Assessment of cognitive coping styles: a closer look at situation-response inventories

Coping With Anxiety: Brain Structural Correlates of Vigilance and Cognitive Avoidance

BACKGROUND

Individuals differ in their dispositional coping behavior when they are confronted with anxiety-provoking situations. Cognitive avoidance is characterized by a withdrawal from threatening information, whereas vigilance denotes the intensive search for threat-related information. Functional neuroimaging studies indicate alterations in brain responsivity to emotional stimuli as a function of cognitive avoidant and vigilant coping, but findings are partially discrepant. Studies on structural correlates of coping styles are scarce.

MATERIALS AND METHODS

By using structural magnetic resonance imaging, the present study examined the relationship between brain gray matter volume and coping strategies in 114 healthy individuals. Individual differences in vigilance and cognitive avoidance were measured by the Mainz Coping Inventory.

RESULTS

Exploratory whole-brain analyses were conducted. Cognitive avoidant coping significantly predicted reduced gray matter volume in the bilateral thalamus, whereas vigilant coping was associated with volumetric increases in the bilateral thalamus. These relationships remained significant when controlling for a potential influence of age, sex, depressive symptoms, and trait anxiety.

DISCUSSION

Our findings indicate that dispositional strategies to deal with anxiety-provoking situations are related to volumetric alterations in the thalamus, a brain structure that has been implicated in the mediation of attentional processes and alertness, and the anticipation of harm. The dispositional tendency to monitor the environment for potential threats (i.e., vigilance), appears to be associated with volumetric increases in the thalamus, whereas the dispositional inclination to divert one's attention away from distressing stimuli (i.e., cognitive avoidance) seems to go along with reductions in thalamic gray matter density.

Medication-related Self-management Behaviors among Arthritis Patients: Does Attentional Coping Style Matter?

Objective:

The aim of this study was to investigate the relationship between the attentional coping styles (monitoring and blunting) of rheumatoid arthritis (RA) and osteoarthritis (OA) patients and: (a) receipt of medication information; (b) receipt of conflicting medication information; (c) ambiguity aversion; (d) medication-related discussions with doctors and spouse/partners; and (e) medication adherence.

Method:

A sample of 328 adults with a self-reported diagnosis of arthritis (RA n=159; OA n=149) completed an Internet-based survey. Coping style was assessed using the validated short version of the Miller Behavioral Style Scale. Measures related to aspects of medication information receipt and discussion and validated measures of ambiguity aversion and medication adherence (Vasculitis Self-Management Survey) were collected. Pearson correlation coefficients, ANOVA, independent samples t-tests and multiple regression models were used to assess associations between coping style and the other variables of interest.

Results:

Arthritis patients in our sample were more likely to be high monitors (50%) than high blunters (36%). Among RA patients, increased information-receipt was significantly associated with decreased monitoring (b = -1.06, p = .001). Among OA patients, increased information-receipt was significantly associated with increased blunting (b = .60, p = .02).

Conclusion:

In our sample of patients with arthritis, attentional coping style is not in accordance with the characteristic patterns outlined in the acute and chronic disease coping literature.

Examining patterns of association with defensive information processing about colorectal cancer screening

To reduce negative psychological affect from information or behavior that is inconsistent with one's positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50-75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.

Coping strategies and patient delay in patients with cancer

This study examined associations between avoidance and approach coping and patient delay in cancer patients (N = 1024). Approach coping was associated with short appraisal intervals (time from symptom discovery to recognition of symptom seriousness). Avoidance coping was associated with long appraisal intervals when adjusting for covariates. Help-seeking intervals (time from recognition of symptom seriousness to contact to general practitioner) were only associated with approach coping and only when adjusting for the influence of covariates. The results revealed a complex relationship between coping and patient delay and supported that normal processing of health threats implies avoidance and approach coping strategies.

Personal factors associated with reported benefits of Huntington disease family history or genetic testing

AIMS

A family history of Huntington disease (HD) or receiving results of HD predictive genetic testing can influence individual well-being, family relationships, and social interactions in positive and negative ways. The aim of this study was to examine benefits reported by people with an HD family history or those who have undergone predictive HD testing, as well as the personal variables associated with perceived benefits.

METHODS

Seventy-four of 433 people completing the International Response of a Sample Population to HD risk (I-RESPOND-HD) survey reported benefits. Knowledge and understanding was perceived as the most common benefit from participants in both groups. The next most frequent perceived benefits from a family history were connecting with others and achieving life meaning and insights. The next most common perceived benefits from genetic testing were life planning and social support. The least common perceived benefit for both groups was renewed hope and optimism. Older age and spirituality were significantly associated with benefits in both groups.

CONCLUSIONS

Perceptions of benefit may not be as likely until later years in people with prodromal HD. A developed sense of spirituality is identified as a personal resource associated with the perception of benefit from genetic testing for HD. Associations among spirituality, perceived benefits, and other indicators of personal and family well-being may be useful in genetic counseling and health care of people with prodromal HD.

Monitoring coping style moderates emotional reactions to genetic testing for hereditary nonpolyposis colorectal cancer: a longitudinal study

OBJECTIVES

The emotional effects of genetic testing for hereditary nonpolyposis colorectal cancer (HNPCC) provided within a counseling program were assessed among 253 individuals.

METHODS

Assessments were scheduled at baseline before testing, and again after 6 and 12 months post-test. Negative emotional reactions were evaluated using the Revised Impact of Event Scale and the Center for Epidemiological Studies-Depression Scale. Monitoring coping style was assessed at baseline using the Miller Behavioral Style Scale.

RESULTS

Mean reductions were indicated in distress and depression levels within the first 6 months after counseling and testing. High monitors were generally more distressed than low monitors, specifically if they had indeterminate or positive results.

CONCLUSIONS

Genetic counseling and testing for HNPCC do not result in long-term distress for most people. Of the variables investigated, only time and coping style have main effects on emotional reactions, and the impacts of mutation status are moderated by coping style. Psychological interventions, aimed to alleviate adverse emotional effects, were suggested for certain participants, i.e. recipients of positive or indeterminate results who are high monitors.

The experiential health information processing model: supporting collaborative web-based patient education

Background

First generation Internet technologies such as mailing lists or newsgroups afforded unprecedented levels of information exchange within a variety of interest groups, including those who seek health information. With emergence of the World Wide Web many communication applications were ported to web browsers. One of the driving factors in this phenomenon has been the exchange of experiential or anecdotal knowledge that patients share online, and there is emerging evidence that participation in these forums may be having an impact on people's health decision making. Theoretical frameworks supporting this form of information seeking and learning have yet to be proposed.

Results

In this article, we propose an adaptation of Kolb's experiential learning theory to begin to formulate an experiential health information processing model that may contribute to our understanding of online health information seeking behaviour in this context.

Conclusion

An experiential health information processing model is proposed that can be used as a research framework. Future research directions include investigating the utility of this model in the online health information seeking context, studying the impact of collaborating in these online environments on patient decision making and on health outcomes are provided.

Association of information satisfaction, psychological distress and monitoring coping style with post-decision regret following breast reconstruction

Little is known of the psychosocial factors associated with decision regret in the context of breast reconstruction following mastectomy for breast cancer treatment. Moreover, there is a paucity of theoretically-based research in the area of post-decision regret. Adopting the theoretical framework of the Monitoring Process Model (Cancer 1995;76(1):167-177), the current study assessed the role of information satisfaction, current psychological distress and the moderating effect of monitoring coping style to the experience of regret over the decision to undergo reconstructive surgery. Women (N=123) diagnosed with breast cancer who had undergone immediate or delayed breast reconstruction following mastectomy participated in the study. The majority of participants (52.8%, n=65) experienced no decision regret, 27.6% experienced mild regret and 19.5% moderate to strong regret. Bivariate analyses indicated that decision regret was associated with low satisfaction with preparatory information, depression, anxiety and stress. Multinominal logistic regression analysis showed, controlling for mood state and time since last reconstructive procedure, that lower satisfaction with information and increased depression were associated with increased likelihood of experiencing regret. Monitoring coping style moderated the association between anxiety and regret (beta=-0.10, OR=0.91, p=0.01), whereby low monitors who were highly anxious had a greater likelihood of experiencing regret than highly anxious high monitors.

Monitoring: a dual-function coping style

Monitoring (Miller, 1991) is defined as a cognitive coping style characterized by the tendency to seek information about threats. This study found that information seeking in stressful situations is perceived by individuals as related to the emotion-focused more than the problem-focused function of coping and that there is considerable variance among individuals in the perceived functions of information seeking and the relationships among information-seeking reactions and their perceived functions. Information-seeking preferences in a natural stressful situation (a final course examination) were predicted by individual differences in perceived functions of information seeking rather than by generalized behavioral coping styles (monitoring). The results were interpreted in relation to the cognitive-affective system theory (Mischel & Shoda, 1995), and implications for the measurement of coping dispositions were discussed.

Psychometric validation of a monitoring-blunting measure for social anxiety disorder: the coping styles questionnaire for social situations (CSQSS)

The purpose of this investigation was to conduct a psychometric validation of the Coping Styles Questionnaire for Social Situations (CSQSS). The CSQSS was developed to measure monitoring and blunting coping styles in social situations based on Miller's conceptualization of how individuals cope with threat-related information. Study 1 evaluated the content validity of the CSQSS monitoring and blunting items. Study 2 examined factor structure, reliability, and construct validity of the CSQSS in a sample of 443 college students. Evidence supported the content and face validity of the CSQSS. In addition, an exploratory factor analysis revealed a two-factor solution consistent with the monitoring and blunting constructs. Both monitoring and blunting scores were positively correlated with measures of social anxiety, with blunting having a stronger relationship. Moreover, individuals with high social anxiety engaged in a significantly higher degree of monitoring and blunting than did individuals with low social anxiety. Taken together, these results provide support for the reliability and validity of the CSQSS. The CSQSS may serve as a useful measure for further examination of monitoring and blunting coping styles in a social anxiety disorder sample.