Use Of Maladaptive Coping Strategies Research Articles

Relationship of caregiver burden with coping strategies, social support, psychological morbidity, and quality of life in the caregivers of schizophrenia

AimTo evaluate the relationship of caregiver burden as assessed by using Hindi Involvement Evaluation Questionnaire (IEQ) with coping strategies, social support, psychological morbidity, and quality of life of caregivers of patients with schizophrenia. Additionally, the relationship of caregiver-burden with sociodemographic variables, and clinical variables, including severity of psychopathology and level of functioning of patients, was studied. MethodologyThe study included 100 patients with schizophrenia and their caregivers recruited by purposive random sampling. ResultsAmong the four domains of IEQ, highest number of correlations emerged with tension domain. Tension domain had positive correlation with the caregiver being single, time spent in caregiving per day, and use of avoidance, collusion, and coercion as coping strategies. Additionally, tension domain was associated with poor quality of life in all the domains of WHO-QOL Bref and was associated with higher psychological morbidity. Worrying urging-I domain of IEQ correlated with frequency of visits, higher use of problem focused coping and poor physical health as per the WHO-QOL Bref. Worrying urging-II domain of IEQ had positive correlation with higher level of positive symptoms, lower level of functioning of the patient, younger age of caregiver, caregiver being unmarried, and higher use problem focused and seeking social support as coping strategies. Supervision domain of IEQ correlated positively with lower income, being an unmarried caregiver, from an urban locality and non-nuclear family. Supervision domain was associated with poor physical health as assessed by WHO-QOL Bref. ConclusionCaregiving burden, especially tension is associated with use of maladaptive coping strategies, poor quality of life and higher level of psychological morbidity in caregivers.

2366 – Booster sessions after cognitive-behavioral group therapy for panic disorder: impact on resilience, coping and quality of life

Panic Disorder (PD) tends to chronicity and one of the risk factors is the use of maladaptive coping strategies to deal with stressful events. To evaluate the response to booster sessions with cognitive techniques of coping strategies on resilience and on quality of life (QoL) of patients who received standard cognitive-behavioral group therapy (CBGT) for PD. A controlled clinical trial with 44 patients with PD (intervention= 20 and control= 24) who previously completed the 12-week CBGT protocol. PD, anxiety, and depression severity symptoms were assessed at baseline and 1, 6 and 12 months after the booster sessions. Coping strategies, resilience and QoL were assessed by Coping Strategies Inventory (CSI), Resilience Scale and WHOQOL-BREF, respectively. Considering the outcome ‘time,’ a significant improvement of PD and depression symptoms was observed in both groups. A significant increase in QoL domain of social relations for the intervention group was found, considering a time*group interaction. There was no significant difference on coping and other QoL domains. Changes on resilience were dependent on the symptoms intensity, and the correlations were negative. The improvement of PD and depression symptoms for both groups may be related to the therapeutic factors of the group sessions format. Therefore, booster sessions with groups after CBGT may benefit patients with PD regardless the use of specific cognitive techniques.

Coping profiles characterize individual flourishing, languishing, and depression

According to the broaden-and-build theory of positive emotions, negative emotions narrow one's thought–action repertoire. In contrast, positive emotions have a broadening effect, expanding cognitive capacity, increasing potential coping strategies that come to mind, and enhancing decision-making, reaction, and adaptation to adversity. Fredrickson and Losada determined that a positivity ratio – the ratio of experienced positive to negative emotions – at or above 2.9 promotes human flourishing. A ratio below 2.9 is indicative of languishing individuals, whereas a ratio below 1.0 is a marker of depression. This study examined whether adaptive and maladaptive coping profiles differentiated those who flourish, languish, or are depressed in two convenience samples – military spouses (n =367) and public school teachers (n=267). Results were consistent with the theoretical predictions, as coping profiles of the groups differed significantly, with flourishing individuals favoring adaptive coping strategies more than those who were languishing or depressed. Conversely, depressed individuals reported greater use of maladaptive coping strategies than those who were languishing or flourishing. These results provide further empirical support for the mathematical model of Fredrickson and Losada, as the set of positivity criteria were predictive of coping profiles in two samples where successful coping and adaptation are important.

Coping mediates the relationship between revised reinforcement sensitivity and alcohol use

This study examined the influence of reward sensitivity (BAS) and threat sensitivity (FFFS) on alcohol use and investigated the mediating role of dispositional coping in this relationship. Specifically, it was proposed that FFFS may exert indirect effects on alcohol use by promoting use of maladaptive coping strategies (e.g. avoidance-focused coping, emotion-focused coping). In contrast, it was expected that BAS would have a direct effect on alcohol use not mediated by coping. The final sample comprised of 337 participants (age, M=26.95, SD=10.61) who completed questionnaire measures of alcohol use, BAS/FFFS, and coping. Path analyses controlling for measurement error (AMOS), revealed significant direct effects of BAS and indirect effects of FFFS on alcohol use. Specifically, the relationship between FFFS and alcohol use was found to be mediated by avoidance-focused coping and emotion-focused coping. It was concluded that the relationship between FFFS and alcohol use can be partly explained by use of maladaptive coping strategies, suggesting that reducing reliance on avoidance-focused, while increasing use of problem-focused and emotion-focused coping may be an effective intervention for individuals with heightened threat sensitivity (i.e. high FFFS).

The associations among coping, nadir CD4+ T-cell count, and non-HIV-related variables with health-related quality of life among an ambulatory HIV-positive patient population

We investigated HRQoL among HIV-positive outpatients from October, 2006-December, 2007, incorporating medical chart review, and a survey of coping styles. Consented HIV-positive patients receiving medical care at University of Colorado Denver, with HAART as first antiretroviral regimen, completed the MOS-HIV and Brief COPE survey instruments. Linear regression identified a priori factors hypothesized to be associated with the MOS-HIV composite mental and physical health scores (MHS, PHS). Brief COPE survey maladaptive and adaptive coping components were added to the models and retained if significant. Among the 157 patient cohort, parsimonious multivariable linear regression models (P < 0.05) indicated higher nadir CD4+ T-cell counts and adaptive coping were associated with a higher MHS; public/no insurance, mental illness, current number of non-HIV medications, and maladaptive coping were inversely associated with MHS. Nadir CD4+ T-cell count and efavirenz use were associated with a higher PHS; mental illness, current number of non-HIV mediations, and maladaptive coping were inversely associated with PHS. Factors independently associated with lower MHS and lower PHS include lower nadir CD4+ T-cell counts, and use of maladaptive coping. Efforts to reduce use of maladaptive coping strategies and earlier identification and treatment of HIV may improve HRQoL in HIV-positive patients.

Coping strategies and social support as predictors and mediators of eating disorder carer burden and psychological distress

Caring for someone with an eating disorder is associated with a high level of burden and psychological distress. While models for the prediction of carer burden have previously been investigated, these have typically neglected the role of coping strategies and social support. Thus, the current study will examine predictors of both carer burden and carer psychological distress in eating disorder carers. Further, the mediating roles of coping strategies and social support will be investigated. Fifty-six carers completed a self-report questionnaire assessing burden, psychological distress, needs, expressed emotion, coping strategies and social support. Use of maladaptive coping strategies was a unique predictor of both burden and psychological distress. Further, maladaptive coping was a consistent mediator on the outcome of carer burden. Social support, however, did not significantly predict, or mediate, carer burden. Interventions focusing on teaching appropriate coping strategies would benefit carers.

Fear and perceived uncontrollability of emotion: Evaluating the unique contribution of emotion appraisal variables to prediction of worry and generalised anxiety disorder

Novel theoretical frameworks place the symptom profile of generalised anxiety disorder (GAD) within the context of dysfunctional emotional processes. It is suggested that fear and intolerance of emotions exacerbate subjective distress and motivate the use of maladaptive coping strategies, such as worry. To date, studies evaluating these models have suffered two key limitations. Firstly, few studies have involved treatment-seeking samples, and secondly, none have evaluated the unique variance attributable to emotion appraisal variables above and beyond previously established predictors of worry and GAD. The present study begins to address these limitations by assessing the contribution of fear and perceived uncontrollability of emotions in predicting worry and clinical GAD status after controlling for variance attributable to depressive symptoms, meta-cognitive beliefs, intolerance of uncertainty, and perceptions of external threat. Supporting current models, results showed that perceived control over emotional reactions was a unique predictor of GAD diagnostic status and both clinical and non-clinical worry.

Psychological Determinants of Health-Related Quality of Life in Patients With Chronic Liver Disease

The negative impact of chronic liver disease on health-related quality of life (HRQoL) of patients with chronic liver disease (CLD) has long been established, and treatable physiological or psychological factors may potentially influence HRQoL.The authors assessed the interrelationships of multiple psychological factors and HRQoL in patients with CLD.Both direct and indirect relationships among HRQoL, depression, anxiety, coping, and self-efficacy in 164 patients with CLD were assessed.Depression, largely determined by low self-efficacy and, possibly, by use of maladaptive coping strategies, influenced HRQoL in three groups of liver patients.HRQoL in CLD patients may be positively affected by enhancing coping and self-efficacy skills, thus improving levels of depression.

Psychological Stress and Self-Reported Functional Gastrointestinal Disorders

Functional gastrointestinal disorders (FGID) are common, but despite their relevance in public health care, the etiology of FGID remains essentially unknown. Stress has been suggested as a pathophysiological factor in FGID. The aims of the present study were (a) to determine the prevalence of FGID in a sample of apparently healthy students, and (b) to determine the association of stress and FGID. The prevalence rates of 21 different FGID were assessed using an internet-based design. Subjective experience of chronic stress, individual coping strategies, and dispositional stress reactivity were measured. A total of 668 subjects provided complete data sets (66% women). About 64.2% reported at least one FGID. Symptoms of FGID were significantly predicted by increased levels of perceived chronic stress, dispositional stress reactivity, and use of maladaptive coping strategies. FGID are common in apparently healthy young individuals. The importance of stress-related factors in individuals suffering from FGID indicates that stress-reducing interventions may be beneficial in these patients.

Psychological Determinants of Health-Related Quality of Life in Patients With Chronic Liver Disease

The negative impact of chronic liver disease on health-related quality of life (HRQoL) of patients with chronic liver disease (CLD) has long been established, and treatable physiological or psychological factors may potentially influence HRQoL. The authors assessed the interrelationships of multiple psychological factors and HRQoL in patients with CLD. Both direct and indirect relationships among HRQoL, depression, anxiety, coping, and self-efficacy in 164 patients with CLD were assessed. Depression, largely determined by low self-efficacy and, possibly, by use of maladaptive coping strategies, influenced HRQoL in three groups of liver patients. HRQoL in CLD patients may be positively affected by enhancing coping and self-efficacy skills, thus improving levels of depression.

Pathways to intrusive memories in a trauma analogue paradigm: a structural equation model

Structural equation modeling was used to develop and test an integrated model of how emotional and cognitive factors contribute to the development of intrusive memories after a distressing event. The emotional constructs included preexisting emotion and emotional reactivity to the distressing event. Cognitive constructs included peritraumatic cognitive processing and maladaptive coping strategies. Using a prospective design, 148 undergraduate students viewed a distressing film and recorded their film-related intrusive memories over the following week. The results indicated that emotional reactivity and, to a lesser extent, preexisting emotion, predicted peritraumatic cognitive processing during the film, which in turn predicted the use of maladaptive coping strategies (i.e., rumination, thought suppression, and safety behaviors). Furthermore, emotional reactivity and maladaptive coping strategies directly predicted intrusive memories. The observed model supported the importance of cognitive variables central to cognitive models, placing them in a broader context.

Perceived stress, coping and night‐eating in college students

AbstractThe present study investigated the role of coping in the relationship between perceived stress and night‐eating syndrome (NES) in college students. Participants were 95 undergraduates 18 to 29 years of age, and predominantly female and white or Caucasian. Anonymous paper‐and‐pencil surveys were completed on campus to measure NES, coping styles and level of perceived stress. Significant associations were found between perceived stress and NES (β = 0.259, p &lt; 0.05), perceived stress and maladaptive coping (β = 0.575, p &lt; 0.001) and maladaptive coping and NES (β = 0.252, p &lt; 0.05). Mediation analyses indicate that experiencing higher levels of stress may lead to night‐eating behaviours because of use of maladaptive coping strategies. Furthermore, tests of moderation suggest that individuals who experienced stress and engaged in less adaptive coping were more likely to exhibit night‐eating behaviours (versus those who engaged in more adaptive coping). Of note is the differential impact of adaptive versus maladaptive coping in this association. Current findings provide some insights into possible mechanisms to weight gain in college students. Further, this information may be useful in guiding the development of interventions aimed at improving the psychosocial and behavioural health of college students. Copyright © 2008 John Wiley &amp; Sons, Ltd.

Posttraumatic stress disorder in the family and friends of patients who have suffered spontaneous subarachnoid hemorrhage

Significant others (SOs), such as spouses and life partners, of patients who have survived subarachnoid hemorrhage (SAH) can experience psychiatric symptoms and psychosocial disability. The cause of such symptoms has not been established. Authors of the present study analyzed whether posttraumatic stress disorder (PTSD) subsequent to a loved one's SAH is a plausible explanation for these symptoms. The authors examined a large representative sample of 86 patient/SO pairs 3.5 months postictus. All SOs were evaluated using a diagnostic PTSD measure, and coping skills were assessed. The cognitive, physical, and emotional status of patients was comprehensively examined. Twenty-six percent of SOs met the diagnostic criteria for PTSD, which represents a 3-fold increase in the rate expected within the general population. To establish the cause of PTSD, a logistic regression was performed, and results of this test showed that the use of maladaptive coping strategies was the best predictor of the disorder. A patient's level of disability held no significant association with the development of PTSD in his or her SO. The elevated incidence of PTSD in SOs helps to explain why these persons report concerning levels of psychiatric symptomatology and psychosocial disability. Greater attention must be given to an SO's adjustment to the experience of having a loved one suffer an SAH. This need is all the more pertinent given that SOs often act as informal caregivers and that PTSD could interfere with their ability to effectively minister. Because bad coping skills seem to be the main cause of PTSD, teaching SOs better strategies might prevent the disorder and any resulting psychosocial disability.

Evidence of high levels of anxiety and depression in polymorphic light eruption and their association with clinical and demographic variables

Polymorphic light eruption (PLE) is a prevalent photosensitivity condition associated with psychological distress. Objective To examine patients with PLE for evidence of anxiety and depression, the influence of demographic and clinical variables, and the coping strategies used. In a cross-sectional design, patients with PLE (n = 145) who had attended a hospital dermatology department completed validated questionnaires assessing anxiety, depression, social anxiety, and coping strategies. Clinical variables examined were: (i) number of months of the year affected by PLE; (ii) facial involvement; (iii) time taken for the rash to resolve; and (iv) whether the patient ever used steroids for their condition. Participants ranged in age from 16-78 (mean 44 years, SD 11.9), 81% female, with a mean age at onset of PLE of 28 years. Evidence of high levels of anxiety and depression was found in PLE, with 22% and 8% of patients scoring as probable cases for anxiety and depression, respectively. Higher levels of anxiety were associated with younger age of onset of PLE (r = -0.25, P < 0.01) and facial involvement (t = 2.84, P < 0.01), and depression was also associated with facial involvement (t = 3.60, P < 0.01). Furthermore, higher levels of depression and anxiety were associated with the use of maladaptive coping strategies, and depression was found to be the principal predictor of quality of life. High levels of anxiety and depression occur in PLE. Clinicians should be alert to the potential need for psychological management, particularly in patients with facial involvement and a younger age of onset of PLE.

Relationship of Coping Styles With Quality of Life and Depressive Symptoms in Older Heart Failure Patients

This study examines the relationship between coping styles, quality of life, and depressive symptoms in older heart failure patients. Eighty heart failure patients seeking treatment in an outpatient heart failure or family practice clinic participated in a study examining depression, disability, and heart failure. Patients completed a clinical interview and questionnaires about mood, functional impairment, comorbid illness, quality of life, and coping. Heart failure severity and maladaptive coping styles, including denial, self-distraction, and self-blame, negatively affected quality of life and depressive symptoms. The use of maladaptive coping strategies involves efforts that divert attention from the illness and suggests the need to provide heart failure patients the skills to directly address the stress associated with their illness. Interventions that target these coping strategies may help patients take a more active role in their heart failure management and may improve psychological and cardiac outcomes.

Effects of Quality of Life and Coping on Depression among Adults Living with HIV/AIDS

This prospective study examined the effect of maladaptive coping strategies and psychological quality of life (QOL) on depression at two time points in a diverse sample of persons living with HIV/AIDS (N = 85). The use of maladaptive coping strategies to deal with the stress of living with HIV/AIDS, particularly engaging in various kinds of avoidant behaviors, was significantly associated with greater depression at baseline and increased depression at three months. QOL was the single most important predictor of depression. In an effort to develop effective clinical methods aimed at decreasing depression among adults living with HIV, future studies need to focus on improving quality of life and increasing adaptive coping strategies associated with the stress of living with HIV/AIDS.

Age and Gender Effects on Coping in Children and Adolescents

The aim of this study was to investigate age and gender effects of children’s and adolescents’ coping with common stressors in 3 age groups (late childhood, early, and middle adolescence). Furthermore, age and developmental differences in situation-specific coping with 2 stress domains were examined. N = 1,123 participants (ages 8 to 13 years) were asked to complete the German Coping Questionnaire for Children and Adolescents (Hampel et al., 2001) in response to both an interpersonal and an academic stressor. Adolescent boys and girls, as well as girls from all age ranges scored lower on adaptive and higher on maladaptive coping strategies. With regard to interaction effects, female early adolescents coped maladaptively with common stressors, showing a decreased employment of adaptive (e.g., distraction, positive self-instructions) and an enhanced use of maladaptive coping strategies (e.g., rumination, aggression). Situation-specific coping did not differ consistently with age and gender. Implications of the findings for mental health care and developing clinical treatment of children and adolescents are discussed.

Teenagers' Attitudes About Coping Strategies and Help-Seeking Behavior for Suicidality

To identify youths' attitudes about coping and help-seeking strategies for suicidal ideation/behavior and examine their demographic and clinical correlates. A self-report survey was completed by high school students (N = 2,419) in six New York State schools from 1998 through 2001. The relationship between suicide attitudes and gender, depression, substance problems, serious suicidal ideation/behavior, and first-hand experience with a suicidal peer was examined. Two factors that approximate avoidance and approach coping responses, maladaptive coping strategies and help-seeking strategies, respectively, were identified. Boys scored higher than girls (t = 7.96, df = 2341, p < .001), and depressed youths (t = 15.56, df = 2323, p < .001), students with substance problems (t = 11.07, df = 2340, p < .001), and suicidal youths (t = 15.14, df = 2341, p < .001) scored significantly higher than their healthy counterparts on the maladaptive coping strategies factor. Students with first-hand experience with a suicidal peer scored significantly higher on the maladaptive coping strategies factor than those without this experience (t = 7.95, df = 2321, p < .001). Lower risk groups scored significantly higher on an adaptive help-seeking strategies factor. High-risk adolescents' attitudes are characterized by core beliefs that support the use of maladaptive coping strategies in response to depression and suicidal thoughts and behaviors. Targeting such attitudes is a recommended component of youth suicide prevention efforts.

Relationship of Functional Quality of Life to Strategies for Coping With the Stress of Living With HIV/AIDS

The authors examined factors associated with four dimensions of functional quality of life (physical functioning, energy/fatigue, social functioning, and role functioning) in 142 men and women living with HIV/AIDS. Participants completed the Brief COPE inventory and the Medical Outcomes Study Health Survey, with HIV-relevant items added. Greater use of maladaptive coping strategies was associated with lower levels of energy and social functioning. Pain severe enough to interfere with daily living tasks was associated with a lower level of functional quality of life on all four quality of life dimensions. Interventions aimed at developing adaptive coping strategies and improving pain management may improve functional aspects of quality of life in persons living with HIV/AIDS.

Coping strategies and the impact of challenging behaviors on special educators' burnout.

Although challenging behaviors have been identified as a source of staff stress, few researchers have directly addressed this relationship. In the present study, 55 teachers and support staff in special schools for children with mental retardation completed questionnaires assessing burnout, coping strategies for challenging behavior, and their exposure to challenging behavior. Results showed that (a) use of maladaptive coping strategies for challenging behaviors constitutes a risk for staff burnout, (b) this risk is in addition to that associated with exposure to challenging behavior, and (c) use of maladaptive coping strategies moderated the impact of exposure to challenging behaviors on emotional exhaustion burnout. Implications for future research and for the support of staff working with individuals who have challenging behaviors are discussed.