A count of coping strategies: A longitudinal study investigating an alternative method to understanding coping and adjustment

Do coping style and future time perspective relate to surrogate decision-making preparedness? A cross-sectional analysis of heart failure caregivers

OBJECTIVES

To assess if future time perspective (FTP) moderates the relationship between heart failure (HF) caregiver coping style and preparedness to make a surrogate medical decision.

METHOD

Cross-sectional data was analyzed to assess associations among three different coping styles (i.e. avoidance, active, minimizing), FTP, and odds of feeling prepared to make a medical decision on behalf of a loved one with heart failure.

RESULTS

A total of 231 caregivers were included in analyses. No significant interaction effects emerged among coping style and FTP on odds of feeling prepared to make a surrogate medical decision. Caregiver burden was significantly and inversely related to feeling prepared across each coping style model. Reports of having the provider present for the medical wishes conversation was significantly related to odds of feeling prepared across each coping style model.

CONCLUSION

FTP did not appear to moderate the relationship between coping styles and preparedness to make a medical decision on behalf of a loved one with heart failure. Future research should continue to explore possible characteristics that can be targeted to improve feelings of decision-making preparedness among caregivers of loved ones with HF.

"There Is Nothing I Can't Face Now": Coping With Child Loss Among Bereaved Parents in Ghana

Coping resources play a critical role in parents' recovery from the trauma associated with child loss. In Ghana, little is known about how parents cope with child loss despite the relatively high prevalence of child loss in the country. This study, therefore, sought to map out coping strategies bereaved parents adopt in response to child loss. Twenty Ghanaian parents were purposively sampled and their accounts were thematically analyzed. Findings from the study show that bereaved parents adopted both cognitive and behavioral coping mechanisms. Religion and social support also emerged as useful coping resources for bereaved parents. Additionally, bereaved parents showed evidence of posttraumatic growth following child loss. The findings underscore the need for practitioners to develop programs around adaptive coping methods that bereaved parents are familiar with to enhance their chances of developing progressive outcomes in the course of managing the distress associated with child loss.

The Influence of Negative Emotions on Mobile Phone Addiction Among Chinese College Students: The Mediating Role of Negative Coping Styles and the Moderating Role of Gender

Background

Negative emotions (depression and anxiety) are highly correlated with mobile phone addiction among college students, but the underlying mechanisms between variables need further exploration. The aim of this study is to further elucidate the relationship between negative emotions and mobile phone addiction among college students, with negative coping styles as the mediating variable and gender as the moderating variable.

Methods

A survey was conducted on 509 college students from two universities in Anhui Province, China, covering topics such as mobile phone addiction, depression, anxiety, and negative coping styles. SPSS software was used to analyze the relationship between variables.

Results

Depression, anxiety, negative coping styles, and mobile phone addiction are all significantly positively correlated. Negative coping styles mediate the relationship between depression, anxiety, and mobile phone addiction among college students. Gender regulates the relationship between depression/anxiety and mobile phone addiction. Specifically, the impact of negative emotions (depression and anxiety) on mobile phone addiction is greater in the male group than in the female group.

Conclusion

This study further reveals the psychological mechanisms behind the relationship between negative emotions (depression and anxiety) and mobile phone addiction. Negative coping styles are the mediating factor in this relationship, while gender is the moderating factor in this relationship.

The coping, appraisal, and resilience in aging (CARA) model: Longitudinal findings from the Normative Aging Study

Resilience is central to understanding how individuals withstand the adverse effects of stress, but there is no generally agreed-upon definition of what constitutes resilience in later life. The present study tests the coping, appraisal, and resilience in aging model, which posits that resilient older adults, when faced with a problem, can draw upon their lifelong experience to minimize coping effort to conserve resources but still maintain a sense of coping efficacy (perceptions of how well they had handled the specific problem). We assessed coping effort and efficacy in 896 men in the Veterans' Affairs Normative Aging Study (Mage in 1993 = 64.46, SD = 6.6, range = 50-89) who were followed for 24 years (1993-2016), providing 3,459 observations. Multilevel modeling showed that coping effort decreased significantly, but coping efficacy showed only modest decreases with age. Group-based multitrajectory models indicated three groups. Struggling Copers (22.4%) had low, stable coping effort and efficacy. Modest Decliners (36.9%) had moderate levels of coping effort and high efficacy, both of which decreased with age. Optimal Copers (40.7%) had initially high coping effort, which declined more steeply, and stable, high coping efficacy. Struggling Copers were highest on neuroticism and pessimism at baseline, while Modest Decliners were lowest on neuroticism and highest on extraversion. The complex pattern of results suggested that both resource conservation and decreasing perceived control models were applicable, but to different subgroups. Nonetheless, nearly 80% of the sample were able to sustain high levels of coping efficacy, indicating good resilience in later life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An intervention study of poly-victimization among rural left-behind children based on the theoretical framework of planned behavior

BACKGROUND

Poly-victimization (PV) not only threatens physical and mental health but also causes a range of social problems. Left-behind children in rural areas are more likely to experience PV problems. However, there have been fewer studies on PV among rural children, and even fewer intervention studies.

OBJECTIVE

The difference-in-differences method was employed to analyze the impact of intervention measures, based on the theory of planned behavior, on PV among left-behind children in rural areas.

METHODS

The study subjects were left-behind children from six middle schools in two cities in southern China, who completed the baseline survey from 2020 to 2021. They were divided into a control group and an intervention group, each consisting of 228 cases, based on their schools. Before and after the intervention, the Self-made victimization-related knowledge, attitude, and practice questionnaire, Poly-victimization scale, and Middle school students' coping style scale were used to evaluate the victimization-related KAP(knowledge, attitude, and practice), victimization occurrence, and coping styles of left-behind children, respectively. Stata 15.0 was used to establish a difference-in-differences regression model to analyze the impact of the intervention measures on poly-victimization and coping styles.

RESULTS

Mixed Anova revealed that after the intervention, the KAP scores of the intervention group were significantly higher than those of the control group (p < 0.05). After the intervention, the incidence of child victimization in the intervention group dropped to 9.60% (n = 22), lower than in the baseline survey, with a statistically significant difference (p < 0.01). The incidence of PV among children in the intervention group was lower than that in the control group, with the difference being statistically significant (p < 0.01). The net reduction in the incidence of PV among children was 21.20%. After the intervention, the protection rate for preventing PV among children was 73.33%, and the effect index was 3.75. The intervention improved children's coping styles, problem-solving, and help-seeking, while reducing negative coping styles such as avoidance and venting, with the differences being statistically significant (p < 0.05).

CONCLUSION

Intervention measures based on the theory of planned behavior reduce the occurrence of PV among left-behind children, and the intervention effects on different types of victimization are also different.

Coping strategies and symptoms of Adjustment Disorder among adults with Attention Deficit Hyperactivity Disorder (ADHD) during the Covid-19 pandemic

BACKGROUND

The current study examined whether coping strategies and symptoms of Adjustment Disorder in adults with ADHD differed from what was observed in the general adult population during the Covid-19 pandemic, and compared the extent to which coping strategies and symptom levels of Adjustment Disorder were related to ADHD.

METHOD

This cross-sectional study was based on survey data collected during the spring of 2021 from 231 adult ADHD patients in specialist care and 1148 volunteers without ADHD in Sweden. The survey included questions about sociodemographic and clinical characteristics, along with the Brief-COPE and Adjustment Disorder-New Module 8 questionnaires. Regression models adjusting for sociodemographic and clinical characteristics were used for between-group comparisons of coping strategies and symptoms of Adjustment Disorder.

RESULTS

There were some notable differences in the use of coping strategies between persons with and without ADHD; however, many of these differences were not observed in the adjusted models. The use of behavioral disengagement was more frequently observed among individuals with ADHD, whereas planning was more common among individuals without ADHD. Individuals with ADHD appeared to show higher symptom levels of Adjustment Disorder during the pandemic. Passive coping strategies, such as denial, self-blame, and behavioral disengagement, were associated with higher symptom levels of adjustment disorder in both individuals with and without ADHD.

CONCLUSION

In conclusion, the results highlight that persons with ADHD may need more support to adjust to large societal changes than the general public. Potential targets for intervention towards members of this group include reducing resignation and maladaptive coping strategies.

Psychological distress and coping skills used by individuals in the crisis caused by the COVID-19 pandemic

BACKGROUND

Psychological distress, as a key indicator, describes a person's emotional problems and psychological reactions to adapt to the environment. This study aimed to investigate the relationship between psychological distress and coping strategies used by individuals during the crisis caused by COVID-19.

MATERIALS AND METHODS

The current research is an analytical cross-sectional study that was designed in 2021. The sampling area included the three cities of Lar, Gerash, and Evaz in the south of Fars province in the south of Iran. The study population was the residents of these three cities during the COVID-19 pandemic. The final sample size in the present study was 384 people. Individuals were selected through available sampling. By answering questions from the self-assessment system of COVID-19 disease, the Ministry of Health and Medical Education filled out the necessary information for individual screening and registration of the symptoms of COVID-19 disease. Then, they completed the Coping Methods Questionnaire and the Psychological Distress Questionnaire.

RESULTS

The mean age of the participants was 40.90 years. One hundred sixty-seven (43.5%) participants were male, and 217 (56.5%) were female. The mean score of problem-oriented coping style was significantly different between the levels of education (P = 0.001). The mean score of problem-solving coping style for the participants suspected of being infected with COVID-19 was 6.18 scores lower than others, and the difference was statistically significant (P = 0.001). Multiple regression with a forward selection also showed that among the studied variables, age, problem-oriented, and emotion-oriented coping strategies were important variables affecting mental distress.

CONCLUSION

People who were not suspected of having COVID-19 symptoms had a higher mean problem-oriented coping score than those who were suspected of having COVID-19. Therefore, early identification of suspects and the implementation of counseling and training programs can be very effective.

Patient activation and psychological coping strategies to manage challenging circumstances during the COVID-19 pandemic in people with kidney disease

BACKGROUND

Coping with health problems requires some degree of self-management; however, an individual's ability to self-manage can be threatened during challenging times, such as the COVID-19 pandemic. Exploring differences and changes in psychological well-being and coping strategies between those with low and high patient activation may inform appropriate interventions to support psychological coping.

METHODS

People with chronic kidney disease (CKD) (non-dialysis and transplant) were recruited from 11 hospital sites across England between August and December 2020. Participants responded to an online survey study, including the Brief Coping Orientation to Problem Experienced (COPE) Inventory, Depression, Anxiety and Stress Scale (DASS-21), Short Health Anxiety Index (SHAI), and Patient Activation Measure (PAM-13). A follow-up survey was conducted 6-9 months later. Paired t tests assessed within-group changes, and chi-squared tests compared coping strategies utilised by low- and high-activated participants. General linear modelling was performed to determine the relationship between patient activation and coping strategies, and covariates.

RESULTS

Two hundred and fourteen participants were recruited (mean age: 60.7, 51% male, mean eGFR: 38.9 ml/min/1.73 m2). Low-activated participants were significantly more anxious than high-activated participants (P = 0.045). Health anxiety significantly decreased (i.e., got better) for high-activated participants (P = 0.016). Higher patient activation scores were associated with greater use of problem-focused strategies (β = 0.288, P < 0.001). Age (β = - 0.174, P = 0.012), sex (β = 0.188, P = 0.004), and education level (β = 0.159, P = 0.019) significantly predicted use of problem-focused strategies.

DISCUSSION

Those with higher activation had lower levels of anxiety, and more frequently used adaptive coping strategies during the pandemic. Targeted support and interventions may be required for people with CKD to enhance patient activation, encourage more positive adaptive coping strategies, and mitigate maladaptive coping strategies.

The Influence of Anxiety and Avoidant Coping on Probable Cannabis Use Disorder

Objective

Individuals with anxiety frequently use cannabis to cope and are at greater risk for developing probable cannabis use disorder (CUD). Previous literature suggests avoidant coping styles are associated with higher anxiety levels and risk for problematic cannabis use, while action-oriented coping is associated with lower anxiety and problematic cannabis use. No studies have examined whether anxiety and action-oriented coping or avoidant coping interact to influence risk for CUD, which was the aim of the present study.

Method

College students were recruited as part of a cross-sectional study on cannabis use. Participants (N = 371; 72.2% female) completed the Depression Anxiety and Stress Subscale (DASS-21), Cannabis Use Disorder Identification Test-Revised (CUDIT-R), and the Brief-COPE (B-COPE).

Results

The data were analyzed using logistic moderation analysis. After controlling for gender, anxiety was a positive significant predictor of probable CUD, but action-oriented coping and avoidant coping were not. The interaction between anxiety and avoidant coping on probable CUD was significant, indicating that participants with high avoidant coping (regardless of high or low anxiety) and those with high anxiety (even with low avoidant coping) were more likely to have probable CUD than those with both low anxiety and low avoidant coping. No significant interaction was observed with action-oriented coping.

Conclusions

Results suggest that avoidant coping, but not action-oriented coping, influences the relationship between anxiety and risk for probable CUD. Findings emphasize the importance of targeting both anxiety and avoidant coping when considering risk for probable CUD.

A Moderation Model for Bolstering Resilience to Suicidal Psychopathology: Positive Sociopsychological Constructs and Coping Flexibilities Buffering the Impact of Daily Life Stress Among Medical Students

ABSTRACT

Positive sociopsychological constructs and coping flexibility may be helpful for alleviating suicidal psychopathology, although relatively little research has examined this possibility among medical students. This survey aimed to investigate whether positive sociopsychological constructs and coping flexibility could buffer the negative impact of daily life stress and bolster the resilience to suicidal ideations and attempts among medical students. This cross-sectional model was based on a study of 787 Indian medical students (725 women and 62 men; mean age, 21.08 years; SD = 2.78; range, 19-37 years) who were asked to complete a battery of self-administered questionnaires. For the purpose of determining the independent and interaction impacts of potential variables of influence, hierarchical multiple linear regression models were used. The moderation analysis investigated that the association between daily life stress and suicidal ideation was buffered among the students having higher levels of positive mental health and coping flexibility, whereas this association was no longer significant at the highest level of positive mental health. Furthermore, the relationship between daily life stress and suicidal attempts continued to be buffered by above-average levels of coping flexibility, emotional stability (ES), and optimism. These findings represent that promoting positive mental health, coping flexibility, ES, and optimism may be a promising approach to mitigate suicidal thoughts and attempts in interventions for medical students at high risk. These modifiable moderating factors can be enhanced by empirically supported treatment and prevention efforts to bolster suicidal resilience.

An Examination of Coping Strategies that Moderated the Effects of COVID-19-Related Stress on Anxiety Among Older Adults in Aotearoa/NZ

Objectives: 1. To describe perceived stress and changes in anxiety and coping among older adults between 2018 and 2020. 2. To examine the moderating roles of social support, exercise, alcohol use, and smoking on the relationship between perceived stress and anxiety. Methods: Longitudinal data collected from 3275 participants (M = 68.1 years) as part of the NZ Health, Work, and Retirement study's 2018 and 2020 biennial surveys, were analyzed using hierarchical regression. Results: Older adults perceived COVID-19 as a low-level source of stress. Social support and alcohol use moderated the relationship between perceived mental stress and anxiety. At high-stress levels, only social support exerted a protective effect against the negative impact of stress on anxiety. Discussion: These findings support the general resilience of many older adults and highlight the effectiveness of coping strategies used by those groups who are more likely to be vulnerable to mental stress during a pandemic.

Pre-pandemic mental health and coping strategy usage during the COVID-19 pandemic: a cross-sectional analysis of the Southern Cities Study

BACKGROUND

Little is known about the usage of coping strategies recommended by the World Health Organization and the Centers for Disease Control and Prevention during the COVID-19 pandemic and whether coping strategy usage varies by pre-pandemic mental health. This study examined the prevalence of different coping strategies and associations of their usage with pre-pandemic mental health.

METHODS

Data were collected from adults residing in metropolitan areas of the U.S. South in May/June 2020 using random-digit-dialing and web-based surveys (n = 1,644). We estimated the prevalence of each coping strategy: (1) keeping up-to-date about COVID-19; (2) taking breaks from the news or social media; (3) taking care of physical health; (4) engaging in relaxing activities; (5) reaching out to and spending time with others; and (6) trying to find comfort in religious or spiritual beliefs. We examined the association between the use of each strategy and pre-pandemic mental health using modified Poisson regression, adjusting for covariates. We also analyzed the association between pre-pandemic mental health and the number of coping strategies employed using ordered logistic regression.

RESULTS

The most prevalent strategies were: "keeping up-to-date about COVID-19" (53%), "taking care of physical health" (52%), and "reaching out to and spending time with others" (52%). Good pre-pandemic mental health was associated with an increased prevalence of "reaching out to and spending time with others" (adjusted prevalence ratio, 1.43; 95% confidence interval, 1.07-1.91). The use of other coping strategies and the number of coping strategies used during the pandemic did not vary by pre-pandemic mental health.

CONCLUSIONS

Our findings suggest that people who had good pre-pandemic mental health were more likely to connect with other people during the COVID-19 pandemic. Given the well-documented impact of social support on mental health in disaster contexts, efforts to promote safe social connections for those with pre-existing mental health concerns are needed.

Lived experiences and meanings of the COVID-19 pandemic: A case of the elderly survivors

The extent of risk brought about by the COVID-19 pandemic on the well-being of the elderly has emphasized the need to investigate their experiences during these challenging times. This study was conducted to explore the elderly's lived experiences as COVID-19 patients and to understand how they make sense of and cope with what happened to them when infected with COVID-19. Using Husserl's descriptive phenomenology, 13 elderly from Naval, Biliran Province, Philippines were chosen as participants using purposive sampling. The total number of participants was determined through theoretical saturation. In-depth interviews and the writing of field notes were done to collect information on the participants' experiences. The transcripts were analyzed following Colaizzi's steps in descriptive phenomenological method of analysis. Four general themes emerged for the elderly's lived experiences during the pandemic. These included discrimination, social isolation, anxiety and stress, and fear. Findings revealed that despite the challenges the elderly encountered during the pandemic and when they tested positive for COVID-19, they had seen it as an opportunity to improve and change their practices. The strategies that the elderly employed to cope with the pandemic were all adaptive and have resulted in positive outcomes. Results of the study emphasize the need for more programs and policies to enhance the care and support provided to the elderly during a health crisis.

College Graduates' Negative Life Experiences, Coping Strategies and Enlightenment During the COVID-19 Pandemic: A Qualitative Study in China

Objective

The current study aimed to explore comprehensively college graduates' negative life experiences, coping strategies, and enlightenment in a qualitative way.

Methods

This was a qualitative study. Purposeful sampling was used to select 31 college graduates majoring in various subjects from a Chinese University. The one-on-one semi-structured interviews were conducted online through Tencent QQ/WeChat and were recorded and transcribed verbatim. A phenomenological approach was used to guide this research in the data collection and analysis. Thematic analysis was used to identify themes across interviews around their negative life experiences, coping strategies, and enlightenment.

Results

College graduates' negative life experiences were mainly focused on three aspects: negative work experience (eg, lack of adaptation, busy schedule, low salary), negative personal life experience (eg, multiple pressure, psychological problems, the hardship of life), and negative social life experience (eg, the incomprehension of those around you, complex interpersonal relationship, social complexity). The coping strategies they used can be classified into two categories: emotion-focused strategies (eg, accepting reality, self-persuasion, keeping a positive attitude), and problem-focused strategies (eg, goal-setting, asking for help to solve the problem, persistence). As for life enlightenment, six themes emerged: accept life, strive to life, love life, cherish life, recognize life, and learn to live.

Conclusion

College graduates' negative experiences came from multiple levels, and they use multiple coping strategies to deal with the challenges. Our results provide important guidance for researchers and policymakers to design effective and targeted intervention programs to improve college graduates' coping abilities in response to negative life experiences and help them better transition from school to work. Specifically, future research and intervention to promote college graduates' mental health should target various social-ecological levels, focus on promoting coping from an ecological perspective, as well as facilitate post-traumatic growth to help them grow from negative life experiences and cope positively.

Risk Factors and Consequences of Parental Burnout: Role of Early Maladaptive Schemas and Emotion-Focused Coping

Resulting from chronic exposure to parenting stress, parental burnout is a syndrome located on a continuum between stress and depression. Research interest is growing, and several risk factors have already been identified, but more studies are needed. We assessed the relationship between early maladaptive schemas (as potential risk factors), coping strategies, and the three dimensions of parental burnout (emotional and physical exhaustion, emotional distancing, and loss of parental accomplishment). A total of 115 French-speaking parents answered an online questionnaire. Results (correlations and acyclic graph driven by emotion-focused coping) confirmed the influence of EMSs on the expression of parental burnout. More specifically, schemas in the following three EMS domains were identified as major risk factors: disconnection and rejection (especially abandonment/instability, emotional deprivation, and defectiveness/shame), impaired autonomy and performance (especially dependence/incompetence and failure), and over-vigilance and inhibition (especially negativity/pessimism and punitiveness). Interestingly, our results suggest that emotional coping is not a risk factor for parental burnout, but a consequence of emotional and physical exhaustion and loss of parental accomplishment. Thus, the more parents reported overactivation of these EMSs, the more they are exhausted, and the more they use emotion-focused coping. These results are discussed in terms of possible therapies.

Brief Assessment of Adaptive and Maladaptive Coping Strategies During Pandemic

This study aimed to analyse the internal structure, internal consistency, and convergent and divergent validity for the Coping Strategies Scale. We found a two-factor solution (maladaptive coping; adaptative coping) with a second-order general factor (coping strategies) that demonstrated adequate factorial structure and internal consistency for a brief nine items instrument in a sample of 211 economically active Brazilians (M_age = 37.07; SD = 13.03). The adaptive strategies factor converged with quality of life and work. It also diverged from phobia, stress, and anxiety. Maladaptive coping strategies converged with phobia, stress, and anxiety and diverged from the quality of work and life. According to the results, we found that coping strategies are a vital personal resource to overcome daily adversity, including those from the current pandemic. The present instrument may impact worldwide, offering conditions to investigate and promote mental health positive outcomes by reinforcing coping assessment during pandemics.

Using a cognitive framework with nurses to manage stress

Nursing can be a stressful occupation with many nurses struggling to cope with stress on a day-to-day basis. Considerable evidence suggests that positive coping strategies can be an effective part of stress management education programs. This article describes the theoretical rationale for a cognitive framework for stress management that was developed as part of a well-being educational program for cancer nurses. This framework included an associated mnemonic (www.pst) to assist in the recall and utilization of positive coping strategies. The stress management framework was intended to increase nurses' perceptions of personal control which is central to stress management. The academic coping literature is complex, jargon laden and often conceptually abstract, and may not easily be understood by a nonacademic audience. The cognitive framework described here is an evidence-based, user-friendly tool that could be used and evaluated by counsellors, educators, and researchers in different settings.

Reciprocal relationships between self-esteem, coping styles and anxiety symptoms among adolescents: between-person and within-person effects

BACKGROUND

Previous researches have not distinguished the between-person effects from the within-person effects when exploring the relationship between self-esteem, coping styles, and anxiety symptoms among adolescents. To address this gap, this study investigated reciprocal associations among self-esteem, coping styles, and anxiety symptoms in a three-wave longitudinal panel survey, using an analytical strategy that disaggregates the within-person and the between-person variance.

METHODS

Data was drawn from the Longitudinal Study of Adolescents' Mental and Behavioral Well-being Research study conducted in 10 public schools in the Guangdong province of China. All participants had a baseline visit (N = 1957, mean age 13.6, grades 7 and 10) and follow-up interviews at 1-year intervals for 3 years. A random intercept cross-lagged panel model combined with mediation analysis was performed.

RESULTS

At the within-person level, the following results were observed. (1) Low self-esteem and anxiety symptoms bidirectionally predicted each other. (2) Low self-esteem and negative coping style bidirectionally predicted each other. (3) Anxiety symptoms predicted subsequent negative coping style but not vice versa. At the between-person level, we obtained the following main results. (1) Significant predictive effects on the random intercept were found among all three study constructs. (2) There were sex differences regarding the association between self-esteem and anxiety symptoms and the correlation of females was stronger than that of males. (3) Self-esteem mediated the reciprocal relations between coping styles and anxiety symptoms.

CONCLUSIONS

Overall, findings revealed a reciprocal relationship between low self-esteem and anxiety symptoms for both females and males. Besides, anxiety symptoms predict subsequent negative coping style but not vice versa. We also highlighted the mediating role of self-esteem in the reciprocal relations between coping styles and anxiety symptoms. Thus, interventions targeted at promoting self-esteem and cultivating positive coping style may help reduce adolescent anxiety.

Psychometric Validation of the Brief-COPE Scale in a Sample of Individuals with Multiple Sclerosis: A Brief Report

People with multiple sclerosis (MS) must often cope with high levels of stress, especially during the ongoing COVID-19 pandemic. The Brief-COPE is commonly used to assess how individuals use different coping strategies to deal with stressful life situations, but its application with people who have MS has not been validated. The purpose of this study was to assess the measurement structure and psychometric properties of the Brief-COPE in a sample of community-dwelling adults with multiple sclerosis, using exploratory factor analysis. Results revealed a three-factor measurement structure: (a) flexible coping, (b) succumbing coping, and (c) substance use coping. Correlations among these three factors and external measures of related concepts provided evidence of the validity of these factors. The Brief-COPE can be incorporated in rehabilitation counseling, mental health, and health care settings to assess coping strategies, assisting people with MS with managing stressful life events during and after the pandemic. Rehabilitation and health researchers can use it to assess the effectiveness of psychosocial interventions aimed to improve coping abilities and mental health of people with MS.

Anxiety-related activity of ventral hippocampal interneurons

Anxiety is an aversive mood reflecting the anticipation of potential threats. The ventral hippocampus (vH) is a key brain region involved in the genesis of anxiety responses. Recent studies have shown that anxiety is mediated by the activation of vH pyramidal neurons targeting various limbic structures. Throughout the cortex, the activity of pyramidal neurons is controlled by GABA-releasing inhibitory interneurons and the GABAergic system represents an important target of anxiolytic drugs. However, how the activity of vH inhibitory interneurons is related to different anxiety behaviours has not been investigated so far. Here, we integrated in vivo electrophysiology with behavioural phenotyping of distinct anxiety exploration behaviours in rats. We showed that pyramidal neurons and interneurons of the vH are selectively active when animals explore specific compartments of the elevated-plus-maze (EPM), an anxiety task for rodents. Moreover, rats with prior goal-related experience exhibited low-anxiety exploratory behaviour and showed a larger trajectory-related activity of vH interneurons during EPM exploration compared to high anxiety rats. Finally, in low anxiety rats, trajectory-related vH interneurons exhibited opposite activity to pyramidal neurons specifically in the open arms (i.e. more anxiogenic) of the EPM. Our results suggest that vH inhibitory micro-circuits could act as critical elements underlying different anxiety states.

Linking University Students' Mindfulness to Positive Adjustment Amidst COVID-19 Pandemic: a 6-month Cross-Lagged Panel Design

Objectives

In the face of a global pandemic, research on wellness-fostering resources is urgently needed, especially with longitudinal designs and diverse samples. According to the mindfulness-to-meaning theory and broaden-and-build theory, this study examined the reciprocal associations among a group of Chinese university students' trait mindfulness, positive and negative affect, and use of positive coping strategies, including positive reappraisal, planning, and seeking of emotional support during the COVID-19 pandemic.

Methods

Participants were 247 Hong Kong university students (M _age = 20.96, SD = 2.38; female = 86%) who completed survey measures of mindfulness, positive and negative affect, and positive coping strategies at baseline and 6-month follow-up. Data were analysed using a cross-lagged panel design, controlling for participants' age.

Results

The proposed reciprocal model exhibited an excellent fit with the data. There was a reciprocal association between trait mindfulness and positive affect over time. However, no significant reciprocal effect was found among mindfulness, negative affect, and positive coping strategies.

Conclusions

Theoretically, the current findings extended the two theories to a non-Western population during a critical time and suggested a long-term reciprocal association between positive affect and mindfulness. Our study provided important insight into university students' positive well-being during COVID-19 and demonstrated the wellness-fostering effect of mindfulness.

Effects of interpersonal relational role analysis on nursing students' depressive symptoms and coping styles

PURPOSE

This study aims to investigate the effects of interpersonal relational role analysis (IRRA) on nursing students' depressive symptoms and coping styles.

DESIGN AND METHODS

This study was conducted with randomized controlled, pretest-posttest control group design, and follow-up test patterns (n = 10).

FINDINGS

As a result, IRRA had a positive effect on nursing students' depressive symptoms and coping styles.

PRACTICE IMPLICATIONS

Psychiatric nurses and other mental health professionals can readily use IRRA to help reduce depressive symptoms in groups with mild to moderate depressive symptoms and to develop effective styles to cope with stress.

Older adults' mentioned practices for coping with loneliness

In recent years, loneliness has been receiving increasing attention, yet there remains a lot to learn about how older adults cope with loneliness. In this study, the practices older adults consider for coping with loneliness and the relationship between various types of coping practices, loneliness, and personal resources are examined. Several hypotheses about the relationship between social and emotional loneliness, personal resources, and mentioning coping practices are formulated. Data was collected in Gipuzkoa (Basque Country, Spain) through structured interviews using a telephone survey among a representative sample of older adults aged 55 and over (N = 894). Results show that lonely and non-lonely respondents alike consider a few coping practices and prefer active and individual coping practices over social and passive ones for coping with loneliness. Experiencing emotional loneliness is related to mentioning more individual and active coping practices. Social coping practices were considered less often by respondents who experienced better self-rated health and more often by respondents with vision loss, a higher educational level and higher quality of life. In conclusion, while older adults differ in coping efforts they mention, these differences are only explained to a small extent by their experience of loneliness and available resources. For future research and practice development, a deeper understanding of the process of coping with loneliness is needed.

Coping strategies and their association with diabetes specific distress, depression and diabetes self-care among people living with diabetes in Zambia

OBJECTIVES

Utilising coping strategies to reduce and manage the intensity of negative and distressing emotions caused by diabetes is essential. However, little is known about the use of coping strategies among people living with diabetes in Sub-Saharan African countries like Zambia. This study investigates coping strategies used by people with diabetes in Zambia and how these are associated with diabetes-specific emotional distress, depression and diabetes self-care.

METHODS

Cross-sectional data from 157 people with diabetes aged between 12 and 68 years were collected. Of the 157, 59% were people with type 1 diabetes and 37% with type 2 diabetes. About 4% had missing information in their record but had either type 1 or type 2 diabetes. Coping styles were measured using the Brief Version of the Coping Orientation to Problems Experienced (Brief COPE), diabetes specific-distress using the Problem Areas in Diabetes, depression using the Major Depression Inventory and self-care using the Diabetes Self-Care scale.

RESULTS

Data showed that adaptive coping strategies such as religious coping, acceptance among others, were the most frequently used coping strategies among Zambian individuals with diabetes. Maladaptive coping strategies e.g., self-blame and self-distraction were related to increased diabetes specific-distress and depression. Emotional support was related to better diabetes self-care, while self-blame was related to poor diabetes self-care.

CONCLUSION

There is need to help individuals with diabetes identify adaptive strategies that work best for them in order to improve their quality of life.

Healthcare professionals’ perceptions and experiences of the influence of the COVID-19 pandemic on their personal and work performance

BACKGROUND: Healthcare workers are known to experience higher stress levels compared to other industry workers due to challenges presented in their work environment. The global pandemic of COVID-19 has seen many countries’ healthcare systems struggle to meet the demands of healthcare seekers. OBJECTIVE: The aim of the article is to explore healthcare professionals’ perceptions and experiences of the influence of the COVID-19 pandemic on their personal and work performance. METHODS: Twelve individuals working in the health sector participated in this study. The researchers used a qualitative exploratory and descriptive research design. Semi-structured interviews were used to collect data. RESULTS: Theme one “A feeling of ambivalence”, describes the positive and negative influence that the COVID-19 pandemic has had on HCWs. Theme two “Unfortunately, the support from the government is not as much as it’s said to be in the news”, describes the support required from government services during the pandemic. Theme three “Changes experienced by the individual related to his or her personal and work routine”, describes the changes experienced by healthcare professionals in their daily tasks during the pandemic. CONCLUSION: The study found that the work environment contributed to experiences of burnout and anxiety due to staff shortages, lack of personal protective equipment (PPE) and an increase in work pressure. More research needs to be conducted to inform policies and organizations on how to best support healthcare workers to prevent burnout and anxiety.

Stress appraisal as a mediator between the sense of coherence and the frequency of stress coping strategies in women and men during COVID-19 lockdown

The COVID-19 lockdown experience is a unique and unexpected stressful life situation. In our research project, we explored gender differences in the mean level of stress appraisal (SAQ), the frequency of stress coping strategies (COPE), and the sense of coherence (SOC), as well as gender differences in the strength of the relationships between SAQ, COPE, and SOC during the COVID-19 lockdown. Finally, we tested if stressor appraisal (as a threat, harm/loss, or challenge) mediates the relationship between SOC and COPE in women and men respectively. Data were collected during the first wave of the COVID-19 lockdown in Poland in 2020. An online survey was conducted among 326 adults aged between 18 and 72. We observed gender differences in the level of SAQ, COPE, and SOC and gender differences in the significance and strength of the correlations between these variables. SOC had a twofold effect on COPE in men: direct and indirect through SOC-threat and SOC-harm/loss. In women, SOC did not directly predict COPE frequency but affected COPE in an indirect way through SAQ. SAQ is an important factor that modifies the strength of the SOC effect on COPE in women and men during the lockdown.

Resilience to suicidal behavior in young adults: a cross-sectional study

Despite decades of research on suicide risk factors in young people, there has been no significant improvement in our understanding of this phenomenon. This study adopts a positive deviance approach to identify individuals with suicide resilience and to describe their associated psychological and sociodemographic profiles. Australian young adults aged 18–25 years with suicidal thoughts (N = 557) completed an online survey covering sociodemographic, mental health status, emotion regulatory and suicide-related domains. Latent class analysis was used to identify the individuals with suicide resilience. The predictors of suicide resilience were assessed using logistic regression models. The results suggested that one in ten (n = 55) met the criteria for suicide resilience. Factors that had a significant association with suicide resilience included greater cognitive flexibility, greater self-efficacy in expressing positive affect, reduced use of digital technology and less self-harm and substance use as a response to emotional distress. This study identified the factors that may protect young adults with suicidal thoughts from progressing to suicide attempts. Suicide prevention programs might be optimised by shifting from a deficit-based to a strength-based approach through promoting cognitive flexibility, self-efficacy and reducing maladaptive coping.

Prevalence, severity, and self-management of depressive mood among community-dwelling people with spinal cord injury in Nepal

Background

Depression is a common psychological condition after spinal cord injury. There are increased incidences of self-harm, suicidal behavior, and lower quality of life among people with spinal cord injury and depression. However, self-management of depressive symptoms in the community is less explored.

Objective

This study aimed to examine the prevalence, severity, and self-management of depressive mood in community-dwelling people with spinal cord injury.

Methods

A descriptive study was conducted in 2019 among 115 people with spinal cord injury discharged from three health centers and living in the 13 districts of Bagmati Province. Participants were selected using stratified random sampling. Questionnaires were related to demographics, health and environment, depressive mood, and self-management. Descriptive statistics and quantitative content analysis were used to analyze the data.

Results

Ninety-seven (84.3%) people with spinal cord injury had a depressive mood. Of these, 60.8% had moderate to severe depressive moods. They mainly used the internet and social media, shared feelings with family members, and practiced Hindu religious activities for depressive mood management because of the physical barriers to accessing a healthcare facility and easiness to use of non-pharmacological methods. Nearly half of participants who used sharing of feelings felt their depressive mood disappeared when they often used the method.

Conclusion

Depressive mood following initial hospitalization is highly prevalent among people with spinal cord injury in Nepal, most of whom live in rural settings. Therefore, nurses and other health professionals should provide psychoeducation for this population and their family members to better address mental health problems. Facilitating pathways for those in rural areas to engage in social activities and timely treatment access may improve depressive mood. Nurses and other rehabilitation professionals can use social media to assess depressive moods and deliver management approaches in the community.

Long-term effects of a resilience-based intervention on mental health of children affected by parental HIV in China: Testing the mediation effects of emotion regulation and coping

Resilience-based interventions have been suggested to improve mental health among children affected by parental HIV. Very few studies, however, have explicitly tested the mechanisms of change underlying the effects of resilience-based interventions on mental health among this group of children. The present study utilized a cluster randomized controlled trial to determine the effects of the Child-Caregiver-Advocacy Resilience (ChildCARE) intervention on mental health for children affected by parental HIV. Specifically, we examined the effects of the intervention on three mental health outcomes (i.e., depressive symptoms, school anxiety, loneliness) and whether emotion regulation and coping played mediating roles in the intervention's effectiveness. Child-caregiver dyads (N = 790) were randomly assigned by clusters to three intervention groups and a control group. Children reported on mental health outcomes for 36 months at 6-month intervals. Latent growth curve models showed that there were no direct impacts of the ChildCARE intervention on changes in mental health outcomes beyond 18-month follow-up. Mediation analyses showed that the ChildCARE intervention yielded significant improvements in positive coping, but not negative coping or emotion regulation at 18 months. Emotion regulation, positive coping, and negative coping were consistently associated with the intercepts (i.e., mean at 18 months) of mental health outcomes. Negative coping also significantly predicted the rates of change of mental health outcomes over time. Findings provide important implications for future resilience-based intervention development and highlight the promise of interventions that aim to strengthen emotion regulation and coping skills to improve mental health for children affected by parental HIV.

Associations of Depressive Symptoms, COVID-19-Related Stressors, and Coping Strategies. A Comparison Between Cities and Towns in Germany

BACKGROUND

The COVID-19 pandemic has led to a wide range of stressors related to depressive symptoms. Prevention measures like physical distancing have burdened the general population, especially in highly urbanized areas. However, little is known about the associations between pandemic-related stressors, coping strategies, and depressive symptoms in highly urbanized vs. less urbanized environments.

METHODS

Participants were recruited in a cross-sectional online survey in Germany. Propensity score matching yielded a matched sample of city (n = 453) and town (n = 453) inhabitants. Depressive symptoms, COVID-19-related stressors, and coping strategies were compared between cities and towns. Multiple regression analysis was performed to determine associations between pandemic-related stressors and depressive symptoms for the two groups separately.

RESULTS

City inhabitants showed significantly higher depression scores than town inhabitants (t = 2.11, df = 897.95, p = 0.035). Seven coping strategies were more often used by the city sample. Depressive symptoms were associated with "restricted physical social contact" and "difficult housing conditions" (adjusted R 2= 0.19, F [9,443] = 12.52, p < 0.001) in city inhabitants, and with "fear of infection" and "difficult housing conditions" (adjusted R 2= 0.20, F [9,443] = 13.50, p < 0.001) in town inhabitants.

LIMITATIONS

The data were collected at the end of the first wave and represent a snapshot without causal inferences. Pandemic-related stressors were measured with a newly developed scale.

CONCLUSION

Depressive symptoms, perceived stressors, and approach/avoidance coping strategies differed between city vs. town inhabitants. These differences should be considered in policy-making and mental health care.

Effects of the COVID-19 pandemic on the online learning behaviors of university students in Taiwan

Prior to the coronavirus disease 2019 (COVID-19) pandemic, due to the rarity of pandemics in recent centuries, suitable conditions did not exist in educational institutions for the implementation of asynchronous distance teaching. No empirical studies have been conducted on whether the considerable environmental changes caused by COVID-19 have affected students' online learning behaviors. Therefore, this study collected information on students' online learning behaviors during the COVID-19 pandemic and other periods to examine whether pandemic-caused environmental changes affected students' online learning behaviors. This study focuses on the 60-day transmission after the beginning of the second semester of the 2019 academic year. The data source was from a comparative assessment between the pandemic group (331 students) and the control group (101 students). The Spearman Rank Correlation Test and the Wilcoxon signed-rank test were used as our statistical methods. This paper presents preliminary results on how COVID-19 has affected students' online learning behaviors and proposes asynchronous online learning as a method for maintaining university students' learning during the COVID-19 pandemic.

Habitual use of psychological coping strategies is associated with physiological stress responding during negative memory recollection in humans

Research has identified a variety of strategies people use to cope with stress and that the adaptiveness of various strategies depends on the context in which they are used. However, important questions remain about the role of physiological stress response systems in supporting, influencing, or changing from coping strategies. This study works toward addressing this gap by examining associations between skin conductance level (SCL) and habitual use of coping strategies. It was hypothesized that more use of problem-focused strategies would be associated with SCL trajectories that were more stable and decreased less steeply, with the opposite trend hypothesized for more use of emotion-focused strategies. Participants were 188 college students (78% female) who reported their use of 14 coping strategies. SCL was recorded during recall of a negative family memory from childhood for five minutes. Trajectories of SCL during the recall were estimated with multilevel modeling. Greater self-distraction, planning, active coping, use of emotional support, and coping flexibility were related to trajectories of SCL that decreased less steeply and were more stable. Problem-focused coping and coping flexibility are, therefore, related to reduced SCL reactivity and promoting these skills may benefit mental health.

Using Mixed Methods to Assess the Coping and Self-regulation Skills of Undergraduate Social Work Students Impacted by COVID-19

Developing coping and self-care strategies has always been important for social work students as they prepare for work that can take a psychological, emotional, mental, and physical toll and adversely impact their health and well-being. The COVID-19 pandemic is unprecedented in its impact on social work education as it forced students to quickly transition to online learning and leave field sites abruptly to do remote activities. The degree to which and how social work students effectively coped with these changes has not been adequately studied, despite recognition that understanding how personal experiences and affective reactions influence professional judgment and behavior is a critical social work competency. To help fill this void, a mixed-methods study was conducted using video narratives and survey data to assess the coping and self-regulation skills of a cohort of undergraduate social work students. Findings indicate that these students experienced multiple stressors in all aspects of their biopsychosocial functioning due to COVID-19. Many coping skills learned for use with clients were demonstrated by students themselves. Self-sufficient, avoidant, and socially-supported coping mechanisms were frequently used and relied on by students. Use of self-distraction and active coping increased, while denial decreased within the first month after transitioning to remote learning. Implications of the findings for social work education, practice, and research are discussed.

A path to post-trauma resilience: a mediation model of the flexibility sequence

Background: Psychological resilience has grown in popularity as a topic of study in psychotraumatology research; however, this concept remains poorly understood and there are several competing theories of resilience. Objective: This study sought to assess the support for one proposed theory of resilience: the flexibility sequence. Method: This study use secondary data analysis of panel survey data (N = 563). Participants were aged 18 years or over and based in the UK. A series of sequential mediation models was used to test the flexibility sequence theory as a proposed pathway of resilience on mental health outcomes (post-traumatic stress disorder, anxiety, and depression) among a trauma-exposed sample from the UK. Results: The 'feedback' component of the proposed flexibility sequence components was associated with reduced symptom severity with all outcomes, whereas 'context sensitivity' and 'repertoire' were significantly associated only with depression as an outcome. When indirect mediation pathways were modelled via the flexibility sequence, statistically significant effects were observed for all outcomes under investigation. Conclusions: These findings support the theorized flexibility sequence pathway of resilience, suggesting that the combination of these skills/processes performs more favourably as a framework of resilience than any in isolation. Further research into more elaborate associations and feedback loops associated with this pathway is warranted.

Coping in Pediatric Burn Survivors and Its Relation to Social Functioning and Self-Concept

Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, self-concept, demographic features, and burn injury characteristics were examined via bivariate correlations. Hierarchical linear regressions examined whether coping strategies predicted social functioning and youth self-concept beyond burn injury and demographic variables. Social functioning concerns were positively correlated with total body surface area (TBSA; r=0.63 and 0.40, respectively). TBSA was the only significant predictor of parent-reported social concerns (β=0.65, p<0.001). Greater distraction coping predicted fewer youth-reported social concerns (β=−0.39, p=0.01). Greater active coping (B=0.67, p=0.002) and lower avoidance coping (B=−0.36, p=0.03) predicted better youth-reported self-concept. This study advances our understanding of coping as potentially protective for psychosocial adjustment. Clinicians working with child burn survivors should incorporate active coping interventions into treatment. Further research including larger and more diverse samples is needed to understand the role of coping approaches on psychological adjustment during burn healing.

Depression and Anxiety in Times of COVID-19: How Coping Strategies and Loneliness Relate to Mental Health Outcomes and Academic Performance

The link between depression, anxiety, and loneliness has been well established in the literature. Yet, the performance consequences of these negative mental health outcomes and the role of coping behaviors, as well as behavioral consequences such as procrastination as mediators have received far less research attention. Due to the COVID-19 social isolation restrictions, people are at risk of falling into a negative mental health spiral that can also affect their performance over time. The purpose of this longitudinal study among 881 first-year bachelor students is to explore the mechanisms by which loneliness, coping strategies in the context of COVID-19, mental health outcomes and procrastination sequentially mediate the relationship depression and anxiety on the one hand, and academic performance on the other hand. We measured mental health variables several times during the COVID-19 crisis and assessed how this translates into academic performance at the end of the academic year. By performing exploratory and confirmatory factor analyses, three high-order factors for the coping strategies in the context of the COVID-19 crisis were identified, namely maladaptive coping, adaptive coping, and supportive coping. Structural equation modeling was used to test the sequential mediational model. The results showed that maladaptive coping strategies employed at T2 during the lockdown, but not adaptive or supportive coping partially mediate the trajectories of depression (T1) and anxiety (T1). Loneliness (T2) partially mediated the trajectory of depression and anxiety (T1), and procrastination fully mediated the impact of depression (T3) on academic performance (T4). These results help understand the mechanisms that influence mental health and academic performance outcomes in response to the COVID-19 crisis. Based on the study outcomes, educational researchers can test strategies to reduce the adverse effects of stressful situations in learning environments by targeting maladaptive coping behaviors and procrastination.

The Moderating Role of Grit in the Relationship Between Perfectionism and Depression Among Chinese College Students

Background: As a personality trait, perfectionism has shown a close association with psychological disorders, such as depression. The protective effect of grit on depression has been confirmed by a series of recent studies. Therefore, it is necessary to investigate the buffering role of grit in the above relationship and the possible underlying mechanism. Objective: Based on the multidimensional theory of perfectionism, we differentiated two dimensions of perfectionism as positive and negative and further examined the relationships between these two dimensions of perfectionism and depression. We also aimed to examine the possible moderating effect of grit on the above two relationships. Methods: Us a questionnaire survey approach, a total of 2,602 college students (1,608 females and 994 males) were assessed using the Frost Multidimensional Perfectionism Scale the Short Grit Scale, and the Center for Epidemiological Studies-Depression Scale. Hierarchical regression analysis was used to investigate the direct effect of two dimensions of perfectionism on depression as well as the moderating role of grit in these associations. Results: After controlling for gender, age, family income, and academic performance, both positive and negative perfectionism had positive predictive effects on depression, and grit negatively moderated these two relationships. Specifically, grit completely counteracted the effect of positive perfectionism on depression yet partly counteracted the effect of negative perfectionism on depression. Conclusion: Grit prevents the depressive symptoms raised by positive and negative perfectionism.

Emotion Regulation Difficulties and Depression Among Individuals With Dermatological and Body Dysmorphic Concerns

ABSTRACT

Existing literature demonstrates strong links between emotion regulation (ER) difficulties and depression. Although high rates of depression are observed among individuals with body dysmorphic disorder and skin disease, little is known about these co-occurring syndromes. To advance our understanding of a vulnerable population, this study examined facets of ER difficulties in relation to depression among adults with skin disease symptoms and body dysmorphic concerns (N = 97). Participants were recruited online and completed self-report measures. The overall hierarchical regression model accounted for 61.6% of the variance in depression. After controlling for anxiety and stress, ER difficulties added 9.9% unique variance. In particular, limited access to ER strategies was the only ER dimension significantly associated with depression. This study integrates divergent literatures and suggests the important role of ER difficulties in depression in this unique sample, thereby highlighting directions for future investigation.

Mental health and its association with coping strategies and intolerance of uncertainty during the COVID-19 pandemic among the general population in Saudi Arabia: cross-sectional study

BACKGROUND

The COVID-19 pandemic has had a major impact on people's lives globally. The outbreak in Saudi Arabia worsened when the number of cases and deaths rose in March and April of 2020, leading to a national lockdown. This study aimed to assess the factors associated with mental health symptoms in a sample of people residing in Saudi Arabia during the COVID-19 pandemic.

METHODS

We conducted an observational cross-sectional study using an online survey distributed via social media, completed by 3032 respondents from all Saudi regions. We collected demographic data, illness history, and scores of validated self-report scales to assess mental health symptoms, intolerance of uncertainty, and coping strategies.

RESULTS

In total, respondents indicated moderate to very severe symptoms during the pandemic as follows: 20.9% for depression, 17.5% for anxiety, and 12.6% for stress. Younger age, female gender, and history of mental illness were associated with higher levels of depression, anxiety, stress, and insomnia. Intolerance of uncertainty and certain coping strategies (such as denial or self-blame) were associated with more severe symptoms.

CONCLUSIONS

Mental health is a key concern during the COVID-19 pandemic, especially for the identified vulnerable groups. Agencies concerned with mental health during crises may use the studied associated factors of mental health symptoms to generate targeted policies or interventions.

Moderation Effects of Coping Flexibility on the Association Between Depressive Symptoms and Suicidal Risk

Background: This study focused on poor coping flexibility, which involves the perseveration of a failed coping strategy, as a moderator of the association between depression and suicidal risk; no study has previously examined the association between coping flexibility and suicidal risk. Aims: This study examined whether individuals with lower coping flexibility would have a stronger suicidal risk when experiencing depression above a certain level. Method: Participants, who were 682 college students, answered questionnaires regarding coping flexibility, depressive symptoms, and suicidal risk. Results: Hierarchical multiple regression analyses showed that in individuals with greater depressive symptoms, lower coping flexibility was associated with higher suicidal risk, but this was not the case in individuals without depressive symptoms. Our hypothesis was supported. Limitations: Our findings cannot indicate the causal direction of the association between coping flexibility and depressive symptoms and suicidal risk. Conclusion: Our findings may be useful in understanding the association between depression and suicidal risk through coping flexibility and contribute to reductions in suicidal risk, as coping flexibility can be improved through training.

Asylum Caseworkers' Experience Working in Lesvos: A Grounded Theory Analysis

PURPOSE

Assisting asylum applicants through their procedure for international protection implies a commitment that most caseworkers accept with deep satisfaction. However, working with asylum applicants who disclose the claim for protection and stories of their journey can be challenging and distressing. The study aimed to understand the experience of caseworkers with the asylum applicants in Lesvos, specifically, the challenges they face and their perception of the qualities that facilitated or inhibited coping.

METHOD

A grounded theory analysis within a constructivist framework involved interviews with thirteen caseworkers, cultural mediators, and operations officers in Levos and Malta.

FINDINGS

A two-phase analysis was conducted due to unexpected findings. The first phase of the analysis uncovered the challenges posed by the work itself, and the caseworkers' personal characteristics which were either helping or hindering addressing these challenges. The second analysis revealed a four-step process as perceived by the asylum caseworkers: starting from the work context, facing challenges, finding ways to respond to them, and finally, the effect that this process had on the caseworkers' perspective about themselves and life.

CONCLUSION

For those who developed adaptative coping, interviews indicated a process of transformation in the caseworkers' perception, a new sense of self and world view, including the development of self-awareness, personal power, the relation to work and the refugees, and a deeper cultural understanding. Recommendations are provided for caseworkers' mental-health and operational support as well as for future research.

Coping in the Covid-19 pandemia: how different resources and strategies can be risk or protective factors to mental health in the Brazilian population

OBJECTIVE

The present study's objective was to investigate the pandemic's impact on mental health and identify variables that can increase or decrease the chances of stress, anxiety, and depression, in both a sample with and one without self-reported mental health issues, in a Brazilian population.

DESIGN

a cross-sectional quantitative study. Data were collected online in May and June of 2020. Participated 1130 adults between 18-78 years old (mean = 37.46 years, SD = 12.18), from 20 Brazilian states, with an average of 58.61 days (SD = 23.2) of social distancing.

MAIN OUTCOME MEASURES

Depression, anxiety and stress symptoms, characterization of social distancing, and Coping strategies.

RESULTS

A significantly higher prevalence of severe depression was found in those who practiced social distancing. Multinomial logistic regressions identified the explanatory model with risk and protection variables to mental health. For the group without a previous mental health diagnosis, using confrontation (OR = 1.39, CI95% 1.23-1.58) and escape strategies (OR = 1.48, CI95% 1.19-1.84) increases the odds of presenting severe depression, while positive reappraisal (OR = 0.85, IC95% 0.78-0.93) and problem-solving (OR = 0.75, CI95% 0.63--0.88) were protective factors. In the group with mental disorders, using confrontation (OR = 1.33, CI95% 1.10-1.60) and escape strategies (OR = 1.49, CI95% 1.12-1.98) were also risk factors for severe depression and no coping protective factors were found.

CONCLUSIONS

Problem-solving and positive reappraisal were protective strategies that potentially reduced the odds of presenting depression and anxiety, but only in people without a previous mental health diagnosis. Public policies must offer psychological support to the most vulnerable, as well as orientation based on scientific evidence, aiming at improving quality of life.

Qualitative, longitudinal exploration of coping strategies and factors facilitating infant and young child feeding practices among mothers in rural Rwanda

Background

Mothers in low-income countries face many challenges to appropriately feed their children in the first year such as poverty, food insecurity and high workloads. However, even in the lowest income families there are mothers who succeed to feed their children according to the recommendations. In this paper, we explored the coping strategies that facilitate appropriate breastfeeding and complementary feeding practices among rural Rwandan mothers from birth to one year of a child’s life.

Methods

This qualitative longitudinal study recruited a purposive sample of 17 mothers who followed the infant and young child feeding recommendations (IYCF). They were selected from a larger study of 36 mothers. In-depth interviews were conducted with mothers of the total group (36 mothers) within the first week, at 4^th, 6^th, 9^th and 12^th months postpartum. Interviews were audio-recorded, transcribed verbatim and analyzed thematically.

Results

Coping strategies included improving mothers’ own diet for adequate breastmilk production, prioritizing child feeding over livelihood chores, livelihood diversification and mothers’ anticipatory behaviors such as preparing child’s food in advance. Some of those coping strategies were shifting overtime depending on the development of the children. Personal factors such as breastfeeding self-efficacy, religious beliefs and perceived benefits of breastfeeding were among the facilitating factors. Additionally, social support that mothers received from family members, other mothers in the community, Community Health Workers (CHWs) and health professionals played an important role.

Conclusion

In challenging contextual conditions, mothers manage to follow the recommended breastfeeding and complementary feeding practices through the interplay of active coping strategies, feeling to be in control and social support. Nutrition promotion interventions that aim to improve IYCF should consider strengthening mothers’ capability in gaining greater control of their IYCF practices and the factors facilitating their appropriate IYCF practices.

COVID-19 quarantine stressors and management among Lebanese students: a qualitative study

The aim of this research paper is to examine the current situation, emotional reactions of university students and their coping mechanisms during and after the COVID-19 quarantine. The study was undertaken in a major higher education institution in Lebanon. An exploratory qualitative research design was adopted. A phenomenological qualitative method was employed where, semi-structured interviews were carried out among 20 university students during and 3 months after release from quarantine. The qualitative analysis have revealed 5 themes during quarantine period namely "Concerns regarding learning and evaluation methods", "Overwhelming load", "Dealing with technical difficulties", "Confinement", and "Coping with problems", in addition to 3 themes after the quarantine period namely "Relief of academic stress", "Fear of becoming infected and jeopardizing family health", "Stigma of being infected". The quarantine has inflicted multiple psychological challenges among university students, which should be highlighted and mediated by higher education institution in order to support the students' learning and their academic achievement.

Risk and Protective Factors Associated With Health-Related Quality of Life of Parents With Mental Illness

Purpose: Health-related quality of life (HRQoL) can be reduced in parents with mental illness (mental illness) who face the dual demands of disabling symptoms and their impact on family, social, and occupational life. This study aimed at analyzing the influence of various factors on HRQoL in parents with mental illness. Method: Baseline data of the German randomized controlled multicenter project CHIMPS (children of parents with mental illness) was used for analyses. The final sample consisted of n = 208 parents with mental illness and n = 197 children and adolescents aged 8-18 years. HRQoL was assessed with the EQ-5D. Results: Parents with mental illness reported significantly lower global and specific HRQoL than the German reference population. They were least satisfied with aspects that relate to anxiety and depression followed by usual activities, pain and discomfort. Better global HRQoL was primarily associated with self-reported physical and mental health, as well as adaptive coping behavior. Associations with mobility, self-care, usual activity, pain and discomfort, anxiety and depression were analyzed and discussed. Conclusions: HRQoL in parents with mental illness is reduced. Clinical interventions should focus on the alleviation of mental health symptoms and probably somatic symptoms and promote adaptive coping skills.

Coping strategies that reduce suicidal ideation: An ecological momentary assessment study

BACKGROUND

While suicide-specific psychosocial interventions often teach coping skills to suicidal individuals, little is known about the strategies that individuals intuitively use on their own to cope with suicidal ideation in everyday life.

AIMS

The present study used Ecological Momentary Assessment (EMA) to examine the effectiveness of specific coping strategies individuals use naturally to reduce the intensity of suicidal thinking.

METHOD

Fifty participants endorsing suicidal ideation with co-morbid mood disorder and borderline personality disorder completed one week of EMA. Real-time use, perceived effectiveness of 7 common coping strategies and intensity of suicidal ideation were assessed at 6 epochs (i.e., timepoints) each day.

RESULTS

Participants reported using an average of 4 coping strategies per epoch. Factor analysis (FA) (exploratory followed by confirmatory FA) identified two coping factors: one that included distraction/positive activity-based strategies (i.e., keeping busy, socializing, positive thinking, and doing something good for self) and a second that contained mindfulness-oriented strategies (i.e., finding perspective, calming self, and sitting with feelings until they pass). Although participants perceived all coping strategies as effective, only strategies in the first factor, distraction/positive activity-oriented strategies, lowered the intensity of suicidal thoughts in everyday life. Furthermore, baseline suicidal ideation was inversely related to overall use of coping strategies and particularly use of coping strategies that were found to lead to lowered suicidal ideation.

CONCLUSIONS

Distraction/positive activity based strategies are helpful in decreasing suicidal ideation in the short-term. These findings can help clinicians advise patients about strategies to use to cope with suicidal thoughts to prevent acting on them in a crisis and they also have the potential to inform development of psychosocial interventions to prevent suicide.

Exploring Lived Experiences of Parents of Youth and Youth with a Foreign Background in Sweden

Background

Sweden is in transition when it comes to the immigrant experience. More research is needed to document the life circumstances and adjustment of those with foreign background living in Sweden.

Objective

This study investigated the lived experiences of parents of youths and young people themselves who have an Iraqi or Syrian background and are living in Sweden.

Method

This cross-sectional qualitative interview study focused on a sample of parents of youth and youth (N = 26) with a foreign background. Participants were either born in Syria or Iraq or had one or both parents born in these countries and had migrated to Sweden. Participant interviews were analyzed using thematic analysis.

Results

In relation to the study aim, the analysis indicated three main themes in participants’ responses which concerned life in Sweden, feeling at home, and coping.

Conclusions

Overall, these themes reflected how the perception of everyday experiences relates to adjustment within a multi-cultural urban Swedish context. This study showed how participants with a foreign background are rich in their own diversity of experiences and viewpoints. Results also pointed towards the promise of social policy and services aimed at benefiting those with a foreign background if such efforts are situated in the microsystems that provide life daily structure, as well as in contexts that offer socialization and networking opportunities (e.g., training, education, work, and school). Further, such action should consider the importance of the extended family as part of family-focused initiatives.

Sources of Stress and Their Associations With Mental Disorders Among College Students: Results of the World Health Organization World Mental Health Surveys International College Student Initiative

The college years are stressful for many students. Identifying the sources of stress and their relative importance in leading to clinically significant emotional problems may assist in the development of targeted stress management interventions. The current report examines the distribution and associations of perceived stress across major life areas with 12-month prevalence of common mental disorders in a cross-national sample of first-year college students. The 20,842 respondents were from 24 universities in 9 countries that participated in the World Health Organization World Mental Health International College Student Initiative. Logistic regression analysis examined associations of current perceived stress in six life areas (financial situation, health, love life, relationships with family, relationships at work/school, problems experienced by loved ones) with six types of 12-month mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, panic disorder, alcohol use disorder, drug use disorder). Population attributable risk proportions (PARPs) were calculated to estimate the upper-bound potential effects of interventions focused on perceived stress in reducing prevalence of mental disorders. The majority of students (93.7%) reported at least some stress in at least one of the six areas. A significant dose-response association was found between extent of stress in each life area and increased odds of at least one of the six disorders. The multivariable models that included all stress measures were significant for all disorders (F = 20.6-70.6, p < 0.001). Interpretation of PARPs as representing causal effects of stresses on disorders suggests that up to 46.9-80.0% of 12-month disorder prevalence might be eliminated if stress prevention interventions were developed to block the associations of stress with these disorders.