Effects of Flexibility in Coping with Chronic Headaches on Depressive Symptoms

Moderating effect of coping flexibility over waiting patiently as a coping strategy for interpersonal stressors and depressive symptoms

Objective: The present study examined the moderating effect of coping flexibility on the association between the coping waiting patiently for interpersonal stressors and depression. Coping flexibility refers to devising and implementing suitable coping strategies according to the situation, coping was defined in this study as holding oneself back and not acting prematurely to address a stressful relationship. Participants: A total of 481 Japanese college students. Methods: Participants completed questionnaires to measure coping, coping flexibility, perceived stress, and depression using a longitudinal design. Results: Multiple regression analysis showed that an interaction between coping and coping flexibility was associated with depression. This result indicated that higher levels of coping was associated with lower depression 16 weeks later when coping flexibility was higher, but the association was not observed when coping flexibility was lower. Conclusions: Our findings contribute to elucidating the condition or process whereby the strategy of waiting patiently as a coping mechanism for interpersonal stressor reduces depression.

Exploring the Effects of Coping Flexibility on Sleep Quality via Subjective Distress: A Longitudinal Study of Young Adults

BACKGROUND

Coping flexibility is one's ability to modify their coping strategies and adapt to the demands of stressful situations. However, limited studies have demonstrated that coping flexibility directly influenced sleep quality. This study examined the relationships between coping flexibility, subjective distress, and sleep quality. We hypothesized that coping flexibility would enhance sleep quality via subjective distress.

METHODS

In total 99 male and 151 female college students completed questionnaires on coping flexibility, subjective distress, and sleep quality. Subsequently, they completed the questionnaire on sleep quality six months later.

RESULTS

Structural equation modeling showed a significant indirect effect of coping flexibility, which indicated that higher coping flexibility was associated with higher sleep quality via reduced subjective distress.

CONCLUSIONS

Our findings suggested that subjective distress and lower coping flexibility were risk factors for poor sleep quality.

Indigenous population and major depressive disorder in later life: a study based on the data from Longitudinal Ageing Study in India

BACKGROUND

Existing evidence suggests that the indigenous older population who live with their families and friends might experience lesser depressive symptoms due to better emotional support and well-being. The present study aimed to investigate the differentials in the prevalence of the major depressive disorder among tribal and non-tribal older populations in India and to explore the contribution of socio-demographic, health-related, and household factors in such disparities.

METHODS

A cross-sectional study was conducted using data from the Longitudinal Aging Study in India (2017-18). The analytical sample included 30,637 older adults, among whom 5,025 and 25,612 belonged to the Scheduled Tribe (ST) and non-Scheduled Tribe (non-ST) social groups, respectively. Major depressive disorder assessed by the Composite International Diagnostic Interview short-form (CIDI-SF) scale was the outcome variable. Descriptive statistics, bivariate and multivariable regression and, decomposition analyses were conducted.

RESULTS

About 4.8% and 8.9% of older adults from the ST and non-ST social groups had major depression. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression. Findings from differences due to characteristics (E) revealed that if the regional differences were minimized, it would decrease the ST-non-ST gap in major depression by about 19.6%. Similarly, equal self-rated health status and chronic conditions among ST and non-ST groups would decrease the gap in major depression by almost 9.6% and 7.9%, respectively. Additionally, an equal status of Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) among older adults would decrease the gap in major depression by about 3.8% and 3% respectively. Also, findings from differences due to coefficients (C) revealed that if older adults from the ST group had the same status of ADL as of older adults from the non-ST group, it would decrease the gap in major depression by about 11.8%.

CONCLUSION

The findings revealed a greater prevalence of major depression in older adults belonging to the non-ST group than the ST group. For both tribal and non-tribal groups, older adults who were unmarried, dissatisfied with living arrangements, and those who faced lifetime discrimination were at increased risk of major depression and these factors along with health-related variables contributed to significant ST-non-ST gap in depression, advantageous to tribal population; suggesting further research on the coping mechanisms of mental illnesses among indigenous population in India.

Evaluating Optimism, Hope, Resilience, Coping Flexibility, Secure Attachment, and PERMA as a Well-Being Model for College Life Adjustment of Student Veterans: A Hierarchical Regression Analysis

The purpose of this study is to examine (a) to what extent demographic covariates, foundational and emerging positive psychology traits (FEPPTs), and PERMA uniquely predict college life adjustment, health-related quality of life (HRQOL), and life satisfaction of student military veterans; (b) PERMA as a happiness and well-being model for college life adjustment, HRQOL, and life satisfaction among student veterans; and (c) FEPPTs as predictors of PERMA. In addition, we tested whether total PERMA scores mediate the relationship between service-connected disability and college adjustment. A total of 205 student veterans responded to an online survey. Results revealed that demographic covariates (e.g., service-connected disability), FEPPTs (e.g., optimism), and PERMA (e.g., positive emotion) significantly accounted for college life adjustment, HRQOL, and life satisfaction of student veterans. In addition, a mediation analysis revealed that PERMA partially mediated the relationship between service-connected disability and college life adjustment of student veterans. The results of this study provide empirical supports for the use of PERMA as a comprehensive well-being model of college life adjustment for student veterans.

Psychological maltreatment, coping flexibility, and death obsession during the COVID-19 pandemic: A multi-mediation analysis

Recent psychological studies have reported that child maltreatment is a common issue during the COVID-19 pandemic, with negative factor leading to greater risk of occurrence of mental health problems. However, the relationship between psychological maltreatment and psychological factors is complex. Understanding the factors, which may help to provide interventions, is a critical step for mental health providers. This study aims to examine the relationships between psychological maltreatment, coping flexibility, coronavirus anxiety, coronavirus stress, and death distress. We collected data from 394 Turkish young adults (76% male: average age 21.36 ± 2.57 years) during the outbreak of COVID-19. The results of multi-mediation analysis showed that psychological maltreatment was positively related to the death obsession. More importantly, this relationship could be explained through the mediated effects of coping flexibility, coronavirus anxiety, and coronavirus stress. This study highlights the non-negligible role of psychological maltreatment in affecting death obsession and the role of coping flexibility in explaining the psychological influence of maltreatment.

Coping with Stress, Executive Functions, and Depressive Symptoms: Focusing on Flexible Responses to Stress

Coping flexibility is conceptually similar to both inhibition and set-shifting. Though they serve different functions, all three are robustly associated with depression. Coping flexibility is the ability to relinquish a coping strategy regarded as ineffective and to devise and implement an alternative one; the concept is based on stress and coping theory. Inhibition is the ability to suppress responses selectively according to a change in the situation, while set-shifting is the process of switching flexibly between task sets, mental sets, or response rules. Inhibition and set-shifting are both executive functions in cognitive mechanisms. We hypothesized that coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. In total, 200 Japanese university students (100 women and 100 men) completed questionnaires that measured coping flexibility and depression and performed the Stroop Color and Word Test and the Wisconsin Card Sorting Test, which measured inhibition and set-shifting. We found that greater coping flexibility was associated with a lower risk of depression, even when the effects of inhibition and set-shifting were controlled for. Our findings suggest that, although coping flexibility is conceptually similar to inhibition and set-shifting, its association with depression differs from theirs.

Effects of Coping Flexibility in Young Women on Depressive Symptoms during Chronic Pain

Chronic pain is a worldwide problem that has a high prevalence rate and is often comorbid with depression. Coping flexibility, which is defined as the ability to discontinue an ineffective coping strategy-evaluation coping-and to produce and implement an alternative strategy-adaptive coping-has attracted much interest as an important factor that attenuates pain-induced stress responses, including depression. This study hypothesized that greater coping flexibility would be associated with lower depression in both women with chronic pain and those with menstrual pain. The participants included women with chronic pain (n = 292) and those with menstrual pain (n = 181) who completed questionnaires on pain intensity, pain acceptance, psychological inflexibility, and coping flexibility for chronic pain. The hierarchical multiple regressions revealed that both evaluation coping and adaptive coping predicted depression even after controlling for the effects of pain intensity, pain acceptance, and psychological inflexibility, which are well-known for their association with depression in patients with chronic pain. The hypothesis was supported in our samples. Our findings may contribute to the development of self-management without self-medication using over-the-counter analgesics by acquiring coping flexibility for chronic pain.

Flexibility in Coping with Stress Questionnaire: structure and psychometric properties

BACKGROUND

Flexibility in coping relies on applying a coping strategy that is appropriate to the circumstances. Individuals who are flexible in coping exhibit sensitivity to subtle signals sent by the environment. Therefore, they are able to adjust their behaviour accordingly and function in a more adaptive manner.

PARTICIPANTS AND PROCEDURE

The study included N = 1535 participants. The following methods were used: the Flexibility in Coping with Stress Questionnaire (FCSQ-14) and the Cognitive Flexibility Inventory (CFI).

RESULTS

The Flexibility in Coping with Stress Questionnaire measures flexibility as a feature of the process of coping with which an individual applies coping strategies. The Flexibility in Coping with Stress Questionnaire is an accurate and reliable method of measuring coping flexibility and three of its subscales: the Repertoire of coping strategies, the Changeability of their use, and Reflexivity.

CONCLUSIONS

The Flexibility in Coping with Stress Questionnaire examines three subscales of flexibility, namely, Repertoire of coping strategies, Changeability, and Reflexivity. This measurement is accurate and reliable. The questionnaire is applied to the study of persons exposed to severe or chronic stress at work, when we want to assess the individual's ability to change their functioning in a stressful situation. It can be used to examine healthy and somatically ill people, in the area of research and clinical diagnosis.

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.

Making Others Laugh is the Best Medicine: Humor Orientation, Health Outcomes, and the Moderating Role of Cognitive Flexibility

Humor orientation is related to numerous prosocial outcomes. This study examined the relationships between humor orientation and mental well-being, loneliness, headaches, and sleep disturbances. We also tested cognitive flexibility as a moderator of these associations among (N = 406) young adults. The results showed that humor orientation was associated with increased mental well-being, lower levels of loneliness, and less headaches. The direct effect from humor orientation to sleep disturbances was not significant. The interaction effects between humor orientation and cognitive flexibility on all four health outcome variables were significant. The implications of the results are discussed in detail.

Examination of the Coping Flexibility Hypothesis Using the Coping Flexibility Scale-Revised

Coping flexibility, as defined by the dual-process theory, refers to one’s ability to relinquish a coping strategy recognized as ineffective—abandonment—and to devise and implement an alternative and more effective strategy—re-coping. The coping flexibility hypothesis (CFH) dictates that richer coping flexibility produces more adaptive outcomes caused by stress responses, such as reduced psychological and physical dysfunction. We tested the reliability and validity of the Coping Flexibility Scale-Revised (CFS-R) and the CFH using the CFS-R, which was developed to measure coping flexibility. In total, we performed three studies involving 6,752 participants. Study 1 provided the psychometric properties of the CFS-R and tested this factorial structure by a confirmatory factor analysis. Study 2 estimated the validity of the CFS-R by examining the associations between its three subscales and variables that were conceptually similar to them. Study 3 tested the CFH using a longitudinal design after controlling for the effects of typical coping strategies and other types of coping flexibility. Overall, the CFH was supported by the use of the CFS-R, and the findings in Studies 2 and 3 showed that it had acceptable validity and reliability. Our findings implied that abandonment and re-coping can predict reduced depressive symptoms more than other types of theoretical framings for coping flexibility. Additionally, a meta-analysis of the Cronbach’s alphas for all samples in this study (k = 9, N = 6,752) showed that they were 0.87 (95% CI [0.87, 0.88]) for abandonment, 0.92 (95% CI [0.91, 0.92]) for re-coping, and 0.86 (95% CI [0.85, 0.87]) for meta-coping.

Effects of waiting patiently as coping strategy for an interpersonal stressor on depressive symptoms

Background: Coping behavior is known to moderate the effect of stressors on depressive symptoms. Increased reassessing coping, that is, waiting patiently for an appropriate opportunity to handle a stressful relationship, as coping strategy for interpersonal stressors is associated with lower depressive symptoms. Objectives: We hypothesized that higher reassessing coping would be associated with lower depressive symptoms in individuals with higher coping flexibility. Coping flexibility is the ability to discontinue a coping strategy that produces undesirable outcomes by monitoring and evaluating stressful situations and the effects of coping strategies. Methods: Two studies involving approximately 1,800 college students were conducted, one using a cross-sectional design (n = 281) and another a longitudinal design (n = 1,468). Results: In both studies, hierarchical multiple regression analyses showed that the interaction between reassessing coping and coping flexibility scores was predictive of a significant depressive symptom score. This indicates that higher levels of reassessing coping are associated with lower levels of depressive symptoms when coping flexibility is higher, whereas reassessing coping is not associated with depressive symptoms when coping flexibility is lower. Conclusions: These results were consistent with our hypothesis in both studies.

Effects of coping flexibility on cardiovascular reactivity to task difficulty

OBJECTIVE

Coping flexibility refers to an individual's ability to effectively modify his or her coping behavior to better fit the nature of each stressful situation they encounter. More flexible coping is believed to produce more adaptive psychological functioning and physical health.

METHODS

We examined the relationship between coping flexibility and cardiovascular reactivity (CVR) to psychological stress. Challenging tasks of two difficulty levels were presented to 24 men and 24 women aged 18 to 24years. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure were measured.

RESULTS

Change scores (from baseline to reactivity) for SBP and HR responses in the difficult task were higher than those in the easy task and were negatively correlated with coping flexibility during the difficult task but not the easy one.

CONCLUSIONS

The findings suggest that more flexible coping is associated with reduced CVR to a difficult task.

Relationship between coping flexibility and the risk of depression in Indian adults

According to the dual-process theory of coping flexibility, coping flexibility is the ability to discontinue an ineffective coping strategy and produce and implement an alternative coping strategy. In order to test the coping flexibility hypothesis, which posits that flexible coping produces adaptive outcomes, the relationship between coping flexibility and the risk of depression was examined in the context of Indian adults. Participants (150 men and 150 women) answered questionnaires measuring coping flexibility and depressive symptoms. The risk of depression was assessed using a Patient Health Questionnaire-9 score of 10 and a Center for Epidemiologic Studies' Depression Scale score of 16 as cut-off points. Logistic regression analyses of the score cut-off points revealed that higher levels of coping flexibility were associated with lower risks of depression, after controlling for the effects of gender, age, and marital status. Overall, the coping flexibility hypothesis was supported in this Indian adult sample. These findings might contribute to preventing recurrent depression and to attenuating depressive symptoms.

Effects of Flexibility in Coping with Menstrual Pain on Depressive Symptoms

Coping flexibility refers to the ability to discontinue an ineffective coping strategy and replace it with a more effective alternative. The coping flexibility hypothesis (CFH) predicts that more flexible coping will produce more adaptive outcomes. This study tested CFH validity among young Japanese women with menstrual pain. A total of 186 college students, who reported menstrual pain as being the most frequent pain they suffered over the past year, completed questionnaires related to coping flexibility and strategies for dealing with menstrual pain. Additionally, they reported on later depressive symptoms experienced during menstruation. A hierarchical multiple regression analysis showed that menstrual pain coping flexibility was significantly associated with reduced depressive symptoms during menstruation, even after controlling for the effects of menstrual pain intensity and coping strategies. Thus, the CFH was supported by the data obtained from menstrual pain sufferers in college.

The impact of coping flexibility on the risk of depressive symptoms

Objective

According to the dual-process theory, coping flexibility is defined as the ability to produce and implement a new coping strategy in place of an ineffective coping strategy. Specifically, coping flexibility includes two processes: evaluation coping and adaptive coping. Evaluation coping refers to sensitivity to feedback about the efficacy of a coping strategy, and adaptive coping involves the willingness to implement alternative coping strategies. The coping flexibility hypothesis (CFH) postulates that more flexible coping will be associated with more adaptive outcomes; importantly, there are numerous theories and studies that support the CFH. The main purpose of this study was to test the CFH based on dual-process theory.

Methods

A total of 1,770 Japanese college students participated and, completed a set of questionnaires that measured coping flexibility (evaluation coping and adaptive coping) and depressive symptoms. Depressive symptoms were measured via the Center for Epidemiologic Studies Depression Scale.

Results

The proportions of women and men who reported depressive symptoms were 58.69% (95% CIs [55.74, 61.66]) and 54.17% (95% CIs [50.37, 57.95]), respectively when a cut-off score of 16 on the CES-D was used. A multivariable logistic regression analysis revealed that evaluation coping (OR = 0.86, 95% CIs [0.83, 0.0.89]) and adaptive coping (OR = 0.91, 95% CIs [0.88, 0.93]) were significantly associated with lower levels of depressive symptoms.

Conclusion

The results of the present study indicated that the CFH based on dual-process theory was supported in a Japanese sample.