Coping strategy-situation fit vs. present control: relations with perceived stress in U.S. college students

BACKGROUND

According to the strategy-situation fit hypothesis, it is adaptive to match coping strategies to the controllability of stressors. Although early research generally supported this hypothesis, recent findings have been inconsistent. The goals of this study were to test the strategy-situation fit hypothesis, addressing limitations of past research, and compare it to an alternative hypothesis from the temporal model of control (i.e., to focus on what one can control rather than matching coping strategies to control appraisals).

DESIGN AND METHODS

College students (n = 159) completed measures assessing their stressors, coping strategies, stressor controllability, perceived control over present aspects of stressors, and perceived stress. Data were collected via online surveys in Fall 2020.

RESULTS

Consistent with the strategy-situation fit hypothesis, using a higher ratio of problem-solving coping for more controllable stressors was associated with less stress. However, using more emotion-focused coping for less controllable stressors was not associated with less stress. In addition, focusing on what one could control in the present was associated with less stress, above and beyond strategy-situation fit.

CONCLUSIONS

It may be more adaptive to focus on what one can control in the present than to match coping styles to stressor controllability.

Psychological distress and self-reported mental disorders: the partially mediating role of coping strategies

BACKGROUND AND OBJECTIVES

Accumulating evidence suggests a substantial prevalence of mental health disorders worldwide and the association between psychological distress and mental disorders. However, the mechanisms underlying this association are underexplored. Using longitudinal data, this study examined coping strategies as a potential mechanism.

METHODS

Participants (N = 2,333) from the Midlife in the United States (MIDUS) completed psychosocial and mental health surveys over 19 years. A parallel mediation model was used to test the direct association between psychological distress (baseline) and self-reported mental disorders (17-19 years follow-up) and the indirect associations via coping strategies (8-11 years follow-up), controlling for demographics and baseline self-reported mental disorders.

RESULTS

Psychological distress predicted an increased likelihood of mental disorders later in life. Emotion-focused coping was a significant mediator of this association, but problem-focused coping was not. Psychological distress was positively associated with emotion-focused coping, and emotion-focused coping was positively associated with mental disorders. Psychological distress was negatively associated with problem-focused coping; however, no association was found between problem-focused coping and mental disorders.

CONCLUSIONS

Findings provide further support for the longitudinal association between psychological distress and mental health disorders and extend prior research by showing the partial mediating role of emotion-focused coping in this association.

Mindfulness, coping, and optimism as mechanisms of change in the 3RP-NF intervention

INTRODUCTION

Neurofibromatosis (NF) is chronic neurogenetic condition that increases risk for poor quality of life, depression, and anxiety. Given the lack of biomedical treatments, we developed the "Relaxation Response Resiliency for NF" (3RP-NF) program to improve psychosocial outcomes among adults with NF.

OBJECTIVE

To move toward effectiveness testing, we must understand mechanisms that explained treatment effects. We tested whether our hypothesized mechanisms of change-mindfulness, coping, and optimism-mediated improvements in quality of life, depression, and anxiety among adults in the 3RP-NF program (N = 114; ages 18-70; 72.80% female; 81.58% White).

METHODS

We conducted mixed-effects models to assess whether these mechanisms uniquely mediated outcomes.

RESULTS

Improvements in quality of life were most explained by coping, (b = 0.97, SE = 0.28, CI [0.45, 1.56]), followed by mindfulness (b = 0.46, SE = 0.17, CI [0.15, 0.82]) and optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]). Improvements in depression and anxiety were most explained by mindfulness (b = -1.52, SE = 0.38, CI [-2.32, -0.85], CSIE = -0.26; b = -1.29, SE = 0.35, CI [-2.04, -0.67], CSIE = -0.23), followed by optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]; b = -0.49, SE = 0.20, CI [-0.91, -0.13]), but were not explained by coping (b = 0.22, SE = 0.43, CI [-0.62, 1.07]; b = 0.06, SE = 0.46, CI [-0.84, 0.97]), respectively.

CONCLUSIONS

Targeting mindfulness, coping, and optimism in psychosocial interventions may be a promising way to improve the lives of adults with NF.

Depression in Uveal Melanoma Survivorship: Examining Psychological Predictors of Adjustment in the First Year Following Diagnosis

BACKGROUND

A rare cancer, uveal melanoma (UM) affects 5 in 1 million adults annually. Research on predictors of mental health in UM survivors is scarce.

PURPOSE

In this prospective study, we tested models that postulate interactions between illness perceptions and coping processes in predicting depressive symptoms 1 year following UM diagnosis.

METHODS

Participants' approach- and avoidance-oriented coping processes and illness perceptions specific to control and chronicity were assessed. Participants (N = 107) completed assessments prior to diagnosis (T0), and 1 week (T1), 3 months (T2), and 12 months after UM diagnosis (T3).

RESULTS

At T1, a significant avoidance coping × chronicity perception interaction (b = 1.84, p = .03) indicated that the link between higher avoidance coping and greater T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions (b = 17.13, p < .001). Chronicity perceptions at T2 interacted significantly with approach-oriented coping at all time points; the link between higher approach coping and lower T3 depressive symptoms was stronger for participants with prolonged chronicity perceptions at T2. Interactions between control perceptions and coping did not significantly predict T3 depressive symptoms.

CONCLUSIONS

Findings lend partial support to predictive models that consider the combined, interacting influence of chronicity perceptions and coping processes on depressive symptoms in survivors of eye cancer.

Influence of illness representations on coping strategies and psychosocial outcomes of infertility: Systematic review and meta-analysis

BACKGROUND

This systematic review and meta-analysis was based on the Common Sense Model, applied to infertility.

AIMS

The aim was to examine the relationships between cognitive (i.e. cause, coherence, consequences, controllability, identity and timeline) or emotional representations of infertility and both coping (i.e. maladaptive and adaptive) and psychosocial outcomes (i.e. distress, anxiety, depressive symptoms, social isolation, low well-being and poor quality of life), reporting followed PRISMA guidelines.

MATERIALS & METHODS

Five databases (PubMed, PsycINFO, PsycARTICLES, PubPsych and CINAHL) were searched, and 807 articles were initially identified.

RESULTS

Seven cross-sectional studies (N = 1208 participants) were retained in qualitative and quantitative analyses. These studies assessed the associations of seven types of representations with either maladaptive or adaptive coping (20 effect sizes), or with psychosocial outcomes (131 effect sizes). A multivariate meta-analysis revealed that none (0/2) of the associations between the sole type of representation considered (i.e. controllability) and coping strategies were statistically significant, whereas three (3/7) of the associations between representations of infertility and psychosocial outcomes were statistically significant. Regardless of p-values, pooled estimates ranged from low (r = .03) to very high (r = .59).

DISCUSSION

Future studies should validate specific measurement tools for measuring cognitive and emotional representations of infertility.

CONCLUSION

Our results highlight the influence of representations of infertility (particularly cognitive representations of consequences and emotional representations) on the psychosocial outcomes of infertility.

Self-compassion buffers the impact of learned helplessness on adverse mental health during COVID-19 lockdown

BACKGROUND

Learned helplessness may be the underlying cause of poor mental health status among college students during the COVID-19 lockdown, and self-compassion as a positive psychological quality may influence the link between learned helplessness and mental health.

METHODS

A sample of 869 Chinese college students (443 male and 426 female), with a mean age of 20.03 (SD = 1.68), completed the Learned Helplessness Scale (LHS), Self-Compassion Scale (SCS), and DASS-21. The moderating effect of self-compassion on the relationship between learned helplessness and anxiety, depression, and stress were calculated.

RESULTS

The interaction term between learned helplessness and self-compassion has a significant coefficient on anxiety, depression, and stress, pointing out self-compassion as a moderator of the association between learned helplessness and adverse mental health.

LIMITATIONS

In the absence of longitudinal data or experimental manipulations, cross-sectional methods cannot verify causal conclusions among the study variables. The analysing results are based only on self-reported data.

DISCUSSION

The present study contributes to a deeper understanding of how learned helplessness and self-compassion during COVID-19 contribute to adverse mental health. The findings suggest that adverse mental health during lockdown is significantly associated with learned helplessness and that self-compassion can buffer this effect, contributing to future psychotherapy and clinical research. Future studies should examine the relationship through a longitudinal design to sort out whether self-compassion is a protective factor against learned helplessness or a moderator of the effects of learned helplessness on mental health.

Relationship of coping strategies with mood symptoms, disease related characteristics and demographic variables in patients with multiple sclerosis: A systematic review study

OBJECTIVE

the aim of this systematic review was to summarize the coping strategies utilized by people with multiple sclerosis (pwMS) and the association of these strategies with mood symptoms, quality of life, fatigue and disability in pwMS.

METHODS

search in the literature was performed across electronic databases of PubMed, Web of Science, and Scopus. No time constraint was applied for searching across the databases. Manual search was also performed on the list of references of the retrieved papers. Two authors independently evaluated the retrieved citations based on predetermined inclusion criteria in two screening stages. This systematic review followed Joanna Briggs Institute (JBI) guidelines for cross-sectional research. The findings related to the coping patterns against MS as well as the relationship between the patterns and MS symptoms were extracted and synthesized.

FINDINGS

A total of 2390 records were identified. After removing duplicates and based on screening, 39 papers met the eligibility criteria for qualitative synthesis, and they were evaluated in terms of quality of study. When comparing genders, women used more religious coping, social support seeking, and positive coping compared to men. Depression and anxiety were associated with maladaptive and emotion-oriented coping strategies. The patients who used positive and problem solving oriented coping strategies had a better score of quality of life. Disability and fatigue were associated with applying avoidance and maladaptive coping strategies.

CONCLUSION

the findings of this review suggest that understanding the relationship between coping strategies and quality of life as well as the symptoms related to the disease is important to understand development of psychological interventions adopted by specialists to support these patients.

Illness Perceptions, Coping, Health-Related Quality of Life and Psychological Outcomes in Cervical Dystonia

This study examined the predictive ability of the Common-Sense Model to explain psychological outcomes in cervical dystonia, a movement disorder that affects the muscles of the head and neck. Illness Perceptions Questionnaire-Revised, brief COPE, Hospital Anxiety and Depression Scale, Cervical Dystonia Impact Profile and the Post-Traumatic Growth Inventory were completed by 118 people with cervical dystonia. Correlations and hierarchical multiple regression models were conducted. Illness perceptions and coping strategies explained 59% of variance in anxiety, 61% of variance in depression and health-related quality of life and 19% of variance in post-traumatic growth. Illness perceptions and coping strategies are significant factors to consider in terms of psychological adjustment and outcomes in cervical dystonia. Psychological interventions targeting illness perceptions and coping strategies may be beneficial in improving psychological outcomes for people with cervical dystonia.

Adverse childhood experiences predict reaction to multiple sclerosis diagnosis

Objective

At the time of multiple sclerosis (MS) diagnosis, identifying those at risk for poorer health-related quality of life and emotional well-being can be a critical consideration for treatment planning. This study aimed to test whether adverse childhood experiences predict MS patients’ health-related quality of life and emotional functioning at time of diagnosis and initial course of disease.

Methods

We recruited patients at the time of new MS diagnosis to complete self-report surveys at baseline and a one-year follow-up. Questionnaires included the Adverse Childhood Experiences (ACEs), as well as the MS Knowledge Questionnaire (MSKQ), the 36-Item Short Form Health Survey (SF-36), and Self-Management Screening (SeMaS).

Results

A total of n = 31 participants recently diagnosed with relapsing remitting MS (median EDSS = 1.0, age M = 33.84 ± 8.4 years) completed the study measures. The ACEs significantly predicted health-related quality of life (SF-36) at baseline (Adjusted R² = 0.18, p = 0.011) and follow-up (Adjusted R² = 0.12, p = 0.03), baseline scores on the SeMaS Depression scale (Adjusted R² = 0.19, p = 0.008), as well as follow-up scores on the SeMaS Anxiety (Adjusted R² = 0.19, p = 0.014) and SeMaS Depression (Adjusted R² = 0.14, p = 0.036) scales. Importantly, increased ACEs scores were predictive of increased anxiety at the one-year follow-up assessment, compared to baseline.

Conclusions

Childhood adversity predicts health-related quality of life and emotional well-being at time of MS diagnosis and over the initial course of the disease. Measured using a brief screening inventory (ACEs), routine administration may be useful for identifying patients in need of increased supportive services.

Coping profiles in multiple sclerosis: Comparison of personal resources

BACKGROUND

Identifying the profiles of multiple sclerosis (MS) patients who employ similar patterns of coping may improve the understanding of how coping is associated with psychological adjustment. The purpose of this study was to identify the groups of MS patients using different coping strategies and compare the levels of psychological resources across the groups.

METHODS

In this cross-sectional study 382 patients with MS completed a battery of self-report measures that assessed their use of different coping strategies, optimism, self-efficacy, health locus of control (HLC), and perception of disease. The groups with different coping profiles were selected by performing a cluster analysis.

RESULTS

Five different coping profiles were highlighted and were defined as follows: "Emotional," "Temperate," "Active," "Passive," and "Problem copers." Significant differences were detected between the groups in the levels of optimism, self-efficacy, HLC, and perception of disease.

CONCLUSION

Patients with MS use a varied repertoire of coping strategies, which allowed distinguishing coping profiles. Groups representing particular profiles differ in terms of psychological resources. This study contributed to increasing the interest in investigating coping profiles. Identifying subgroups of individuals based on their coping profiles and recognizing the differences is important for providing psychological support.

Coping with stress during the first wave of the COVID-19 pandemic by Turkish people with Multiple Sclerosis: The relationship between perceived stress and quality of life

Background

Multiple sclerosis (MS) is a chronic inflammatory disease and acute exacerbations are also a part of the clinical course. The presence of the disease and relapses cause stress in people with MS (pwMS). For this reason, stress coping strategies of the patients are important in reducing perceived stress. Our aim in this study is to evaluate which strategies pwMS use during the COVID-19 pandemic, the effect of the strategies on perceived stress, their relationship with relapses and their role on quality of life (QoL).

Methods

An online form including Perceived Stress Scale (PSS; 10 items), Coping with Experienced Problems Scale (Brief-COPE; 28 items) and SF-12 were sent to 340 pwMS under our follow-up.

Results

During the COVID-19 pandemic, we found that the patients used the strategies of turn to religion, planning and acceptance at a high rate. PSS score was high in 23 (11.2%) of the patients. The patients with low perceived stress used the acceptance strategy more (P=0.008). We found a negative correlation between physical component summary (PCS) of SF-12 and denial (r=-0.2, p<0.001) and distraction (r =-0.1, p=0.04). A negative correlation was found between mental component summary (MCS) of SF-12 and behavioral disconnection (r=-0.2, p=0.006). There was a positive correlation between MCS and humor (r=0.1, p=0.04), use of instrumental support (r=0.2, p=0.009), planning (r=0.1, p=0.04), and positive reframing (r=0.2, p=0.002).

Conclusion

PwMS have been successful in coping with stress in the first half of the pandemic with the combination of emotional and problem-focused strategies. Acceptance strategy was highly adopted by patients with low PSS, and the tendency to use the active coping strategy together with the acceptance strategy was high in patients without relapses. Adoption to emotional strategies may have prevented the severe deterioration in QoL in this study group in the early period of Covid-19 pandemic.

Coping strategies used by patients with relapsing multiple sclerosis from Argentina: correlation with quality of life and clinical features

BACKGROUND

Multiple sclerosis (MS) is a chronic neurodegenerative and inflammatory disease. The adaptation to MS depends on the effectiveness of coping, which moderates the process of adaptation and psychological well-being.

OBJECTIVES

We aimed to analyze the coping strategies of an Argentinean population of patients with MS (PwMS) and their association with clinical variables and health-related quality of life (QoL).

METHODS

A nationwide cross-sectional study. Screening instruments: Demographics and clinical data, coping strategies (Brief Coping Orientation to Problems Experienced, [COPE-28]), health-related QoL (MS Impact Scale, [MSIS-29]), Fatigue Severity Scale, and physical disability (self-administrated Expanded Disability Status Scale, [EDSS]).

RESULTS

We included 249 PwMS. Most responders were female (74.7%) with a mean age at survey of 38.6 (±10.7) and had a MS duration of 7.3 years (range: 1-43 years) and a mean EDSS of 1.9 (±1.8). Younger age (r = -0.17), active MS (r = 0.25), higher fatigue (r = 0.22), MSIS-29 total (r = 0.34), MSIS-physical (r = 0.26), MSIS-psychological scores (r = 0.44), higher scores for perception of both severity of MS (r = 0.12) and wheelchair-dependency (r = 0.14) correlated significantly with the use of maladaptive coping strategies. However, active MS (β2.10, p = 0.01), MSIS-psychological score (β0.28, p < 0.0001), high education level (β - 1.15, p = 0.04), and EDSS (β - 0.84, p = 0.0001) were independent predictors of the utilization of maladaptive coping strategies after having applied multivariate analysis via linear regression.

CONCLUSIONS

Maladaptive coping strategies used by PwMS are associated with relevant clinical aspects of the disease and with worse health-related QoL scores.

Two brief group interventions for individuals with tinnitus in Israel

Background/Aims

Subjective tinnitus is a common impairment throughout the world and typically cannot be cured. Coping strategies are cognitive, affective, and behavioural approaches for managing stressors like tinnitus. The aim of this study was to investigate the effects of two brief interventions on coping and tinnitus-related distress.

Methods

A total of 45 individuals with tinnitus in Israel were allocated into one of three groups: acceptance and commitment therapy, coping effectiveness training, or a waitlist control group. Outcomes were assessed at three time points by the Brief Coping Orientation to Problems Experienced scale and the Tinnitus Handicap Inventory, a measure of tinnitus-related distress.

Results

There was a significant difference among the groups on post-intervention Tinnitus Handicap Inventory assessment, but not on coping, when controlling for baseline scores. Pairwise comparisons indicated that the coping effectiveness training group scored significantly lower on the Tinnitus Handicap Inventory than the waitlist control group.

Conclusions

While the results are promising, a larger study is needed to further explore the efficacy of the brief coping effectiveness training intervention.

Goal Pursuit, Goal Adjustment, and Pain in Middle-Aged Adults Aging With Physical Disability

Objective: Aging with physical disability disrupts one's ability to achieve valued goals due to changes in symptoms and function. It is unclear how to cope optimally in this context. This study examined whether two possible strategies-tenacious goal pursuit (TGP) and flexible goal adjustment (FGA)-were associated with reduced pain interference and depressive symptoms and greater well-being, and protected against pain intensity, and FGA was more protective with increasing age and worse physical function. Method: Middle-aged adults with muscular dystrophy, multiple sclerosis, post-polio syndrome, or spinal cord injury (N = 874; M_AGE = 58.3 years, range = 46-68; M_{DISEASEDURATION} = 26.2 years, range = 2-67) completed two questionnaires, a year apart. Results: TGP and FGA use was associated with greater well-being. FGA use predicted decreased depressive symptoms. Concurrent use of both predicted decreased pain interference. Discussion: Adults with disability employ a variety of goal management strategies. Findings support TGP and FGA as potential intervention targets for healthy aging with disabilities.

Health locus of control and mental health in patients with multiple sclerosis: Mediating effect of coping strategies

In patients with multiple sclerosis (MS), mental health is significantly affected and conditioned by many factors, including psychological ones. This study team aimed to determine whether different coping strategies mediate the relationship between health locus of control (HLC) and mental health in MS patients. In this cross-sectional study, a total of 382 patients with MS were included. The patients completed General Health Questionnaire-12, Coping Inventory for Stressful Situations, and Multidimensional Health Locus of Control Scale. The demographic and clinical characteristics of the patients were collected using a self-report survey and neurological assessment. A mediation analysis was used to test the study hypothesis. Problem-oriented coping was found to be a significant mediator in the relationship between internal HLC and mental health (indirect effect: -0.129 [95% confidence interval [CI]: -0.193, -0.079]; standardized indirect effect: -0.113 [95% CI: -0.165, -0.070]). Emotion-focused coping was found to be a significant mediator in the relationship between power of others HLC and mental health (indirect effect: 0.114 [95% CI: 0.058, 0.178]; standardized indirect effect: 0.125 [95% CI: 0.062, 0.195]). Emotion-focused coping was also found to be a significant mediator in the relationship between chance HLC and mental health (indirect effect: 0.215 [95% CI: 0.154, 0.281]; standardized indirect effect: 0.209 [95% CI: 0.149, 0.272]). Patients with internal HLC were found to have positive mental health due to their problem-focused coping strategies, while patients with external HLC had worse mental health as they used more emotion-focused strategies. Hence, problem-focused and emotion-focused coping strategies can be considered mediators of the relationship between HLC and mental health in patients with MS.

Control-coping goodness-of-fit and chronic illness: a systematic review of the literature

Chronic illnesses such as cancer, diabetes, and chronic pain often create intense and pervasive stress. Although much research has focused on the importance of coping in managing chronic illness, the importance of controllability appraisals in determining the efficacy of various coping strategies (i.e., the 'goodness-of-fit hypothesis') for individuals living with chronic illness has yet to be established. To evaluate support for the goodness-of-fit hypothesis, we conducted a systematic literature review, identifying and synthesising results of 15 studies that reported on conditional effects of problem-, emotion-, and meaning-focused coping strategies, depending on controllability appraisals. Results across studies were mixed, with some coping strategies but not others demonstrating significant interaction effects with controllability appraisals in models predicting psychological and physiological markers of health. Studies demonstrated considerable heterogeneity in design and measurement, with the majority reliant on cross-sectional design and thus unable to infer temporality in the effects of coping on adjustment. In addition, lack of consensus regarding the measurement and categorisation of coping precluded definitive conclusions regarding contextual effects of many strategies. To better understand these patterns of coping as they unfold in daily experience, future work should incorporate contemporary methods such as experience sampling and multilevel statistical modeling.

An explorative study on coping flexibility with behavioral approach system-activating stimuli: A comparison of people with and without bipolar disorder

Life events play a significant role in affecting mood symptoms of people with bipolar disorder (BD). However, we lack empirical data about the associations among disorder, mood state, behavioral activation system (BAS) sensitivity, and psychosocial functioning level. Thus, the present study aimed to identify the role of coping flexibility with BAS activating stimuli in relation to mood states among a sample of individuals with BD (n = 90) and a healthy control group (n = 90). Through multiple regressions, the moderating role of coping flexibility was determined. Findings showed that coping flexibility had an additional value in predicting mood states beyond BAS sensitivity and psychosocial functioning level. Specifically, perceived controllability was considerably important for the BD group, whereas fit index was crucial in the controls. In addition, a moderation analysis showed that perceived controllability alleviated the effects of BD diagnosis, BAS sensitivity, and psychosocial functioning level on mood states. Theoretically, this study helps integrate the concept of coping flexibility into the BAS dysregulation theory as it applies to BD. The practical implication for enhancing mindfulness practice is also discussed.

Perceived cognitive deficits and depressive symptoms in patients with multiple sclerosis: Perceived stress and sleep quality as mediators

Multiple Sclerosis (MS), an autoimmune disorder marked by inflammation of the central nervous system, is associated with a myriad of symptoms. Individuals with MS are more likely to experience depressive symptoms, perhaps due to perceived cognitive impairments. Thus, we aimed to explore perceived stress and sleep deficits as potential mediators of the association between perceived cognitive deficits and depressive symptoms. We recruited a sample of 77 MS participants from an outpatient, university-based MS clinic in the United States. Participants ranged in age between 30 and 75 years old (M = 51.12; SD = 9.6), with more females than males (83% female; n = 64). Participants completed the Perceived Deficits Questionnaire, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Scale - Revised. Correlation analyses and mediation analyses were conducted with bootstrapping technique. Statistical analyses revealed that higher levels of perceived cognitive deficits were associated with lower quality of sleep, more perceived stress, and higher levels of depressive symptoms. Additionally, both perceived stress and sleep quality served as a significant mediator in the perceived cognitive impairments and depressive symptoms linkage. Our novel findings demonstrate the importance of underlying mechanisms (e.g., sleep quality and perceived stress) in the conceptualization of MS. Perceived stress and sleep quality are potentially modifiable factors, perhaps serving as a target for future treatment, to buffer risk of MS patients developing depression.

A Pilot Randomized Clinical Trial Comparing Three Brief Group Interventions for Individuals With Tinnitus

Background

Tinnitus (ie, ear or head noises not caused by external sounds) is common among the general population and is the most prevalent service-connected disability in the United States’ Department of Veterans Affairs system. While numerous clinical interventions have been created to systematically address the range of issues caused by tinnitus, only a few tinnitus interventions have focused on both teaching and assessing coping strategies. The present pilot study involved a randomized clinical trial comparing 3 brief group interventions to a usual-care (UC) group (ie, a wait-list control group): the first intervention based on acceptance and commitment therapy (ACT), a second based on cognitive-behavioral therapy (CBT), and a third based on coping effectiveness training (CET). Each intervention group also received tinnitus-related audiological education.

Participants

Forty individuals met the eligibility requirements and were randomized into 1 of the 4 groups (ACT, CBT, CET, or UC). An intent-to-treat analysis was used in this study.

Measures

The Brief COPE scale was used to assess coping. Coping was assessed at 3 time points (pre-intervention, post-intervention, and at 4-week follow-up). The outcomes were 3 coping factors (engagement coping, disengagement coping, and social support coping).

Results

When examining differences among the groups on mean coping scores over time, significant group differences were found on social support coping, with the CET group scores significantly higher than the UC group.

Discussion

While all 3 brief interventions teach stress-reduction techniques, ACT and CBT focus primarily on managing one’s unwanted thoughts and emotions. CET teaches participants both a range of coping strategies (eg, stress-management approaches) to more effectively manage stressors that cannot be changed, as well as coping strategies (eg, such as problem-solving) that can be used to eliminate stressors that can be changed. CET also teaches communication skills for telling others about one’s tinnitus-related issues. CET instructs individuals on how to select coping strategies that are appropriate for different kinds of stressors and how to seek social support, which is a skill not explicitly taught by ACT or CBT. Results of this study were derived from a small sample size, and thus, future research should focus on replicating the results among a larger sample. In addition, future research could focus on adapting the CET intervention to a different delivery format.

Concept analysis of coping with multiple sclerosis

OBJECTIVE

The concept of coping with disease appears frequently in the literature; however, there is no precise definition of coping. The aim of this study is to clarify coping concept, and to identify its attributes, antecedents, and consequences in patients with multiple sclerosis.

METHODS

Rodgers' evolutionary method of concept analysis was used to clarify the concept of coping. A literature review was conducted with key terms 'multiple sclerosis', 'coping', 'adjustment', and 'deal with'. After searching databases, 1370 papers were found for the period 1995-2017. Finally, 55 articles and texts were selected for analysis. Data analysis was carried out using thematic analysis. An independent researcher checked the process to ensure credibility and reduce personal bias.

RESULTS

Coping with multiple sclerosis is a multidimensional concept with three main attributes: maintenance of emotional balance, acceptance of the disease, and self-regulation. Social support, awareness toward the disease, attitude toward the disease, and religious-spiritual beliefs were found as antecedents. Health promotion, adherence to treatment regimen, independence in personal life and social relationships, and improvement of family relationships were found as consequences of these attributes.

CONCLUSION

These findings not only add to the body of knowledge in health science, but also serve as an important motivation for further theory development and research in this context. Nurses and health professions can also benefit from a deeper understanding of coping concept in providing and planning healthcare for these patients.

Effect of a transactional model education program on coping effectiveness in women with multiple sclerosis

OBJECTIVES

Multiple sclerosis (MS) is a chronic and progressive disease that causes stress due to its unpredictability and lack of definitive treatments. This study examined the effects of an educational program using a transactional model to help women with MS cope with their disease.

MATERIALS AND METHODS

In a randomized clinical trial, 80 female patients from the MS Society of Iran were randomized to the intervention (n = 40) or a control group (n = 40). Outcomes were assessed using Cohen's Perceived Stress Scale (PSS) and the Jalowiec Coping Scale (JCS), which were completed by both groups at baseline, 1 month, and 3 months after the intervention. The intervention consisted of six educational sessions administered over 2 months based on a transactional model. The data were analyzed using repeated measures ANOVA.

RESULTS

Average PSS scores decreased significantly over time in the intervention group, while increasing in the control group. Between-group differences were significant at both 1-month and 3-month follow-up (p < .001). Both problem-focused and emotion-focused coping styles improved over time in use and effectiveness in the intervention group, whereas little or no change occurred in these coping behaviors in the control group.

CONCLUSION

The transactional model-based education program tested here was successful in reducing stress levels and increasing healthy coping styles in women with MS. If these findings are replicated in future studies, widespread adoption of this program may help women with MS cope more successfully with their disease.

Appraisal of transplant-related stressors, coping strategies, and psychosocial adjustment following kidney transplantation

This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients.

Coping with multiple sclerosis-the role of social support

OBJECTIVE

The aim of this study was to get insights in mechanisms of coping and social support in multiple sclerosis (MS).

BACKGROUND

Multiple sclerosis is the most common chronic inflammatory disease of the central nervous system in young adults. MS strains the patient through its unpredictable course and increasing disability.

MATERIAL AND METHODS

A cross-sectional study was conducted. Two hundred and forty-three patients with MS were consecutively examined at two neurological hospitals. Besides sociodemographic variables, the level of impairment, depression, social support, and coping behavior was assessed.

RESULTS

Researched patients were on average 44.0 years old (SD=11.6), were diagnosed for 8.2 years (SD=7.1), and had a mean EDSS of 4.0 (SD=2.2). Patients with MS with an EDSS of 3.0-6.0 are using more intensively cognitive or behavioral coping techniques than less (EDSS≤2.5) or stronger impaired patients (EDSS≥6.5). The level of impairment was further correlated with the amount of reported social support.

CONCLUSION

Differences in coping behavior could be observed for different levels of impairment through MS. Patients tackle more intensively and more actively with their disease when trying to adapt to increasing disability with an EDSS range between 3.0 and 6.0. In addition, the coping behavior of patients with MS was connected to social support, especially support by family, friends, or other patients with MS. Results refer to the importance of special trainings to enhance coping abilities of patients with MS.

Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence

Objective:

To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment.

Design:

Cross-sectional.

Setting:

Multiple Sclerosis Clinic Centre.

Subjects:

A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing–remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4).

Interventions:

Not applicable.

Main measures:

Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS).

Results:

Problem solving was linked to higher mental health ( β = 0.28) and higher affective well-being ( β = 0.36), emotional release was related to lower depression ( β = −0.22); avoidance was associated to higher mental health ( β = 0.25), higher affective well-being ( β = 0.24), and lower depression ( β = −0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = −2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = −2.02; affective well-being: Sobel z-value= 2.05; p < 0.05).

Conclusions:

Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.