Age differences in coping: does less mean worse

Factors Influencing Farmers' Use of Adaptive and Maladaptive Coping Strategies

OBJECTIVES

Chronic stress is associated with a variety of negative outcomes for farmers in the United States (U.S) and worldwide, who face near-constant exposure to internal (e.g. family conflict) and external (e.g. weather) stressors. Research indicates that farmers' stress may be reduced by engaging in adaptive coping strategies and avoiding maladaptive coping strategies. However, little is known about what predicts their coping strategy use. Informed by the transactional theory of stress and coping, the present manuscript seeks to identify factors associated with U.S. farmers' use of adaptive and maladaptive coping strategies.

METHODS

U.S. farmers (N = 135) completed survey assessments of factors theorized to be associated with coping strategy choice (maladaptive beliefs about farm stress management, farm stress management self-efficacy, age, and sex) as well as measures of adaptive and maladaptive coping.

RESULTS

Farm stress management self-efficacy was a significant, positive predictor of adaptive coping, and maladaptive beliefs about farm stress management were a significant, positive predictor of maladaptive coping. Maladaptive beliefs about farm stress management and farm stress management self-efficacy interacted to predict maladaptive coping, such that the positive relationship between maladaptive beliefs about farm stress management and maladaptive coping was significant at higher levels of self-efficacy. Sex was unrelated to coping strategies, and age was negatively associated with maladaptive coping strategies but unassociated with adaptive coping strategies.

CONCLUSION

The findings point to the utility of increasing farm stress self-management self-efficacy to increase farmers' adaptive coping and reducing maladaptive beliefs about farm stress management to reduce maladaptive coping. Efforts to promote adaptive coping by increasing self-efficacy should also target maladaptive beliefs farmers hold toward stress management, because increasing self-efficacy may also increase the likelihood of maladaptive coping when maladaptive beliefs are present.

Support- and meaning-focused coping as key factors for maintaining adult quality of life during the COVID-19 pandemic in Germany

Introduction

During the COVID-19 pandemic, questions about both consequences and helpful strategies to maintain quality of life (QoL) have become increasingly important. Thus, the aim of this study was to investigate the distribution of coping factors during the COVID-19 pandemic, their associations with QoL and the moderating role of certain sociodemographic characteristics.

Methods

Analyses were based on cross-sectional self-reports from German adult participants (N = 2,137, 18-84 years, 52.1% female) of the CORONA HEALTH APP Study from July 2020 to July 2021. Multivariate regression analyses were used to predict (a) coping factors assessed with the Brief COPE and (b) QoL assessed with the WHOQOL-BREF while taking measurement time, central sociodemographic, and health characteristics into account.

Results

During the COVID-19 pandemic, German adults mostly pursued problem- and meaning-focused coping factors and showed a relatively good QoL [Mean values (M) from 57.2 to 73.6, standard deviations (SD) = 16.3-22.6], except for the social domain (M = 57.2, SD = 22.6), and with a decreasing trend over time (β from -0.06 to -0.11, ps < 0.01). Whereas, escape-avoidance coping was negatively related to all QoL domains (β = -0.35, p < 0.001 for psychological, β = -0.22, p < 0.001 for physical, β = -0.13, p = 0.045 for social, β = -0.49, p < 0.001 for environmental QoL), support- and meaning-focused coping showed positive associations with various QoL domains (β from 0.19 to 0.45, ps < 0.01). The results also suggested differences in the pursuit of coping factors as well as in the strength of associations with QoL by sociodemographic characteristics. Escape-avoidance-focused coping was negatively associated with QoL levels in older and less educated adults (simple slopes differed at ps < 0.001), in particular.

Conclusions

The results demonstrated what types of coping may be helpful to avoid QoL deterioration (i.e., support- and meaning-focused coping) and provide implications for future universal or targeted health promotion (i.e., older or less educated adults who lack social or instrumental support) and preparedness in the face of unknown challenging societal situations similar to that of the COVID-19 pandemic. Cross-sectional trends of enhanced use of escape-avoidance-focused coping and QoL deterioration point toward a need for increased attention from public health and policy.

Psychological Impact of Cancellation of Elective Surgeries for Ophthalmic Patients during COVID-19 Pandemic

The COVID-19 pandemic has disrupted routine hospital services globally. The cancellation of elective surgeries placed a psychological burden on patients. A questionnaire study was conducted to identify the psychological impact of canceling cataract operations on patients at Kowloon East Cataract Center, Tseung Kwan O Hospital, Hong Kong, from April to June 2020. In total, 99 participants aged 59 years old and above, who had their cataract surgeries postponed or as scheduled, were studied using the standardized patient health questionnaire (PHQ-9) and generalized anxiety disorder questionnaire (GAD-7). None of the patients who had their cataract surgeries rescheduled reached the cutoff score for major depression in PHQ-9, whereas, according to GAD-7, five patients had mild symptoms of anxiety, and one had severe symptoms. There was no significant psychosocial impact of the cancellation of cataract surgeries on patients.

"Important" Life Events and Depression among Older Adults

The current article examines the role of psychosocial factors in the relationship of life events and depression among older adults by focusing on a single "most important" life event. Using data from a random community sample of older adults, the study finds that although health-related events do exacerbate the level of depression resulting from an undesirable life event, their exclusion from the analysis still results in a significant relationship between non-health-related events and depressive symptomatology. Controlling for both types of undesirable life events, the study further documents that psychological resources are more effective than social resources in predicting subsequent level of depression for those experiencing health-related events. For those experiencing non-health-related life events, social resources are most important in predicting subsequent symptomatology. Implications are discussed.

Coping Strategies of Middle-Aged and Older Women Who Have Undergone a Mastectomy

The purpose of this study was to examine the types of coping strategies used by middle-aged (n = 51) and older women (n = 49) who had a mastectomy and the relationship between the types of coping strategies used and the level of depression they experienced. Although both age groups of women used active-cognitive and active-behavioral coping strategies, more of the older women employed avoidance strategies than their middle-aged counterparts. The type of coping strategies used was not associated with depression levels for the middle-aged women. For older women, using avoidance strategies and not using cognitive strategies were associated with higher depression scores

Coping trajectories in later life: a 20-year predictive study

OBJECTIVES AND METHOD

Information about aging-related change in coping is limited mainly to results of cross-sectional studies of age differences in coping, and no research has focused on predictors of aging-related change in coping behavior. To extend research in this area, we used longitudinal multilevel modeling to describe older adults' (n = 719; baseline M = 61 years) 20-year, intraindividual approach and avoidance coping trajectories, and to determine the influence of two sets of predictors (threat appraisal and stressor characteristics; gender and baseline personal and social resources) on level and rate of change in these trajectories.

RESULTS

Over the 20-year study interval, participants declined in the use of approach coping and most avoidance coping strategies, but there was significant variation in this trend. In simultaneous predictive models, female gender, more threat appraisal, stressor severity, social resources, and depressive symptoms, and fewer financial resources were independently associated with higher initial levels of coping responses. Having more social resources, and fewer financial resources, at baseline in late-middle-age predicted faster decline over time in approach coping. Having more baseline depressive symptoms, and fewer baseline financial resources, hastened decline in use of avoidance coping. Independent of other variables in these models, decline over time in approach coping and avoidance coping remained statistically significant.

CONCLUSION

Overall decline in coping may be a normative pattern of coping change in later life. However, it also is modifiable by older adults' stressor appraisals, their stressors, and the personal and social resources they possess at entry to later life, in late-middle-age.

Aging and disability: biopsychosocial perspectives

Understanding the complex trajectories of disability and aging requires a biopsychosocial approach that considers disability in the broader context of later adulthood. Although disability service researchers and gerontologists have many shared interests and a similar mission, the fields are relatively new to one another and have had little historical interaction. The purpose of this article is to increase and improve collaboration among investigators in these fields by providing some background in social gerontology to the disability researcher, and by applying key theories in aging to the issue of growing older with physical disability. The article discusses particular problem areas for older adults, including social support, and also discusses the parallel paradoxes of aging and disability.

Coping with chronic pain among younger, middle-aged, and older adults living with neurological injury and disease

Objective. This article compares use of pain coping strategies among older, middle-aged, and younger adults living with chronic pain and seeks to determine whether the relationship between pain severity and coping is moderated by age. Method. Participants were 464 adults reporting chronic pain secondary to multiple sclerosis, spinal cord injury, or neuromuscular disease. Participants completed a survey including measures of pain severity and the Chronic Pain Coping Inventory. Results. After controlling for clinical and demographic variables, older adults (older than 60) reported a wider range of frequently used strategies and significantly more frequent engagement in activity pacing, seeking social support, and use of coping self-statements than did younger or middle-aged adults. Moderation analyses suggest that, for younger adults, efforts at coping generally increased with greater pain severity, whereas this relationship did not exist for older adults. Discussion. These data suggest differences in the quantity and quality of pain coping among age groups.

Treatment of older adults with co-morbid personality disorder and depression: a dialectical behavior therapy approach

BACKGROUND AND SIGNIFICANCE

The treatment of personality disorders in older adults, particularly those co-morbid with other Axis I disorders (e.g., Major Depressive Disorder), is an understudied clinical phenomenon. It has also been demonstrated that personality disorders in older adults complicate treatment of other psychopathology, as well as result in heightened interpersonal disturbance and emotional distress.

METHODS

Two studies utilizing standard Dialectical Behavior Therapy (DBT) to treat depression and personality disorders in older adults are reviewed. Study 1 examined 34 chronically depressed individuals aged 60 and older who were randomly assigned to receive 28 weeks of antidepressant medication plus clinical management, either alone (MED) or with the addition of DBT skills-training and scheduled telephone coaching sessions (MED + DBT). Study 2 had two phases of treatment: Phase I: 8-week open-trial of antidepressant medication (n = 65); Phase II: 24-week randomized trial of DBT + MED versus MED alone for those who prospectively failed to respond to the Phase I medication trial (n = 37).

RESULTS

Study 1 demonstrated that 71% of MED + DBT patients were in remission at post-treatment, in contrast to 47% of MED patients. This became a significant difference at the 6-month follow-up; where 75% of MED + DBT-D patients were in remission compared with only 31% of MED patients. Study 2 showed that after 8 weeks of treatment with antidepressant medication alone (Phase 1) only 14% of the sample had at least a 50% reduction in HAM-D scores. Phase II results showed on average, the DBT + MED group reached depression remission by the post-group assessment and maintained these gains while the MED group did not reach remission, until the follow-up assessment. Results demonstrated superiority of DBT + MED compared to MED alone on Interpersonal Sensitivity and Interpersonal Aggression at post-treatment and 6-month follow-up.

CONCLUSION

Results from these two treatment development studies indicate that applying standard DBT for the treatment of co-morbid MDD or MDD + PD in older adults is feasible, acceptable, and has clinical promise. Modifications to standard DBT and an overview of a new treatment manual for this population are summarized.

Mental health, stress correlates and psychotropic drug use or non-use among aged caregivers to elders with dementia

The goal of the study was to compare caregivers who used psychotropic drugs with caregivers who were non-users in order to pinpoint differences in coping styles between the two groups. We performed a secondary analysis of a study on the stress and psychological well-being of persons caring for relatives with dementia. We compared elderly caregivers, as either psychotropic drug users (n = 61) or non-users (n = 133), over various psychosocial characteristics relating to the care-giving context. Results reveal that users, as compared to non-users were: (a) more disturbed (appraised a greater stress) by the relative's dysfunctional behaviours, after controlling for the frequency of the behaviours; and (b) experienced more conflict during interpersonal interactions, although their appraisal of self-satisfaction with formal and informal support to their care-giving activities did not differ significantly. Strikingly, users combined and called on a greater number of problem-focused and emotion-reducing coping strategies than did non-users. They more frequently used affective regulation and information seeking coping styles. Stress-related measures (especially stress appraisal and conflict) contributed more to the variation in mental distress of users than of non-users. Results provide a theoretical and empirical rationale for therapeutic interventions such as the cognitive behavioural approach.

Coping strategies and health status of elderly arthritic women

With increasing age many elderly people experience personal and social losses. Physical health declines, there is a loss of vigour and an increased susceptibility to disease. Osteoarthritis, the most common form of arthritis in the elderly, is the greatest cause of disability and limitation of activity in older populations. The purpose of this descriptive study was to investigate how elderly women cope with the physical impairment and pain associated with osteoarthritis and to examine the relationship between coping strategies and health status. The sample consisted of 130 women over 75 years, living alone in one of five life care communities. Three instruments were used to collect data: The Ways of Coping Scale, The Arthritis Impact Measurement Scale and The Musculoskeletal Impairment Index. Pearson product-moment correlations and stepwise multiple regression were used to analyse data. The mean age of the sample was 83.2 years and over 40% had attained bachelor's degree or higher. The most utilized coping strategy was self-control. The study variables accounted for 49% of the variance in physical health and 20% in psychosocial health.