to date, and the extent to which coping may moderate the relationship between stress and well-being is not known. Using data from an Australian online study, we explored the potential moderating (i.e. buffering or exacerbating) role of coping in the relationship between stress and well-being in a sample of autistic adults (N = 86). Our findings indicated that increased stress was associated with lower well-being. Further, moderation analyses showed that while both engagement coping (e.g. problem solving, positive appraisal) and disengagement coping (e.g., self-distraction, being in denial) strategies had significant positive and negative direct effects on well-being respectively; engagement coping also moderated the relationship between stress and well-being, buffering the impact of stress on well-being. Our results illustrate the different underlying mechanisms by which coping strategies may be associated with stress and well-being. They also highlight the potential protective role of engagement coping strategies, which can be incorporated into the promotion and maintenance of well-being in autistic adults.

640-P: Coping Strategies, Quality of Life, and Glycemic Control among Adolescents with Diabetes Distress

Objective: Up to half of adolescents with type 1 diabetes (T1D) experience diabetes distress (DD) which has been associated with lower health-related quality of life (HRQOL) and suboptimal glycemic control. The ways in which adolescents respond to DD may serve as a risk or protective factor for these outcomes, but few studies have examined the coping strategies adolescents use to manage DD. Methods: Participants included 198 adolescents with elevated DD who completed baseline data for a randomized controlled trial (Mage 15.3±1.4, 58% female, 58% Non-Hispanic White, MT1D duration 6.4±3.7 years, MA1c = 9.2±2.2%). Adolescents completed the Responses to Stress Questionnaire, assessing coping strategies related to diabetes stressors. Subscales include primary control engagement coping (e.g., problem solving), secondary control engagement coping (e.g., positive thinking), and disengagement coping (e.g., avoidance). Adolescents also completed the Type 1 Diabetes and Life (T1DAL) measure of HRQOL. HbA1c data were gathered from medical records or at-home kits. The association of coping strategies with HRQOL and HbA1c was examined among adolescents experiencing DD. Results: Bivariate correlations revealed that higher use of primary and secondary engagement coping strategies was associated with higher HRQOL (r=0.58; r=0.58, respectively), while higher use of disengagement coping strategies was associated with lower HRQOL (r=−0.51). Higher use of primary engagement coping strategies was associated with lower HbA1c (r=−0.21) while higher use of disengagement strategies was associated with higher HbA1c (r=0.17); all p<0.05. Discussion: Among a diverse group of adolescents experiencing DD, the use of engagement coping strategies was significantly correlated with higher HRQOL and lower HbA1c. These results highlight the value in promoting engagement coping strategies and discouraging the use of disengagement coping strategies among adolescents experiencing DD. Disclosure E.Straton: None. H.Inverso: None. R.Streisand: None. S.S.Jaser: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK121316)

Various types of stress and greater use of disengagement coping are associated with worse sleep disturbance in oncology patients undergoing chemotherapy.

Various types of stress and the choice of coping strategies may be risk factors for higher levels of sleep disturbance in oncology patients. Purposes were to evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and the use of coping strategies among three subgroups of patients with distinct sleep disturbance profiles (i.e., Low, High, Very High). Oncology outpatients (n=1331) completed measures of global (Perceived Stress Scale), cancer-specific (Impact of Event Scale-Revised), and cumulative life (Life Stressor Checklist-Revised) stress, resilience (Connor-Davidson Resilience Scale) and coping (Brief Cope) prior to their second or third cycle of chemotherapy. Sleep disturbance was assessed six times over two chemotherapy cycles. Differences were evaluated using parametric and non-parametric tests. All stress measures showed a dose response effect (i.e., as the sleep disturbance profile worsened, levels of all types of stress increased). Compared to Low class, the other two classes reported higher levels of global perceived stress and higher occurrence rates and effect from previous stressful life events. Impact of Event Scale-Revised scores for the Very High class indicated post-traumatic symptomatology. Patients in High and Very High classes had resilience scores below the normative score for the United States population and used a higher number of disengagement coping strategies. Our findings suggest that very high levels of sleep disturbance are associated with higher levels of various types of stress, lower levels of resilience, and higher use of disengagement coping strategies. Clinicians need to perform routine assessments and implement symptom management interventions to reduce stress and encourage the use of engagement coping strategies.

Higher Stress in Oncology Patients is Associated With Cognitive and Evening Physical Fatigue Severity.

Cognitive and physical fatigue are common symptoms experienced by oncology patients. Exposure to stressful life events (SLE), cancer-related stressors, coping styles, and levels of resilience may influence the severity of both dimensions of fatigue. Evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and coping in oncology patients (n=1332) with distinct cognitive fatigue AND evening physical fatigue profiles. Latent profile analysis, which combined the two symptom scores, identified three subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles (i.e., Low, Moderate, High). Patients completed measures of global, cancer-specific, and cumulative life stress as well measures of resilience and coping. Differences among the latent classes in the various measures were evaluated using parametric and nonparametric tests. Compared to Low class, the other two classes reported higher global and cancer-specific stress. In addition, they reported higher occurrence rates for sexual harassment and being forced to touch prior to 16 years of age. Compared to the other two classes, High class reported lower resilience scores and higher use of denial, substance use, and behavioral disengagement. To decrease both cognitive and evening physical fatigue, clinicians need to assess for relevant stressors and initiate interventions to increase resilience and the use of engagement coping strategies. Additional research is warranted on the relative contribution of various social determinants of health to both cognitive and physical fatigue in oncology patients receiving chemotherapy.

Youth coping and cardiac autonomic functioning: Implications for social and academic adjustment.

Extending literature on youth coping and stress physiology, this two-wave longitudinal study examined independent and interactive roles of youth coping with daily stressors (i.e., peer, academic) and cardiac autonomic functioning in subsequent social and academic adjustment across the transition to middle school. Our sample consisted of 100 typically developing youth (10-12years old at Time 1, 53 boys, 43% ethnic minorities) who reported on their coping strategies in response to peer and academic stress. Youth participated in laboratory tasks (i.e., baseline, mother-youth conversations about youth's actual peer and academic challenges) during which sympathetic and parasympathetic activities were recorded, and cardiac autonomic functioning indicators were derived. Youth, mothers, and teachers reported on various aspects of youths' social and academic adjustment at Times 1 and 2. Results revealed that, for both peer and academic domains, greater use of engagement coping strategies was prospectively linked with better adjustment 7months later, but only among youth who exhibited higher (greater sympathetic-parasympathetic coactivation) but not lower (limited coactivation, or coinhibition) cardiac autonomic regulation at baseline. Findings suggest that a match between more engagement coping behaviors and greater cardiac autonomic capacity to coactivate the parasympathetic and sympathetic branches is linked with better social and academic adjustment.

Associations between coping strategies and mental health outcomes in autistic adults.

Compared to the general population, mental health difficulties are commonly reported in autistic adults. However, the ways in which coping strategies are associated with mental health and well-being in this population remain unknown. Further, we do not know if, and if so, how these associations might differ to that of non-autistic adults. In this study, we hypothesized that in both our autistic (N=255) and non-autistic (N=165) adult samples, disengagement coping strategies (e.g., denial) would relate to poorer mental health and well-being, while engagement coping strategies (e.g., problem solving) would relate to better mental health and well-being. Regression analyses revealed that higher use of disengagement coping strategies was significantly associated with higher levels of anxiety and depression, and lower levels of well-being in both samples. In contrast, increased use of engagement coping strategies was associated with better well-being, but only in the autistic sample. Our results contribute to the characterization of negative and positive mental health outcomes in autistic adults from a coping perspective, with potential to offer novel information regarding coping strategies to consider when addressing support options for mental health difficulties in the autistic adult population. LAY SUMMARY: Mental health conditions (such as anxiety and depression) and poor well-being are commonly reported in autistic adults. Research suggests that how one copes with stress is associated with one's mental health and well-being. However, we have little information about how coping strategies relate to the mental health of autistic adults, and whether this might be different in non-autistic adults. In this study, we examined the relationship between coping strategies and mental health in a large group of autistic individuals aged 15-80 years. We then compared this with similar aged non-autistic individuals. We found that in both the autistic and non-autistic individuals, using more disengagement coping strategies (such as being in denial, blaming oneself) was related to poorer mental health and well-being. Additionally, using more engagement coping strategies (such as problem solving, acceptance) was related to better mental health and well-being, but only in the autistic individuals. These results can help inform support services, as they highlight the coping strategies that may need to be focused on (i.e., developing engagement coping strategies and reducing disengagement coping strategies) in order to better support the mental health of autistic individuals.

Responses to academic stress mediate the association between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents

Objective: Sleep difficulties are pervasive in Chinese adolescents, which exert aversive influence on their emotional health. However, the underlying mechanisms of this effect remain unclear. This study addressed whether stress responses mediate the concurrent and prospective relationship between sleep difficulties and depressive/anxiety symptoms in Chinese adolescents. Method: 17,946 adolescents (14–18 years-old) were administrated the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised Children's Manifest Anxiety Scale and the Responses to Stress Questionnaire. Further, 710 of them finished the one-year follow-up assessments. Structural equation models were conducted to determine the concurrent and prospective mediation effects of stress responses and the moderated effect of gender and age. Results: Involuntary engagement and disengagement responses, as well as engagement coping, significantly mediated the cross-sectional relationship between sleep difficulties and depressive/anxiety symptoms. Moreover, sleep difficulties at baseline predicted enhanced involuntary engagement responses but reduced the use of engagement coping strategies one year later, resulting in an elevated level of depressive/anxiety symptoms. Finally, females and younger adolescents with greater sleep difficulties were more likely to generate maladaptive stress responses. Limitations: First, sleep difficulties were only measured using self-reported approaches. Second, potential confounding variables (e.g., socioeconomic status) were not adjusted for. Third, our study only focused on typically-developing youth samples rather than clinical samples. Conclusions: Our findings highlight the important role of stress responses in the relationship between sleep difficulties and depressive/anxiety symptoms. The findings might also shed some light on the psychological intervention of sleep difficulties and mood disorder in adolescent populations.

College students coping with interpersonal stress: Examining a control-based model of coping

ABSTRACTObjective: The ways that college students cope with stress, particularly interpersonal stress, may be a critical factor in determining which students are at risk for impairing mental health disorders. Using a control-based model of coping, the present study examined associations between interpersonal stress, coping strategies, and symptoms. Participants: A total of 135 undergraduate students from 2 universities. Methods: Interpersonal stress, coping strategies, depression, anxiety, and somatization were assessed via self-report. Results: Students reporting more interpersonal stress reported more depression, anxiety, and somatization, and they reported less use of engagement coping strategies and greater use of disengagement coping strategies. Engagement coping strategies accounted for a significant portion of the association between interpersonal stress and mental health symptoms. Unexpectedly, coping strategies did not moderate the association between stress and mental health symptoms. Conclusion: Interventions designed to improve students' coping strategies may be an effective way to reduce mental health problems on college campuses.

Motivation and coping with the stress of assessment: Gender differences in outcomes for university students

The main objectives of the present research were to test a conceptual model linking motivational processes involved in coping with the stress of university assessment, and to examine gender differences in these processes. Self-determined motivation was hypothesized to predict coping strategies and the response to assessment-related stress, and coping was hypothesized to play a considerable role in short- and long-term outcomes of assessment. We examined this model using multiple group path analysis. In Study 1 (N=265), music students’ use of engagement-coping strategies led to stronger musical career intentions, while disengagement-coping strategies led to weaker intentions. In Study 2 (N=340), students’ increased use of engagement coping, and decreased use of disengagement coping strategies led to higher grades, higher positive affect and lower negative affect. In both studies, engagement and disengagement-coping were predicted by autonomous and controlled motivation, respectively. Motivation also indirectly predicted academic outcomes through stress appraisal and coping. While women experienced higher levels of stress, men were more negatively affected by the use of disengagement-oriented coping. Gender differences were also found on the links between engagement-oriented coping and outcomes. These results fill an important gap in the literature regarding gender differences in the outcomes coping in education, as well as contributing to a better understanding of the processes linking motivation, coping and academic outcomes.

The role of trait emotional intelligence in academic performance during the university transition: An integrative model of mediation via social support, coping, and adjustment

The authors propose conceptual models linking trait emotional intelligence (TEI) with achievement both directly and indirectly via perceived social support (PSS), engagement coping (EC), and adjustment, in the context of the university transition. The models were tested in a multiwave design with a sample of incoming Australian undergraduates (N=470). In structural equation analyses, TEI was found to be a direct predictor of higher PSS and the greater use of EC strategies. Further, mediation analyses revealed that TEI was indirectly associated with academic adjustment via EC and psychological adjustment via EC and PSS operating in parallel. TEI was also found to be indirectly associated with achievement via EC and academic adjustment linked serially in a three-path mediated sequence. These direct and indirect relations were robust when controlling for known confounding influences. The empirically supported mediating processes extend the literature by elucidating some of the pathways through which TEI is linked with better adjustment and achievement.

Communication avoidance, coping and psychological distress of women with breast cancer.

This study examined the relationship between communication avoidance of cancer-related topics with psychological distress, and the mediating role of coping strategies, in women with breast cancer. Women diagnosed with breast cancer (N = 338) completed an online survey including measures of self- and perceived-partner communication avoidance, psychological distress (depression, anxiety and stress), and coping strategies. Linear regression analyses indicated that women's and perceived-partner's communication avoidance was associated with anxiety, depression, and stress in the cancer-affected women. Bootstrapping analyses showed significant mediation effects of self- and perceived-partner communication avoidance on all distress outcomes through greater disengagement coping, and on anxiety through lower engagement coping. Emotionally valenced topics (i.e., disease progression and sexuality) were most avoided and practical issues were least avoided. Enhancing couple communication about cancer and women's adaptive coping skills (i.e., discourage use of disengagement coping strategies and promote use of engagement coping strategies) may be important targets for psychosocial intervention.

Functional neuroimaging of working memory in survivors of childhood brain tumors and healthy children: Associations with coping and psychosocial outcomes

Purpose: Pediatric brain tumors are the second most common cancer diagnosis in individuals under age 20 and research has documented significant neurocognitive, psychosocial, and emotional late effects. Associations among these deficits have not been adequately considered and the role of survivors’ coping with stress in relation to deficits is unknown. Further, research has yet to examine neurobiological processes related to neurocognitive, psychosocial, and emotional difficulties in survivors through the use of functional neuroimaging. Method: Questionnaire measures and functional neuroimaging were used to examine the neurocognitive, psychosocial, and emotional functioning and coping responses of survivors of pediatric brain tumors (N = 17; age 8–16) and healthy children (N = 15). Results: Survivors experienced elevated levels of psychosocial and behavioral/emotional difficulties relative to healthy controls and normative data. Increases in brain activation in prefrontal and other anterior regions in response to a working memory task were associated with better psychosocial functioning, use of engagement coping strategies, and less use of disengagement coping strategies. Regression analyses suggest coping accounts for a significant portion of the association between brain activation and behavioral/emotional functioning. Conclusions: This study extends late-effects research by examining neurobiological processes associated with psychosocial and emotional difficulties. These findings contribute to our understanding of difficulties in survivors and provide a foundation for research exploring these associations and mediators of deficits in future longitudinal studies.

Asian Americans’ adherence to Asian values, attributions about depression, and coping strategies.

Using Brickman et al.'s (1982) theoretical framework of responsibility attributions, the authors examined the relationships among adherence to Asian values, attributions about the cause of and solution to depression, and preferred coping strategies in a nonclinical sample of Asian Americans. Results of a path analysis (N = 238) indicate that attribution of cause fully mediated the relations between adherence to Asian values and use of coping strategies. Adherence to Asian values was positively related to attributing the cause of depression to internal factors, which was in turn associated with greater use of disengagement coping strategies and decreased use of engagement coping strategies. In addition, an internal attribution for the solution to depressive symptoms was related to more reliance on engagement coping strategies and a lower use of disengagement coping strategies. Practical implications of the results are discussed.

Psychologic distress among spouses of patients undergoing cardiac rehabilitation

The goal of this study was to identify common sources of distress in spouses of patients undergoing cardiac rehabilitation and to compare spouses classified as being in distress and those classified as nondistressed on demographic variables, their experiences of stress, coping strategies employed, marital intimacy, and level of family functioning. The study aimed to describe the needs of spouses with respect to possible interventions. A cross-sectional analysis was used. The study was located at the University of Ottawa Heart Institute Prevention and Rehabilitation Centre's cardiac rehabilitation program. Scores on the Brief Symptom Inventory, Heart Disease Hassles Scale, Coping Strategies Inventory, Miller Intimacy Scale, and McMaster Family Assessment Device were used as outcome measures. Two hundred thirteen female spouses of patients undergoing cardiac rehabilitation participated in this study. Sixty-six percent of the spouses met the criteria for distress. This was more common in younger spouses (51.99 +/- 9.94 years) than in older spouses (55. 74 +/- 10.54 years) (t = -2.45; P =.013). Distressed spouses used disengagement coping strategies significantly more than the nondistressed spouses (t = 6.91; P =.0001). Distressed spouses also reported significantly less intimacy in their marriages (t = -3.99; P =.0001) and poorer family functioning (t = 5.86; P =.0001). The most prevalent symptoms of psychologic distress included feeling tense, having trouble falling asleep and feeling easily hurt. The most prevalent stressors were as follows: (1) worries about treatment, recovery, and prognosis (75.5%); (2) moodiness of the patient (66.7%); (3) worries about the patient returning to work and about money (38.8%); (4) sexual concerns (36.7%); and (5) helplessness or apathy on the part of the patient and increased spousal responsibility (36.1%). Spouses of patients undergoing cardiac rehabilitation should be screened for psychologic distress, and those in distress should be offered interventions focused on assisting them to deal with specific stressors related to their experience with a spouse with heart disease. Interventions indicated include stress-management techniques and encouraging the use of engagement coping strategies. In addition, marital and family concerns need to be directly addressed in support interventions.

Psychologic distress among spouses of patients undergoing cardiac rehabilitation

OBJECTIVE: The goal of this study was to identify common sources of distress in spouses of patients undergoing cardiac rehabilitation and to compare spouses classified as being in distress and those classified as nondistressed on demographic variables, their experiences of stress, coping strategies employed, marital intimacy, and level of family functioning. The study aimed to describe the needs of spouses with respect to possible interventions.DESIGN: A cross-sectional analysis was used.SETTING: The study was located at the University of Ottawa Heart Institute Prevention and Rehabilitation Centre's cardiac rehabilitation program.OUTCOME MEASURES: Scores on the Brief Symptom Inventory, Heart Disease Hassles Scale, Coping Strategies Inventory, Miller Intimacy Scale, and McMaster Family Assessment Device were used as outcome measures.RESULTS: Two hundred thirteen female spouses of patients undergoing cardiac rehabilitation participated in this study. Sixty-six percent of the spouses met the criteria for distress. This was more common in younger spouses (51.99 ± 9.94 years) than in older spouses (55.74 ± 10.54 years) (t = −2.45; P = .013). Distressed spouses used disengagement coping strategies significantly more than the nondistressed spouses (t = 6.91; P = .0001). Distressed spouses also reported significantly less intimacy in their marriages (t = −3.99; P = .0001) and poorer family functioning (t = 5.86; P = .0001). The most prevalent symptoms of psychologic distress included feeling tense, having trouble falling asleep and feeling easily hurt. The most prevalent stressors were as follows: (1) worries about treatment, recovery, and prognosis (75.5%); (2) moodiness of the patient (66.7%); (3) worries about the patient returning to work and about money (38.8%); (4) sexual concerns (36.7%); and (5) helplessness or apathy on the part of the patient and increased spousal responsibility (36.1%).CONCLUSIONS: Spouses of patients undergoing cardiac rehabilitation should be screened for psychologic distress, and those in distress should be offered interventions focused on assisting them to deal with specific stressors related to their experience with a spouse with heart disease. Interventions indicated include stress-management techniques and encouraging the use of engagement coping strategies. In addition, marital and family concerns need to be directly addressed in support interventions.