Self-perceived problem-solving ability, stress appraisal, and coping over time

Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review

BACKGROUND

Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions.

METHODS

Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible.

RESULTS

Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores.

CONCLUSION

Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.

Mechanisms through which executive dysfunction influences suicidal ideation in combat-exposed Iraq and Afghanistan veterans

OBJECTIVE

Executive dysfunction has previously been associated with suicidality, but it remains unclear how deficits in executive functioning contribute to increased suicidal thoughts and behaviors. Although it has been proposed that poorer executive functioning leads to difficulty generating and implementing appropriate coping strategies to regulate distress and inhibit suicidal thoughts and behaviors, studies have not systematically examined these relationships. Therefore, the present study examined various hypotheses to elucidate the mechanisms through which executive dysfunction influences suicidal ideation (SI) in combat-exposed Iraq/Afghanistan veterans.

METHOD

Veterans who endorsed SI were compared to those who denied SI on demographic and diagnostic variables and measures of neuropsychological functioning, psychological symptoms, coping styles, and combat experiences. Serial mediation models were tested to examine mechanistic relationships among executive functioning, psychological distress, coping, and SI.

RESULTS

Those who endorsed SI had worse executive functioning, greater psychological distress, and greater avoidant coping relative to those who denied SI. Serial mediation model testing indicated a significant indirect path, such that executive dysfunction increased psychological distress, which in turn increased avoidant coping, leading to SI.

CONCLUSIONS

Findings support and extend previous hypotheses regarding how executive functioning contributes to increased risk of suicidality via increased distress and avoidant coping. Intervention efforts focused on reducing suicidality may benefit from techniques that enhance executive functioning (e.g. computerized training, cognitive rehabilitation) and in turn reduce distress prior to targeting coping strategies.

A problem-solving intervention for cardiovascular disease risk reduction in veterans: Protocol for a randomized controlled trial

BACKGROUND

Health behaviors related to diet, tobacco usage, physical activity, medication adherence, and alcohol use are highly determinative of risk for developing cardiovascular disease. This paper describes a study protocol to evaluate a problem-solving intervention that aims to help patients at risk for developing cardiovascular disease address barriers to adopting positive health behaviors in order to reduce cardiovascular risk.

METHODS

Eligible patients are adults enrolled in Veterans Affairs (VA) health care who have not experienced a cardiovascular event but are at elevated risk based on their Framingham Risk Score (FRS). Participants in this two-site study are randomized to either the intervention or care as usual, with a target of 400 participants. The study intervention, Healthy Living Problem-Solving (HELPS), consists of six group sessions conducted approximately monthly interspersed with individualized coaching calls to help participants apply problem-solving principles. The primary outcome is FRS, analyzed at the beginning and end of the study intervention (6months). Participants also complete measures of physical activity, caloric intake, self-efficacy, group cohesion, problem-solving capacities, and demographic characteristics.

CONCLUSION

Results of this trial will inform behavioral interventions to change health behaviors in those at risk for cardiovascular disease and other health conditions.

TRIAL REGISTRATION

ClinicalTrials.gov identifier NCT01838226.

Peeling Back the Onion: Personality, Problem Solving, and Career Decision-Making Style Correlates of Career Indecision

A model to predict affective and informational antecedents of career indecision was proposed. The model attempted to explicate paths between personality dispositions, appraisal of problem-solving skills, career decision-making styles, and antecedents of career indecision. Both personality and coping constructs were posited to examine the relative contribution of dispositional and perceived skill variables. Using a college student sample, results from a path analysis indicated that the disposition of neuroticism was a powerful predictor of perceived problem-solving skills, a dependent decision- making style, and both affective and informational antecedents of career indecision. The predicted effects of the coping constructs were of a much smaller magnitude. Directions for future research are discussed and several suggestions for career counseling assessment and intervention selection are made.

Problem-Solving Appraisal in Counseling and With Different Populations

Heppner, Witty and Dixon have presented the development and theoretical base of the Problem Solving Inventory (PSI). They link it to numerous validity and reliability studies, with findings in predicted directions. This article expresses concerns about its use as a target in counseling and its applicability to individuals of the nonmajority culture.

Problem-Solving Appraisal and Human Adjustment

This article reviews and synthesizes more than 120 studies from 20 years (1982-2002) of research that has examined problem-solving appraisal as measured by the Problem Solving Inventory (PSI). The goals of the article are fourfold: (a) introduce the construct of problem-solving appraisal and the PSI within the applied problem-solving literature, (b) summarize and integrate existing findings using the PSI within and across four major content areas (psychological adjustment, physical health, coping, and educational and vocational issues), (c) identify promising research directions that might stimulate future research and promote theory development, and (d) identify implications for practitioners in the helping professions. We conclude that problem-solving appraisal as measured by the PSI is a useful psychological construct with implications for theory and many applications to build on peoples' strengths to enhance their life satisfaction and well-being.

Social-Cognitive Processes in Behavioral Health

Social cognitive variables are salient factors in the prevention, development, and maintenance of health-related problems. These variables are of particular interest to counseling psychologists, as they are amenable to a variety of psychological interventions. We review several social-cognitive processes that have been studied in relation to behavioral health and health-related problems. We then discuss implications for assessment and theory-based interventions.

A survey of diet self-efficacy and food intake in students with high and low perceived stress

Objective

Given the rise in obesity and obesity-related disorders, understanding the relationship between stress, self-efficacy and food choice in young adulthood may have implications for preventing negative health outcomes later in life that stem from poor eating habits. The current study examined whether stress levels and diet self-efficacy may be associated with unhealthy eating habits in young adults.

Methods

Male and female undergraduate students (N = 136) completed questionnaires that tap into diet self-efficacy (DSE), perceived stress (PS), sodium, and fat intake. Sex differences in choice of food were predicted, and low levels of perceived stress and high diet self-efficacy were expected to be associated with lower fat and sodium intake.

Results

Findings indicate an interaction between perceived stress and diet self-efficacy on fat intake and a main effect for diet self-efficacy on sodium intake in this population. As expected, low levels of perceived stress and high diet self-efficacy were associated with the lowest levels of fat and sodium intake in students. Findings were driven by females.

Conclusions

This study provides preliminary evidence that diet self-efficacy and perceived stress levels relate to nutrient intake in young adult females, and that increasing diet self-efficacy and reducing perceived stress in young adult females may lead to reductions in fat and sodium intake, leading to healthier eating habits.

Effects of an internet-based lifestyle intervention on cardio-metabolic risks and stress in Korean workers with metabolic syndrome: a controlled trial

OBJECTIVE

This study examined the effects of an Internet-based Best Exerciser Super Trainer (BEST) program on cardio-metabolic risks and stress among workers with metabolic syndrome.

METHODS

This study utilized a non-randomized, pretest, and posttest, controlled design with a convenience sample of 48 Korean male workers. The workers in the BEST group participated in a 16-week Internet-based program: 150 min of regular physical activity per week, 200- to 300-kcal reduced daily diet for weight control, one-on-one counseling, and mobile phone text messages. Workers in the Education group received text messages and an educational booklet.

RESULTS

There were significant group by time interactions in cardio-metabolic risks: body weight (p = .022), visceral fat mass (p = .033), and waist circumference (p = .037). There was no group by time interaction in stress (p > .05); however, the BEST group showed a significantly greater reduction in health-related stress than those in the Education group (p = .025).

CONCLUSION

This study yielded evidence of the beneficial impact of the Internet-based BEST program for workers with metabolic syndrome on selected cardio-metabolic risks and health-related stress.

PRACTICE IMPLICATIONS

Internet-based one-on-one counseling and mobile phone text messages can assist individuals with targeted lifestyle modifications for metabolic syndrome.

Self-appraised problem-solving skills and the prediction of secondary complications among persons with spinal cord injuries

Secondary complications following spinal cord injury (SCI) include decubitus ulcers and recurrent urinary tract infections. These conditions can significantly impair quality of life and prove life-threatening; it is also believed that these conditions are mediated by behavioral pathways. According to the social problem-solving model, persons who report effective problem-solving skills should be capable of adhering to long-term therapeutic regimens of self-care necessary to prevent these complications. We tested this assumption in the present study. Discriminant function analyses revealed self-appraised skills in approaching and defining problems contributed to the prediction of secondary complications among 53 persons with SCI. Results are discussed in light of the social problem-solving model, and the utility of problem-solving interventions in rehabilitation is explored.

Can anti-speeding messages based on protection motivation theory influence reported speeding intentions?

The study investigated the effects of anti-speeding messages based on protection motivation theory (PMT) components: severity, vulnerability, rewards, self-efficacy, response efficacy, and response cost, on reported speeding intentions. Eighty-three participants aged 18-25 years holding a current Australian driver's license completed a questionnaire measuring their reported typical and recent speeding behaviors. Comparisons were made between 18 anti-speeding messages used on Australian roads and 18 new anti-speeding messages developed from the PMT model. Participants reported their reactions to the 36 messages on the perceived effectiveness of the message for themselves and for the general population of drivers, and also the likelihood of themselves and other drivers driving within the speed limit after viewing each message. Overall the PMT model-derived anti-speeding messages were better than jurisdiction-use anti-speeding messages in influencing participants' reported intention to drive within the speed limit. Severity and vulnerability were the most effective PMT components for developing anti-speeding messages. Male participants reported significantly lower intention to drive within the speed limit than did female participants. However, males reported significantly higher intention to drive within the speed limit for PMT-derived messages compared with jurisdiction-based messages. Third-person effects were that males reported anti-speeding messages to be more effective for the general driving population than for themselves. Females reported the opposite effect - that all messages would be more effective for themselves than for the general driving population. Findings provided support for using a sound conceptual basis as an effective foundation for anti-speeding message development as well as for evaluating proposed anti-speeding messages on the target driver population.

Towards an idiothetic understanding of the role of social problem solving in daily event, mood and health experiences: A prospective daily diary approach

OBJECTIVES

Utilising D'Zurilla's (1986, 1990) transactional social problem solving model as the theoretical framework, the present study sought to examine the dynamics of the social problem solving process in relation to intraindividual experiences of events, mood, and physical health in daily life.

DESIGN

The study incorporated both idiographic and nomothetic strategies, combining a daily diary approach within a prospective design. As such, each individual's experience of events, mood, and health were assessed on a daily basis, and the prospective relations between social problem solving and these day-to-day experiences examined.

METHODS

Participants' (university students) completed a measure of social problem solving at baseline followed, approximately 5 weeks later, by daily self-reports of mood (positive & negative), events (hassles & uplifts), and physical health (health status & URI symptoms) for a period of 14 days. The data were analysed using multilevel hierarchical modelling.

RESULTS

Days on which individuals had greater than their average hassles were associated with higher negative and lower positive mood (i.e. domain specific & cross-over effects), whilst greater uplifts were linked to positive mood only. With regard to health, individuals reported worse status and more URI symptoms on days with greater than their average negative (hassles, negative mood) but not positive influences (uplifts, positive mood). Both social problem solving orientations and skills dimensions were associated prospectively with daily health outcomes, and these relationships were not moderated by day-to-day experiences of mood or events.

CONCLUSIONS

The data clarify the importance of social problem solving to within-person daily event, mood, and health experiences. The implications of these findings for contemporary transactional social problem solving models are discussed.

A review on coping mechanisms against obesity bias in physical activity/education settings

Obesity bias such as teasing or weight criticism during physical activity can lead to psychological or emotional damage for overweight or obese individuals. The literature indicates that the adverse effects of stigmatization on overweight or obese individuals can be mediated by coping mechanisms. However, little is known about how overweight or obese children and adolescents cope with weight stigma in physical activity/education settings. This paper provides a conceptual analysis of coping mechanisms through reviewing work on weight stigma in psychology literature and discusses the future research directions. The most promising areas for future research include conducting an in-depth qualitative exploration of overweight or obese individuals' coping mechanisms against obesity bias and studying potential individual and situational factors as moderating variables in physical activity/education settings.

Self-regulation processes and health: the importance of optimism and goal adjustment

This article discusses how self-regulatory models can be used to understand people's response to health threats. The article begins with a general discussion of the principles and assumptions of self-regulatory models of behavior. Two distinct lines of research are then presented addressing two important processes of adaptive self-regulation. First, we provide a brief overview of the literature on optimism and adjustment to chronic disease and other health outcomes. Second, we present an overview of the process of disengagement from unattainable goals, focusing on recent research. We close by making recommendations for future research.

Ways of coping with obesity stigma: review and conceptual analysis

There is clear documentation of bias and discrimination aimed at overweight persons, but less is known about methods individuals use to cope with weight stigma. This paper provides an analysis of such methods, integrating work on weight stigma with what is known from other relevant areas (e.g., race and gender bias). Multiple means of coping have been studied, ranging from attempts to change the stigmatizing condition (losing weight) to taking pride in the condition and mobilizing social action to prevent discrimination. The most promising areas for future research, methodological challenges, and the importance of individual difference and situational factors as moderating variables are discussed.

Coping, meaning in life, and suicidal manifestations: examining gender differences

Life meaning and coping strategies were investigated as statistical predictors of suicidal manifestations in a sample of 298 university undergraduates. Participants completed measures of hopelessness, sense of coherence, purpose in life, coping for stressful situations, suicide ideation, prior suicide attempts, and self-reported likelihood of future suicidal behavior. Moderated multiple regression techniques examined the incremental validity of life meaning by coping interactions for predicting each suicide variable separately by gender. The interaction of sense of coherence and emotion-oriented coping made a unique, significant contribution to the statistical prediction of all suicide variables for women. For men, the interaction between sense of coherence and emotion-oriented coping contributed significantly to the statistical prediction of suicide ideation. All interactions remained significant when hopelessness was statistically controlled. The hypothesis that life meaning acts as a buffer between coping style and suicidal manifestations was partially supported. Implications for suicide prevention and intervention are discussed.

Ethnicity, coping, and distress among Korean Americans, Filipino Americans, and Caucasian Americans

The authors examined appraisal, coping, and distress among Korean American, Filipino American, and Caucasian American Protestants. No interaction effects emerged among ethnic groups, but there were significant ethnic main effects for appraisal and coping. Compared with the Caucasian Americans, both Asian American groups appraised stressors as more challenging, and the Korean Americans appraised them also as greater losses. Both Asian American groups reported using more strategies of accepting responsibility, religious coping, distancing, and escape-avoidance than the Caucasian Americans did; the Filipino Americans also reported more problem-solving strategies than the Caucasian Americans. For all participants, challenge appraisals predicted adaptive coping (problem solving and positive reappraisal) and less distress. Problem solving, seeking social support, and positive reappraisal predicted less distress; self-control, accepting responsibility, and escape-avoidance predicted greater distress. The authors stressed the value of assessing ethnicity in coping research.

Dimensionality and correlates of problem solving: the use of the Problem Solving Inventory in the Chinese context

The dimensional structure of the Problem Solving Inventory (PSI) was investigated using data collected from a sample of 499 Chinese university students in teacher training. While the original three-factor model provided poor fit to the data, the revised two-factor model provided more adequate fit but failed to consider a PSI construct tapped in the original PSI formulation. The newly constructed PSI scales based on the present data provided viable alternative scales reflecting constructs of self-efficacy, rational coping and dysfunctional coping. These newly developed problem-solving scales were predictive of indices of psychological adjustment in terms of depression, burnout, and perceived self-efficacy toward helping others. The use of the PSI in the Chinese context is discussed.

Self-esteem and optimism in men and women infected with HIV

BACKGROUND

Self-esteem and optimism have been associated with appraisal and outcomes in a variety of situations. The degree to which the contribution of self-esteem and optimism to outcomes over time is accounted for by the differences in threat (primary) or resource (secondary) appraisal has not been established in persons with human immunodeficiency virus (HIV).

OBJECTIVES

To examine the longitudinal relationship of personality (self-esteem and optimism) on primary and secondary appraisal and outcomes of well-being, mood, CD4+ T-lymphocyte count, and selected activities.

METHODS

Men (n = 56) and women (n = 42) infected with HIV completed eight self-report measures twice over 18 months. Hierarchical Multiple Regressions were used to examine the relationship of personality variables on appraisals and outcomes. The mediating effects of primary and secondary appraisals were explored.

RESULTS

Self-esteem uniquely accounted for 6% of the variance in primary appraisal and 5% in secondary appraisal. Optimism accounted for 8% of the unique variance in secondary appraisal. Primary and secondary appraisal mediated differently between personality and outcome variables. A strong predictor of well-being, mood disturbance, and activity disruption at Time 2 was participants' initial level of these variables. Socioeconomic status was a strong predictor of mood.

CONCLUSIONS

Self-esteem and optimism are important but different resources for adapting to HIV disease. Strategies for reducing threats and increasing resources associated with HIV may improve an individual's mood and sense of well-being.

Nurse stress associated with aggression in people with dementia: its relationship to hardiness, cognitive appraisal and coping

This study examined the relationship between aggressive behaviour displayed by people with dementia and nurse stress. This was achieved by re-examining the relationships between the hardy personality (total hardiness), primary appraisal (challenge and threat appraisal), secondary appraisal (coping options available), and coping methods (action and palliative coping) from the perspective of nurse stress in response to aggressive behaviour displayed by people with dementia. One hundred and two nurses from 15 nursing homes and hostels were sampled by way of a questionnaire. Hierarchical regression was performed to analyse the strong hypothesized relationships between the variables examined. Results indicated that resident aggression was significantly related to an increase in nurse stress (M=34.79, SD=7.93). Of the variables examined, only threat appraisal was significantly related to nurse stress (beta[94]=0.48, P < 0.05). Perceiving the possibility of aggressive behaviour by the resident as threatening was found related to a high stress level in nurses sampled.

An empirical test of alternate theories of anger in early adolescents

BACKGROUND

Anger is an especially important phenomenon to understand in early adolescents. While many explanatory theories of state anger can be applied to early adolescents, few, if any, researchers have attempted to test these theories in this age group.

OBJECTIVE

To test three theories explaining state anger vis-a-vis each other using hierarchical analysis of sets.

METHOD

This was a theory-testing study with a complex correlational design. A total of 141 adolescents aged 12 to 14 years responded to the State Anger Scale and instruments measuring variables linked to stress theory (perceived stress and primary appraisal), differential emotion theory (depression and state anxiety), and trait theory (trait anger and hostility), that were randomly ordered across instrument packets.

RESULTS

Using hierarchical analysis of sets, the results indicated that the sets of variables used to test all three theories explained a statistically significant proportion of variance in state anger when entered first in the analysis. Comparatively, the trait theory variables explained more variance in state anger when entered first (41%) in the analysis than did the emotion theory variables when entered first (31%) in the analysis or the stress theory variables when entered first (21%) in the analysis.

CONCLUSIONS

The stress theory, the differential emotion theory, and the trait theory all provided theoretically sound and relevant explanations of state anger for early adolescents. However, the trait theory provided the most powerful explanation.

The Factor Structure of the Problem Solving Inventory

Heppner and Petersen (1982) derived a three-dimensional structure for the items of the Problem Solving Inventory using principal components analysis. D'Zurilla and Maydeu-Olivares (1995) pointed out the lack of any clear link of the scales of the Problem Solving Inventory (PSI) to social problem-solving theory, which impairs the interpretation of any empirical results obtained with the use of this inventory. To address this issue, we used maximum likelihood factor analysis to investigate the dimensional structure of this inventory. We found that an unrestricted three-dimensional model adequately fit this data but did not match Heppner and Petersen's structure, nor could it be interpreted substantively. Neither four- nor five-dimensional models could be interpreted regardless of the rotation procedure used. Although a two-factor model did not fit the data adequately either, a careful content analysis of the PSI items revealed only two interpretable clusters of items in this inventory, measuring problem-solving self-efficacy and problem solving skills, respectively. In addition, there is also a heterogeneous cluster of items responsible for the residual third dimension appearing in Heppner and Petersen's as well as in the current analyses. Using a theory-guided item-selection procedure we constructed two new PSI scales measuring the two interpretable constructs. The items composing these scales are shown to fit an independent clusters two-dimensional solution.

Perceived problem-solving ability, stress, and coping in mothers of children with physical disabilities: potential cognitive influences on adjustment

Examined the contribution of perceived problem-solving ability to the adjustment of mothers of children with a physical disability, in conjunction with appraised disability-related stress and approach and avoidance coping, as a further evaluation of Wallander and Varni's Disability-Stress-Coping model emphasizing cognitive processes. One hundred sixteen mothers of children, ages 2 to 20, with spina bifida or cerebral palsy completed measures of relevant constructs. Results show that the mother's appraisal of disability-related stress is strongly associated with her reported maladjustment. However, perceptions of competence in problem solving are associated with better overall adjustment. A portion of this relation appears mediated by coping styLe, as confidence in one's problem-solving ability increases so does the likelihood of selecting more adaptive coping strategies when faced with disability-related stress. Overall, consideration of perceived problem-solving ability appears to make a valuable contribution to the Disability-Stress-Coping model and to current understanding of the experience of coping with raising a child with a disability. Perceived problem-solving ability can also be linked to clinical intervention, as discussed.

Relations between problem orientation and optimism, pessimism, and trait affectivity: a construct validation study

This study investigated the construct validity of the Positive and Negative Problem Orientation scales of the Social Problem-Solving Inventory-Revised (SPSI-R) by examining the relations between these scales and measures of optimism, pessimism, and trait affectivity. Consistent with expectations based on social problem-solving theory, positive problem orientation was found to have a relatively large amount of variance in common with optimism and positive affectivity, and negative problem orientation was found to share a large amount of variance with pessimism and negative affectivity, but not enough to be considered redundant in either case. Positive problem orientation was found to add significant incremental validity to the prediction of adaptive problem-engagement coping even after partialing out the variance associated with optimism and positive affectivity. In addition, negative problem orientation was found to add unique variance to the prediction of psychological distress even after controlling for pessimism and negative affectivity.

Applicability of the goodness-of-fit hypothesis to coping with daily hassles

This study examined the applicability of Lazarus and Folkman's (1984) goodness-of-fit hypothesis to the relationship between college students' daily hassles and psychological symptomology. Specifically, the model predicts that, given a daily hassle which one may change, it is more functional to alter the source of the daily hassle than it is to let the stressor go unchecked and simply try to manage the negative emotions produced by the event. Conversely, given a stressor one cannot alter, it is more functional to regulate the emotions produced by the event than to engage in repeated futile attempts to change an uncontrollable stressor. It was predicted that subjects who tended to violate these principles across multiple daily hassles would be characterized by the highest psychological symptomology. Although the 69 college students' frequency of daily hassles was positively associated with psychological symptomatology and students tended to match the method of coping with the appraised controllability of their daily hassles, no support for the goodness-of-fit hypothesis was found.